The decision on the type of valve used should be made in conjunction with your cardiothoracic surgeon and your cardiologist. Ultimately the choice will depend on a patient's preferences, lifestyle, and individual risks as determined by age and other medical conditions. When the aortic valve is too narrow or stenotic, the ventricle has to work harder to pump the blood out to the body. This extra work consumes significant energy and ultimately requires extra blood flow to the heart itself. If there is not enough blood flow, the heart becomes ischemic causing anginal chest pain.
Aortic stenosis is often progressive, growing worse with time.
As the valve gets tighter, the heart has to continue to work harder and harder to keep pumping blood out of the heart. At some point the heart can no longer compensate, resulting in episodes of low blood pressure or hypotension or even syncope . As the heart fails to compensate, fluid will build up in the lungs creating congestion. When the aortic valve leaks, the heart has to work harder and similar problem occur. The ventricle must pump more blood with each contraction to produce the same forward output, creating a condition called volume overload.