Aortic stenosis is a condition that causes the heart’s aortic valve to narrow.
The aortic valve connects the heart’s main pumping chamber (left ventricle) to the aorta.
Aortic stenosis can occur due to a congenitally abnormal aortic valve or due to degeneration of the valve.
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It’s a fairly common condition, particularly in adults over age 65 years.
In later stages, when symptoms are present,valve replacementis necessary.
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Why Does Aortic Stenosis Happen?
Narrowing of the aortic valve can happen for several reasons.
Some more common causes include degenerative valve disease, congenital valve disease, and rheumatic heart disease.
People with congenital aortic valve narrowing may begin to have symptoms as soon as 30 years old.
Lastly,rheumatic heart diseasecan cause aortic stenosis.
Rheumatic heart disease happens years after rheumatic fever, a condition related to untreated strep infections.
Rheumatic heart disease typically affects the mitral valve, but the aortic valve can also be affected.
Aortic stenosis starts as mild but becomes more severe and causes symptoms over time.
Progressive Aortic Stenosis
Progressive aortic stenosis is a term that includes mild and moderate aortic stenosis.
Often, people with severe aortic stenosis have symptoms.
Those with severely narrowed valves experience the most rapid progression.
Once aortic stenosis is severe, the two-year survival rate is 30% to 50% without valve replacement.
Those with mild aortic stenosis may take years to progress to severe disease or require a valve replacement.
Treatment of Aortic Stenosis
Aortic stenosis historically required open heart surgery to correct.
There are two types ofprosthetic heart valvesthat may be used: mechanical (artificial) or bioprosthetic.
Mechanical valves last longer, but they requireopen heart surgery.
People with these valves need to take lifelonganticoagulant(blood-thinning) medication.
These valves do not require long-term medication, but it may be recommended short-term after implantation.
Surgical Aortic Valve Replacement
Surgical aortic valve replacement requires open heart surgery to implant a new valve.
However, open heart surgery is more invasive than TAVR, and the recovery period is longer.
TAVR
In TAVR, a bioprosthetic aortic valve is implanted using a catheter-based technique.
TAVR is a great option for people with aortic stenosis who have frailty or other medical conditions.
TAVR is often preferred in people older who are 65 years old or older.
Postoperative Care
Postoperative care differs based on the key in of procedure.
Speak with your heart team about any exercise, driving, or other activities restrictions.
You will also receive instructions on how to care for any surgical wounds.
Interventional cardiologists who perform TAVRs have one to two years of additional procedural training.
Many health centers have specialized valve teams with expertise and experience managing complex valvular heart disease.
Cardiologists and heart surgeons work together to determine the best course of action regarding valve replacement.
A specialized heart team will determine the best treatment plan for individual patients.
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Centers for Disease Control and Prevention.Valvular heart disease.
American College of Cardiology.Anticoagulation strategies after bioprosthetic valve replacement: What should we do?
National Heart, Lung, and Blood Institute.Transcathter Aortic Valve Replacement (TAVR).
American Heart Association.Heart valve surgery recovery and follow up.
American Heart Association.Life’s Simple 7.
