Aortic Stenosis

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Hi All,

I am a newbie to this forum and would appreciate some information that you might be able to provide. Many thanks in advance to all the patient responders.

I have a congenital Aortic stenosis with a bicuspid valve. A recent echo test showed a 69 peak gradient which is a considered moderate-severe aortic stenosis. In addition I have moderate regurgitation. So, a valve replacement is eminent at "some stage". Two cardiology professors see no reason for immediate surgery and suggest continuing my normal bi-annual check-ups.

I have two questions:
1. If a replacement is eminent, why wait? I am 40, lead a normal life and am classically asymptomatic - no fainting or sudden shortness of breathe. I am aware that an AS progressively deteriorates, and may cause dilation and irreversible damage to the heart muscle. I am also aware of the consequences of a replacement - Comadin etc. but cannot logically see a reason to wait for symptoms to develop. Surely it is better to be younger and healthier for surgery? I dread the idea of fainting with my small child in my arms and humbly see no reason to let my heart progressively tire itself.
2. I do find that I am somewhat more fatigued during the last year, may miss a beat or two occasionally and do get rare angina pains. Since I have been a "healthy mind-healthy body" freak, I cannot accurately associate these "symptoms" to my AS due to pure denial and living a normal life. Can a stress test pick up hidden symptoms that I am not aware of?

Any ideas, pointers will be most welcome.

Laurence