Patient: Description of condition (time of onset, main symptoms, hospital visited, etc.): Hello. I am a patient with aortic stenosis (moderate) with incomplete closure (severe), now 56 years old, with hypertension, no diabetes, coronary artery disease, currently in good health, and jogging every morning. He is currently in good health and jogs every morning. He had acute endocarditis when he was about 20 years old and developed this disease. Is there a bioprosthetic valve for aortic valve replacement available nationwide? What is the approximate cost? There are two main types of bioprosthetic valves: the traditional bioprosthetic valve (about 22,000 for a simple valve, which varies from place to place), which lasts for about 15 years and is best used by patients in their 60s, and costs about 65,000 overall (in our area). The new generation of biologic valves, which the manufacturer says can last 25-30 years, are expensive (about $56,000 for a simple valve) and cost about $100,000 for the total procedure. Regarding the biologic flap, it can be called in various regions and across provinces. So, if you want to use it, your doctor will get it for you. Patient: Thank you so much. So how long will I last in this case just on that antihypertensive medication of whatever Pulley or whatever? How long will I have to stay in the hospital if I get a valve replacement? Thank you very much! Doctor: Oral medications such as captopril only control blood pressure and do not improve the valve. Hypertension and valve disease. They are two different diseases and are treated differently. Hypertension can be controlled by medication, and the results can be very good. But valve disease, simply taking drugs can not solve the fundamental problem, only to replace the valve. For example, if a door is broken, simply shining some paint will not work. If you want to extend the life. Need surgery, now this surgery is very mature, every year to replace the valve, the country has tens of thousands of people. Success rate is still very high (of course, the level of each hospital is not the same, the success rate is not the same). Generally there are no special circumstances, after hospitalization, you need to do coronary angiography, completely rule out coronary heart disease; your heart function is also good (usually also adhere to the activity), hospitalization time is about 15 days, right. One week of preoperative preparation and more than a week after surgery, you can be discharged from the hospital, just go home and take your time to recuperate. Patient: Thank you very much. I would like to know what effect does the presence of coronary heart disease have on this surgery? Is it to check the heart function? I don’t usually have angina, and I’ve had an ultrasound of my extremities with no plaque formation. I don’t think I have any coronary arteries, right? Doctor: In principle, it is better to have a coronary angiogram to further understand the condition of the coronary arteries before having heart surgery if you are over 50 years old. It is not to check the heart function. Purpose: 1. If there is serious coronary artery disease, it can be treated at the same time (valve replacement + bypass). You can’t say, just replace the valve and later find out that there is still coronary artery disease, then do a second surgery. This would be too irresponsible. 2, if there is coronary heart disease, when doing the surgery, during the surgery, after the surgery, will also do the corresponding treatment, the treatment plan is different. Can not just consider the replacement of the valve, must be considered. 3.Exclude coronary heart disease, just simply replace the valve. There is no need to consider whether it is combined with coronary artery disease, and the treatment is more targeted. We encountered some patients at night in the clinic, very young, more than 40 years old, and no symptoms, did not do coronary angiography before the operation, the result is that after the valve replacement in surgery, can not stop the extracorporeal circulation machine, and then hand probing, suspected of coronary heart disease, after a bridge. This is fortunate, in case the doctor on the stage is inexperienced, it really can not get off the operating table. Although the coronary angiography cost about 5,000 dollars more, even if the angiography showed normal, it was worth it. After all, we are here to treat a patient, and safety is always the first priority. In fact, most patients who have their valves replaced have normal coronary arteries when they have a coronary angiogram before surgery. But after all, people are different, and safety is still the principle.