When is surgery required?

My husband has a bicuspid aortic valve and due to have an angiogram this Friday. He has had some chest pain and does cough a bit at night but on whole is very healthy. We are getting mixed signals about when to have surgery to replace the valve. He would like to wait as long as poss. Is there a recommended measurement of the width of the valve when surgery is then actually necessary. He has been told he has stenosis after the MRI.


This discussion is related to i had two aortic valve's replace .

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The key thing is down to the actual functionality of the valve, i.e. how well it is working.
Is the valve currently leaking? and if so, at what stage is it? Trivial, Mild, Moderate or severe?
If moderate or severe, then I would want the surgery asap. Some cardiologists believe the long term prognosis is far better if done at the mild stage. Other cardiologists follow the rule if it's working well enough, then leave it alone.
If left too long, the heart can end up compensating, and forcing the valve orifice out of shape. They do balloon the orifice before installing a new valve, but in some cases it reverts back to the odd shape, giving problems with the new valve. This can all be avoided if done soon enough. A simple Ultrasound can keep an eye on these situations.