Aortic valve disease

Aortic valve disease, especially aortic stenosis, is increasing due to the increase in age related aortic valve degeneration. Although increase in aging population and co-morbidities such as diabetes, renal dysfunction and systemic vascular disease, the result of aortic valve replacement is improving. Operative mortality of isolated aortic valve replacement was 1.9% in Japan. Concomitant procedure such mitral valve surgery, tricuspid valve surgery, or coronary artery bypass grafting resulted in nearly 2 fold increase in mortality. Regarding reoperation, there were 2 to 3 fold increases in mortality in each category. A new technology, trans-catheter aortic valve implantation (TAVI), has been introduced clinically. After going through the learning curve, the results of TAVI are improving. The procedure may have a role in most difficult group of patients who had not been considered for surgery due to contraindication for open heart surgery.