Q: My 25 year old fiance is due for an AVR surgery but the doctor has advised him to wait for another 3 to 4 years as he feels it is not needed yet. Is there a proper age at which one should be operated? Is it right to wait as he gets palpitations daily which seem to be increasing. Another concern is that we are planning to get married by next year. Will it be safe for us to marry prior to the surgery as the doctor has suggested “no physical activity” to him? I also want to know about the precautions that we have to take after the surgery?

A:The timing of AVR for a 26-year man with aortic valve disease is determined by the patients symptoms and the function of the left ventricle (LV) which is the main pumping chamber of the heart. There are easy and reliable ways to estimate LV function. If your doctor has determined that the LV function of your fiance is such that he does not need AVR now, he may be right. Marriage to a man with aortic valvular disease calls for full understanding on both sides. Physical activity including sexual is permissible provided the LV function is good. Another point to bear in mind is that a man may need to take medications to prevent blood clotting on the valve after the operation. Nor can the possibility be ruled out that the valve may develop problems after many years and may need replacement again. Subject to these limitations, he can have a normal married life and employment.