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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 59142
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Dr Arun, are you there?

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Dr Arun, are you there?

Yes, I am.

Customer: replied 9 days ago.
Hello.
we discussed my mother a few weeks ago. she is 78. an echo showed her aortic valve hasnarrowed. the peak gradient is 64mmhg.she just had an mri. the doctor says the heart muscle is functioning well but the AVA is 1cm2 so the stenosis is now severe.he recommends a follow up echo in 6 months unless she develops symptoms and said they would look then at valve replacement.is this okay to leave for 6 months?
is she safe?
will she need surgery?
is the surgery safe?

It is okay to leave it for 6 months since her heart functions are normal. This is basically an aging disorder so there is no hurry or emergency.

She is safe.

She may need surgery or the latest treatment is; Transcatheter aortic valve replacement (TAVR). Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace a narrowed aortic valve.

Customer: replied 9 days ago.
thank you for your reply.I read that severe AS has a one year mortality of 50%. Especially with symptoms. She has some shortness of breath on exertion and some leg swelling but that has been for 5 years and predates this issue.How safe is TAVI in percentage terms?

TAVR has a 95-99% success rate in good hands.

Customer: replied 9 days ago.
she is not at risk in the meantime?

As mentioned above also, no.

Customer: replied 9 days ago.
what about the sites that say 25 to 50% mortality at one year if untreated?

It is for patients, who have symptoms that do not abate by the medications.

Medical literature varies widely and for a group of patients prognosis may not be applicable to an individual and the same statistics can be read as 75% symptomatic people would be alright, even if untreated.

And there are opinions you have to choose from;

1) From your mother's treating doctor who has asked for a follow-up in 6 months.

2) My opinion given above.

3) An your own search of medical literature (which needs a medical background to interpret in an individual circumstance).

Dr. Arun Phophalia and 2 other Medical Specialists are ready to help you
Customer: replied 9 days ago.
thank you for clarifying

Very welcome.