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Aortic valve stenosis in young patients poses a unique set of challenges in the management.The etiology of the disease varies from congenital hypoplasia of the valve, multiple level left ventricular out flow tract obstruction) to rheumatic aortic valve stenosis which is still prevalent in the developing world.In addition bicuspid aortic valve is the commonest congenital cardiac malformation in the grown up.Need for growth potential, freedom from anticoagulation, durability of the implanted valve and minimal effect on life style of the patient are some of the considerations driving the choice of the operative procedure in these patients.