From Dr. El Sabbagh: I am unsure of what congenital aortic valve tear is. If you mean aortic dissection which is a tear in the wall of the aorta, then it depends on the location of the tear. If the tear is in the ascending aorta, then it would need to be replaced. If it is in the descending aorta, some of those can be treated medically. Aortic valve replacement might be needed if the aortic valve is affected.