Aeortic Valve Replacement

I have a 19 year old female relative who has been diagnosed with significant leakage from the aeortic valve, and that surgery will probably have to be done to either repair or replace the valve.

Questions:

What are the pros/cons of repairing vs replacing the aeortic valve?

If valve replacement needs to be performed, what are the pros/cons of artificial vs natural (cow/pig) valves considering her age and childbearing potentital?  My understanding is that artificial valves require taking Cumiden which can cause birth defects.  However, the natural valves only have a life of 7-10 years, after which surgery needs to be performed again.

How is candicacy for minimally invasive surgery re aeortic valve replacement determined and how effective is it when compared to the more extensive procedure?

What is the long term prognosis of repair and can candicacy be determined from outpatient tests or only when invasive surgery is in progress.

Also, if her mitral valve also needs repair/replacement, is this usually performed at the same time?

One last question.  My relative is from New York.  Are there any disadvantages (post surgical or otherwise) in travelling to the renowned Cleveland Clinic to obtain the necessary surgery as opposed to obtaining qualified surgical care within the New York area?

[CCF CARDIO MD JMF]

Dear Mario,

thank you for your comments.