AORTIC STENOSIS

AORTIC STENOSIS

Aortic valve stenosis — or aortic stenosis is a type of heart valve disease. The valve between the lower left heart chamber and the body’s main artery (aorta) is narrowed and doesn’t open fully. This reduces or blocks blood flow from the heart to the aorta and to the rest of the body.

Treatment of aortic stenosis depends on the severity of the condition. You may need surgery to repair or replace the valve. Without treatment, severe aortic valve stenosis can lead to death.

Symptoms

Aortic valve stenosis ranges from mild to severe. Symptoms generally occur when narrowing of the valve is severe. Some people with aortic valve stenosis may not have symptoms for many years.

Symptoms of aortic valve stenosis may include:

• An irregular heart sound (heart murmur) heard through a stethoscope
• Chest pain (angina) or tightness with activity
• Feeling faint or dizzy.
• Shortness of breath.
• Fatigue, especially during times of increased activity
• Rapid heartbeat.

Aortic valve stenosis may lead to heart failure. Heart failure symptoms include fatigue, shortness of breath, and swollen ankles and feet.

When the aortic valve opening is narrowed, the heart must work harder to pump enough blood into the aorta and to the rest of the body. The extra work of the heart can cause the left ventricle to thicken and enlarge. Eventually the strain can cause a weakened heart muscle and can ultimately lead to heart failure and other serious problems.

Aortic valve stenosis causes include:

Congenital heart defect.

Calcium buildup on the valve (aortic valve calcification).

Rheumatic fever.

Aortic valve stenosis can cause complications, including:

• Heart failure
• Stroke
• Blood clots
• Bleeding
• Irregular heart rhythms (arrhythmias)
• Infections that affect the heart, such as endocarditis
• Death

 Treatment

You may eventually need surgery to repair or replace the diseased aortic valve, even if you don’t have symptoms. Aortic valve surgery may be done at the same time as other heart surgery.

Surgery to repair or replace an aortic valve is usually done through a cut (incision) in the chest. Less invasive approaches may be available..

Aortic valve replacement. Aortic valve replacement is often needed to treat aortic valve stenosis. In aortic valve replacement, the surgeon removes the damaged valve and replaces it with a mechanical valve or a biological tissue valve.

Biological tissue valves break down over time and may eventually need to be replaced. People with mechanical valves will need to take blood-thinning medications for life to prevent blood clots.

Transcatheter aortic valve replacement (TAVR). TAVR is an alternative to open-heart aortic valve replacement surgery. This minimally invasive procedure replaces a narrowed aortic valve.

TAVR is done using smaller incisions and a thin, flexible tube is inserted into a blood vessel and guided to the heart. A replacement valve is passed through the catheter to the aortic valve area. A balloon on the catheter tip inflates to press the new valve into place. Some valves can self-expand. The surgeon removes the catheter once the new valve is securely in place. Surgeons may also perform a catheter procedure to insert a replacement valve into a biological tissue valve that is no longer working properly.