Heart Valve

[Beacon]

My sister has been diagnosed with critical aortic valve stenosis.  A recent MRI of her heart shows normal left ventricular size and hyperdynamic function with moderate concentric LV hypertrophy, LV posterior wall thickness of 1.3 and septal thickness of 1.4.   Her aortic valve area has been stable for the past 3 years, ranging between .5 and .6 cm2 and she is asymptomatic.  Her aortic valve peak velocity has remained stable as about 5 m/sec.  My sister has been strongly advised to have aortic valve replacement surgery and has been told that the left ventricular hypertrophy can lead to heart failure and may become irreversible if she waits.  She is 61 years old and is in excellent health in every other way.  My husband also has moderate left ventricular concentric hypertrophy (LV posterior wall thickness of 1.5 and septal thickness of 1.6) with normal heart valves.  He has PVCs but no history of high blood pressure or any other cardiovascular condition.  Even though his left ventrical and septum walls are thicker than my sister's, he is being advised by his doctor that he is fine.  Is it safe to assume that my sister is also fine-at least until she either has symptoms or until her left ventricle is thicker than it is now?

[CCF-M.D.-CRC]

Dear Beacon,
You are trying to compare apples to oranges.  The left ventricular hypertrophy (LVH) your sister has is due to the increased workload that the heart must perform to pump against the aortic stenosis.  Your husband's LVH is probably due to long standing high blood pressure which is the most common cause in persons with normal heart valves.  

I would agree with her doctors that 0.5 cm is a critical stenosis and should be replaced.  The longer she waits the higher her risk for permanent heart damage or even sudden death!