ABSTRACT
Anatomy and pathophysiology Degenerative disease of the aortic valve occurs with age. Areas of cusp flexion over time develop fibrosis and calcification, impeding valve excursion and creating obstruction to left ventricular outflow.1 The degenerative process is often observed in those greater than 70 years of age, but patients with additional valve pathology (bicuspid aortic valves or rheumatic valvular disease) can present much earlier in life with deterioration of valve function and consequent symptoms.2
