Severe aortic stenosis is often unpreventable and may be related to:
- Buildup of calcium deposits which causes narrowing
- Radiation therapy
- History of rheumatic fever or high cholesterol
There are two main types of aortic stenosis:
Congenital aortic stenosis occurs in those who were born with a narrowed aortic valve, or a valve with two leaflets versus three. Symptoms of congenital aortic stenosis may not occur until later in life.
Acquired aortic stenosis develops with age when calcium builds up on the edges of two or three of the flaps, causing them to fuse together. This may occur in people who have had rheumatic fever or as part of the aging process.
Patients with aortic stenosis may have no symptoms or may experience:
- Chest discomfort or tightness
- Shortness of breath
If your symptoms are mild or you aren't experiencing symptoms, your doctor may recommend you make healthy lifestyle changes and take medications to treat symptoms or reduce the risk of complications. However, if you need surgical intervention, treatment may consist of repair of the valve leaflets or replacement of the valve. Surgery can be either an open repair or minimally invasive. Surgical treatment options include:
Aortic Valve Repair
Surgeons rarely repair an aortic valve to treat aortic valve stenosis, and generally aortic valve stenosis requires aortic valve replacement. To repair an aortic valve, surgeons may separate valve flaps (cusps) that have fused.
Aortic Valve Replacement
Aortic valve replacement is often needed to treat aortic valve stenosis. In aortic valve replacement, your surgeon removes the damaged valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).
Biological tissue valves degenerate 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. Your doctor will discuss with you the benefits and risks of each type of valve and discuss which valve may be appropriate for you.
Transcatheter Aortic Valve Replacement (TAVR)
A less invasive procedure option is called transcatheter aortic valve replacement (TAVR) to replace a narrowed aortic valve. TAVR may be an option for people who are considered to be at a greater risk of complications from surgical aortic valve replacement.
In TAVR, doctors insert a catheter in your leg or chest and guide it to your heart. A replacement valve is then inserted through the catheter and guided to your heart. When the valve is implanted, doctors remove the catheter from your blood vessel.
Doctors may conduct a procedure using a long, thin tube (catheter) to repair a valve with a narrowed opening (valve stenosis). In this procedure, called balloon valvuloplasty, a doctor inserts a catheter with a balloon on the tip into an artery in your arm or groin and guides it to the valve. The doctor performing the procedure then inflates the balloon, which expands the opening of the valve. The balloon is then deflated, and the catheter and balloon are removed.