**5. Conclusion**

There are many decisions to make when managing a patient with aortic valve disease, and it is crucial to conscientiously evaluate each decision as they can all have a huge impact on the patient's life. Regardless of the management approach, it is certain that young age of intervention, especially for neonates and babies under the age of 1, is the main risk factor for poor outcomes. For the pediatric population, an attempt to preserve the native valves for as long as possible is important to minimize reintervention rates. A possible basic algorithm for patients with aortic stenosis could be to either perform balloon valvuloplasty or simple surgical valvulotomy as an initial step and to delay replacement for as long as possible. The choice between balloon or surgery will be dependent on the age, condition severity, and symptoms at presentation. If replacement is then needed at a later age, a supported or non-supported Ross procedure may be the most appropriate. Unfortunately, the management of patients with aortic regurgitation or mixed disease is a lot more complex. Many promising repair techniques have been developed for highly dysplastic bicuspid or unicuspid valves, however, long-term and age-matched results for durability and morbidity are still lacking.
