the best heart clinics near me When Do You Need Surgery? When the heart valves are seriously damaged and impairing blood flow to the rest of the body or causing heart muscle damage, surgery to replace the defective valve may be recommended. Shortness of breath, syncope (fainting), chest pain, and heart failure are common signs of aortic valve disease. These symptoms are warning signs that the heart is working too hard to pump blood-when these symptoms occur, surgery is usually warranted. Testing to further determine if you need surgery should include an echocardiogram of the heart, as well as coronary angiography to assess for blockages in the coronary arteries. These conditions are potentially serious impediments to heart function, often hindering or reversing the natural flow of blood through the heart. Failing to fix a diseased aortic valve can be life-threatening, and untreated patients have less than a 50% survival at 2-3 years. To treat aortic valve disease, surgeons either repair the patient's own valve, or most commonly replace that valve with a tissue or mechanical substitute. Choosing between a bioprosthetic valve versus a mechanical valve is a complex decision that involves many lifestyle factors, age, and whether a patient is able to tolerate blood thinners for the rest of their life.