Elucidation of cardiac physiology in aortic valve replacement: what should we know?

Over the past 50 years, aortic valve surgery has achieved enormous progress towards restoring durable and physiological performance of aortic valve prostheses, physiological coronary circulation, and thus the normal structure and function of the left ventricle. Throughout the entire history of aortic valve surgery, it has been clear that interactions between surgeons and physicians have not only led to improvements in operative techniques and results, but have also facilitated a better understanding of left ventricupathophysiology underlying the surgery. Embracing genetic technology with classical cardiac physiology will create a new platform to yield a more in-depth understanding of the nature of myocardial adaptation to pressure and volume changes associated with valve disease, and myocardial responses to heart valve surgery. Ultimately, this new knowledge will have a significant impact on heart valve surgery and cardiac medicine.