**5. Conclusions**

Consequently aortic stenosis and regurgitation, infective endocarditis and aortic dissection are the most common complications of BAV additionaly this process continues after valve replacement. The person with BAV requires continuous surveillance to treat associated le‐ sions and prevent complications. Arterial hypertension should be meticulously controlled. Smoking should be discouraged and control of hypercholesterolaemia considered, in view of the impact of these factors on the development of aortic stenosis. Aortic root dilatation is common in BAV, even when the valve is haemodynamically normal, and consequently aort‐ ic dissection usually occurs in previously asymptomatic patients. Beta-blockers and statins are the possibilities for medical treatment, and aortic valve repair/replacement and ascend‐ ing aorta replacement are indicated for patients with a severely diseased aortic valve and aorta. All patients should therefore be regularly reviewed to identify progressive root dilata‐ tion [6,94].

### **Author details**

#### Mehmet Demir

**4.3. Pregnancy**

350 Calcific Aortic Valve Disease

when necessary.

**4.4. Exercise**

dilation(>40 mm) [50,104,105].

**5. Conclusions**

roots are at risk for complications during pregnancy.

pregnancy and the potential for late complications [102,103].

During pregnancy there are changes in hemodynamics as well as changes in the aortic me‐ dia, and therefore, women with BAV and significant aortic stenosis and/or dilated aortic

In rare instances, women will develop progressive symptoms during pregnancy and require either valvuloplasty or valve surgery. Both interventions can be performed during pregnan‐ cy, but are associated with both maternal and fetal risks and should be performed only

Although pregnancy can be successfully completed in most instances, aortic surgery may be required early after pregnancy in some women with severe aortic stenosis. Pregnancy itself seems to accelerate the need for surgery postpartum in women with moderate or severe aortic stenosis, perhaps by affecting the ability of the left ventricle to adapt to the fixed out‐ flow obstruction. It is therefore important that women be counseled about both the risk of

Additionally, guidelines suggest that women with BAV and significant aortopathy (ascend‐ ing aorta diameter >4.5 cm)"should be counseled against the high risk of pregnancy" [43].

There are little data available to support recommendations regarding exercise in subjects with BAV. In children with congenital severe aortic stenosis, for instance, sudden death can occur during exercise [121]. The Task Force on Exercise in Patients with Heart Disease rec‐ ommends that athletes with severe aortic stenosis or severe aortic incompetence with left ventricular dilation [left ventricular dimensions >65 mm] should not participate in competi‐ tive athletics. Athletes with or without aortic valve disease who have dilated aortic roots (>45 mm) are advised to only participate in low-intensity competitive sports. No restrictions exist for those with BAV with no significant valve dysfunction or aortic root/ascending aorta

Consequently aortic stenosis and regurgitation, infective endocarditis and aortic dissection are the most common complications of BAV additionaly this process continues after valve replacement. The person with BAV requires continuous surveillance to treat associated le‐ sions and prevent complications. Arterial hypertension should be meticulously controlled. Smoking should be discouraged and control of hypercholesterolaemia considered, in view of the impact of these factors on the development of aortic stenosis. Aortic root dilatation is common in BAV, even when the valve is haemodynamically normal, and consequently aort‐ ic dissection usually occurs in previously asymptomatic patients. Beta-blockers and statins are the possibilities for medical treatment, and aortic valve repair/replacement and ascend‐ ing aorta replacement are indicated for patients with a severely diseased aortic valve and

Bursa Yüksek İhtisas Education and Research Hospital, Cardiology Department, Bursa, Tur‐ key
