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Aortic valve stenosis - Aortic stenosis
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Aortic valve stenosis - Aortic stenosis

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HEART & BLOOD

Heart Disease

Treatment

Medications sometimes can ease symptoms of aortic stenosis. However, the only way to eliminate aortic stenosis is surgery to repair or replace the valve and open up the passageway.

However, surgery isn't always needed right away. If tests reveal that you have mild to moderate aortic stenosis and you have no symptoms, there's generally no need for immediate valve surgery. Instead, your doctor will talk with you about scheduled checkups to carefully monitor the valve so that surgery can be done at the appropriate time. The same approach is usually taken with infants and children with mild to moderate aortic stenosis.

In general, the appropriate time for surgery is when narrowing becomes severe and signs and symptoms develop. If at any point you notice signs and symptoms associated with aortic stenosis, let your doctor know so that your valve can be evaluated.

Some people never develop severe aortic stenosis, so they never need surgery. For others, the condition progresses and surgery is necessary.

Medications
No medications can eliminate aortic stenosis. However, your doctor may prescribe certain medications to help your heart, such as ones to control heart rhythm disturbances associated with aortic stenosis. Cholesterol-lowering medications may help reduce the progression of some types of aortic stenosis.

If you have aortic stenosis, your doctor will recommend that you take antibiotics before certain dental or medical procedures, to prevent the heart infection endocarditis.

Surgery
Surgery is the primary treatment for aortic stenosis. Surgical procedures to treat aortic stenosis include:

  • Aortic valve replacement. This is by far the most common surgical treatment for aortic stenosis. In this type of surgery, surgeons remove the narrowed aortic valve and replace it with a mechanical valve or a tissue valve from a pig, cow or human-cadaver donor. Mechanical valves are made from metal and are durable, but they carry the risk of blood clots forming on or near the valve. If you receive a mechanical aortic valve, you must take an anticoagulant medication for life. Tissue valves, such as those from a pig, cow or human cadaver, rarely raise your risk of blood clots, but they tend to wear out faster than mechanical valves, especially in younger people. Tissue valves may then need to be replaced, typically after seven to 10 years. The results with either type of valve tend to be quite good.

  • Aortic valve repair. Occasionally, repairing the aortic valve is an option. For example, some infants are born with an aortic valve in which the leaflets of the valve are fused together. By operating on the valve and separating these leaflets in a procedure called valvotomy, surgeons can eliminate stenosis and improve blood flow. Or valve repair may involve removing calcium deposits on or near the valve. This helps clear the valve passageway.

Repair or replacement of the aortic valve involves open-heart surgery, performed with general anesthesia. Through an incision the length of your breastbone (sternum), your heart is exposed and connected to a heart-lung machine that assumes your breathing and blood circulation functions during the procedure. The narrowed aortic valve is then repaired or replaced. After the operation, which lasts several hours, you spend one or more days in an intensive care unit, where your heart function and general recovery are closely monitored.

Another surgical procedure is balloon valvuloplasty. This procedure uses a soft, thin tube (catheter) tipped with a balloon to open up the aortic valve passageway. A doctor guides the catheter through a blood vessel in your elbow or groin to your heart and into the narrowed aortic valve. Once in position, a balloon at the tip of the catheter is inflated. The balloon pushes open the aortic valve and stretches the valve opening. The balloon is then deflated, and the catheter with balloon is guided back out of your body. Balloon valvuloplasty may relieve aortic stenosis and its symptoms. However, in adults, the procedure isn't always successful, and the valve tends to narrow again even after initial success. For these reasons, doctors rarely use balloon valvuloplasty today to treat aortic stenosis, except in adults too sick to undergo surgery or in children.

Aortic stenosis can be treated effectively with surgery. However, you may still be at risk of irregular heart rhythms even after you've been treated for aortic stenosis. You may need to take medications to lower that risk. In addition, you may continue to experience symptoms, such as shortness of breath, despite treatment.

 

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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Last Modified : 03/14/08 06:53 PM