I have severe aortic stenosis due to a bicuspid aortic valve, can I have the replacement through my groin?

"While we are very good at doing aortic valve replacements through the groin, this is still not the current strategy for patients under the age of 60. Maybe in the future."
- Dr. Alexander Postalian, General and Interventional Cardiologist

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Episode Transcript

(00:00):
I am 52 years oldand was told to have severe aortic stenosis due
to a bicuspid aortic valve.
My father had the same problem.
I want to have it done through my groin.
I, I'm assuming, is the the fixed procedurewithout opening the chest.
But I was told this is not an option.
Should I look for a second opinion Basics?

(00:21):
First, aortic stenosis. What is it?
There is a valve between your left ventricleand your aorta, which opens
and closes with every heartbeat, boom, boom, boom, boom.
Over time, due to different factors,the valve can become thicker and thicker and thicker
and open less and less.
So instead of opening it like this, opens like this,opens like this until it's tight, opens very little,

(00:42):
and then your heart has to work hard to squeeze blood.
Every heartbeat. Once it reaches that stage,then the valve needs to be fixed with a surgical procedure.
Up until the two thousands,actually in 2004 was the first time
it was done through the groin.
The procedure was only done with open chest surgery.
But since 2016, 17, now it is more common to do itthrough the groin than with open heart.

(01:09):
However, not everybody is a candidate for the procedureto be done through the groin.
Uh, and importantly, if you're really youngand less than 60 is considered really young.
Surgery is still clearly the preferredchoice for a couple of reasons.
One is we don't have really long term data as tohow long the valve done

(01:33):
through the groin lasts, and that is coming.
We have some, but we want more data.
And then the other thing is that if you're really young,you might be a candidate for a mechanical valve,
which lasts much longer than the bioprosthetic valves, whichis the other valve choice,
and the only choice if it's done through the groin.

(01:54):
I think that the choiceof open heart surgery at age 52 is probably the right one,
but there are a lot of mitigating factors,specific circumstances that need to be assessed.
So if you think, if you really wanna get a second opinion,it's always a good idea.