Calcific aortic stenosis: a disease ready for prime time.

Calcific aortic stenosis is the number 1 cause for surgical valve replacement in the United States and Europe. In 2006, surgical valve replacement still remains the number 1 indication for the treatment of this disease process, as defined by the American College of Cardiology/American Heart Association guidelines for valvular heart disease by Bonow et al.1 This standard of care for patients with severe symptomatic aortic stenosis requiring surgical valve replacement was defined in 1968 by Ross and Braunwald2 as the main therapy for this disease. For years, this disease has been described as a passive process that develops secondary to serum calcium attaching to the valve leaflet surface to cause nodule formation. Therefore, surgical replacement of the valve is the obvious approach toward relieving outflow obstruction in these patients. Until recently, the lack of experimental models in this field has limited our understanding of the disease.