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These factors are magnified in young adults who are considering pregnancy, for whom issues of anticoagulation and valve longevity are heightened. The Ross procedure has emerged as a promising alternative; however, its adoption is limited to highly specialized centers. Valve repair is an option for selected patients with AR. These treatment options offer varying degrees of durability and are associated with different risks and complications, especially for younger adult patients. Patient-centered care from a multidisciplinary valve team allows for discussion of the optimal timing of intervention and the advantages and disadvantages of the various treatment options.<\/jats:p><\/jats:sec><jats:sec id=\"ab-hrv220007-3\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The management of severe aortic valve disease in adults younger than 65 years is complex, and there are numerous considerations with each management decision. While mechanical AVR and bioprosthetic AVR have historically been the standards of care, other options are emerging for selected patients but are not yet generalizable beyond specialized surgical centers. A detailed discussion by members of the multidisciplinary heart team and the patient is an integral part of the shared decision-making process.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamacardio.2022.4770","type":"journal-article","created":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T16:03:20Z","timestamp":1671638600000},"page":"281","source":"Crossref","is-referenced-by-count":16,"title":["Management Challenges in Patients Younger Than 65 Years With Severe Aortic Valve Disease"],"prefix":"10.1001","volume":"8","author":[{"given":"Jayson R.","family":"Baman","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit N.","family":"Medhekar","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. 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