Experts in Aortic Stenosis Diagnosis and Treatment

What Is Aortic Stenosis?

The aorta is one of four heart valves that ensure blood flows in the right direction through the heart chambers to the rest of the body. In aortic stenosis, the aortic valve leaflets become stiff, which means the valve cannot fully open and close as it should. As the opening of the stiff heart valve narrows, it becomes harder for the heart to pump blood to the rest of the body, which can cause you to feel unusually tired and out of breath.

Aortic stenosis is a common but serious aortic valve disease that weakens the heart and makes it harder to do the everyday activities you need and want to do. Aortic stenosis will get worse over time and has a poor prognosis if not properly treated.

Aortic Stenosis Risk Factors

Aortic stenosis can be caused by a congenital heart defect, or through one or more of the following risk factors:

• Advanced age, usually after age 60
• Family history of early heart disease
• High blood cholesterol
• High blood pressure
• History of heart inflammation, rheumatic fever, heart attack or heart failure
• Physical inactivity
• Diabetes
• Obesity
• Tobacco use

Aortic Stenosis Symptoms & Diagnosis

As aortic valve narrowing occurs, you may experience chest pain, shortness of breath, heart palpitations or swollen ankles and feet. Alternately, your primary care doctor may detect a heart murmur or other signs of heart valve disease during a routine exam and refer you to a cardiologist, a doctor who specializes in diagnosing and treating heart problems.

In addition to asking about your signs and symptoms, your cardiologist may recommend tests to diagnose aortic valve stenosis, including:

• Cardiac catheterization: A long, thin tube (catheter) is inserted into a large artery in the leg or arm leading to the heart to provide images of the heart and blood vessels.
• Cardiac magnetic resonance imaging (MRI): This noninvasive test uses a combination of large magnets, radio waves and a computer to produce detailed images of the heart and other vital organs.
• Chest X-ray: This gives an overall picture of the heart and lungs.
• Echocardiogram (Echo): This test uses sound waves to give a moving picture of the heart and valves.
• Electrocardiogram (ECG): This test measures the electrical activity of the heart.
• Exercise stress test: A stress test that can show whether you have signs and symptoms of heart valve disease when your heart is working harder than normal.

Surgery for Aortic Stenosis & Other Treatment Options

Treatment for aortic stenosis will depend on the severity of your condition. For mild cases, healthy lifestyle changes and medications may be recommended to ease symptoms and reduce the future risk of complications.

For patients needing more advanced treatment, there are minimally invasive transcatheter interventions or surgical techniques to replace the malfunctioning aortic valve. Your care team will discuss with you the benefits and risks of all treatment for aortic valve disease options you have

Balloon Valvuloplasty

A specialist will insert a long, thin tube (catheter) with a balloon on the tip into an artery in your arm or groin. The catheter is then guided to the aortic valve where the balloon is inflated, widening the valve opening, before being deflated and removed. This procedure is typically only used in adults who are waiting for a valve replacement.

Surgical Aortic Valve Replacement (SAVR)

Your surgeon will remove the damaged aortic valve and replace it with a valve made from biological heart tissue from a human, cow or pig. Biological tissue valves may break down over time though, so depending on your condition, your surgeon may recommend a mechanical valve instead. Patients with mechanical valves need to take blood thinners for life to prevent blood clots.