AORTIC-VALVE DISEASE

Management of aortic valve disease follows traditional algorithms: initial gross diagnosis, noninvasive imaging and quantitation, possible catheterization or angiography, and medical treatment until symptoms or prognosis prediction indicates surgery. Most advances in this subject reflect improved technology and additional data collection therefrom, and subsequent analysis. Noninvasive imaging, especially Doppler echocardiography and nuclear magnetic resonance imaging, enjoy continued refinement. Diastolic dysfunction, a particular pathophysiologic feature of aortic valve disease, has become more clearly characterized. New data reaffirm the old truth that heart failure in infective endocarditis foretells the need for surgery. Though we know more about aortic balloon valvotomy, it is only a temporary treatment. Surgeons still seek the perfect valve prosthesis. Lastly, technology has not lessened the high incidence of rheumatic heart disease in impoverished countries.