The aortic valve is one of four valves in the heart. Its job is to pump blood from the heart to the aorta (largest artery in the body), and from there to the rest of the body. Aortic valve disease occurs when the valve does not work properly, affecting the heart’s ability to supply blood to the body.
Aortic valve stenosis occurs when the valve is narrowed or thickened, and blood cannot flow through effectively. This thickening can develop from calcium building up in the valve which is common during the aging process.
Also called aortic insufficiency, aortic valve regurgitation refers to a leaky aortic valve. The aortic valve has flaps that open and close with each heartbeat. If the flaps do not close securely, blood can leak and flow “backwards,” reducing the amount of blood that is supplied to the rest of the body.
Aortic valve disease is categorized based on symptoms and severity.
Stage A: At Risk
Elements of heart valve disease with a risk of the disease developing
Stage B: Progressive
Mild or moderate disease with an obstruction to normal blood flow
Stage C: Asymptomatic Severe
A severe obstruction exists in the valve, but without symptoms
Stage D: Symptomatic Severe
Severe heart valve disease with symptoms
Some babies are born with aortic valve disease. This is a congenital (present at birth) heart defect. When adults develop aortic valve disease, it is usually caused by a related health condition including:
Not everyone with aortic valve disease exhibits symptoms. It is possible to have a valve defect for years without knowing about it. Symptoms usually occur when the disease becomes more advanced. Patients may experience mild symptoms, or they may be moderate or severe and have a significant impact on daily life. Symptoms can include:
Aortic valve disease needs to be addressed by a heart specialist. It can be a serious condition that leads to other health concerns including:
This condition can affect anyone at any age, but certain characteristics make people more vulnerable to developing aortic valve disease:
Diagnosing aortic valve disease requires an exam by a health care provider and additional testing. The exam will include a review of medical history and any heart-related symptoms, as well as listening to the heart with a stethoscope. If a problem is suspected, the provider may recommend testing that could include:
Health care providers recommend treatment plans based on the symptoms and the severity of the disease. For asymptomatic patients or those with minimal symptoms, watchful waiting and regular checkups with a cardiologist may be recommended. Patients with more advanced aortic valve disease may benefit from the following options:
While medication cannot correct a structural problem with the aortic valve, it may be used to lessen symptoms and improve overall heart health. Medication is often used to address arrythmia, high cholesterol or high blood pressure.
This minimally invasive procedure can open up the narrowing in the valve. It involves a balloon device that is inserted through a small incision and guided to the faulty valve. The balloon is inflated to expand the space in the aortic valve. Valvuloplasty is usually not a permanent solution and will need to be repeated or followed up with a different type of procedure.
Repairing the aortic valve can be done with either minimally invasive technology or with traditional open-heart surgery. Some patients are candidates for one or the other, and the cardiologist will help determine the best option. The minimally invasive approach uses catheter-based technology to guide a repair device through the artery and into the aortic valve. Open-heart surgery involves making a large incision in the chest to access the aortic valve.
Patients with severe aortic valve disease may need a replacement valve. This can be done through either a minimally invasive procedure or open-heart surgery.
Transcatheter aortic valve replacement (TAVR) addresses severe aortic stenosis and is largely considered the most significant recent advancement in minimally invasive valvular disease treatment. With catheter-based technology, the surgeon uses a percutaneous approach to make an insertion in the groin and guides an artificial aortic valve through the femoral artery to the heart. Once it reaches the diseased valve, the new valve is implanted, and it takes over function for the original valve.
The recovery process will vary for each patient and is different depending on whether a minimally invasive or open surgical procedure was performed.
Minimally invasive procedures like TAVR usually result in a shorter recovery time and patients are back to normal activities within about a week. Open-heart surgery requires a much longer recovery time and patients may be limited in daily activities for weeks or months. Cardiac rehabilitation may be recommended to help patients regain strength and gradually get back to their normal activities.
Following valve repair or replacement, patients will need to see their health care provider for regular checkups and imaging to ensure the procedure continues to be successful. Patients with replacement valves may need to take blood thinners to prevent blood clots and reduce the risk of stroke.
The Transcatheter Valve Therapy (TVT) Registry, a combined effort of the Society of Thoracic Surgeons and the American College of Cardiology, has awarded Memorial Hermann-Texas Medical Center a three-star designation, the highest award possible, for achievements in quality, safety and outcomes for transcatheter aortic valve replacement. Memorial Hermann is the only three-star TAVR program in the state of Texas, and one of only a few in the country.
Recently, the FDA approved TAVR therapy for patients with severe aortic stenosis who do not experience symptoms like shortness of breath and fatigue. Previously, only symptomatic patients were candidates for the procedure. This is a major advancement in proactive treatment for patients with diagnosed valve disease. Instead of waiting for the condition to worsen, surgeons can replace a damaged aortic valve before problems arise.
If you’d like a referral to a heart and vascular specialist or want more information about our services, please fill out the form below or call us at (713) 219-3519. For other inquiries, such as obtaining medical records, imaging reports or test results, please call (713) 222-CARE (2273).