The
severity of the Aortic valve stenosis ranges from mild to severe. Many patients
might not experience any symptoms of Aortic valve stenosis until the disease
reaches a high severity.
Congenital Heart DefectSome children are born with an
aortic valve that has only two cusps instead of three. This valve defect may
not cause any problems until adulthood.
Advancing Age
Aortic stenosis mainly affects older people as a result of
scarring and calcium buildup in the valve cusp (flap or fold).
Calcium Build-up
Calcium deposits can build up on the heart valves (aortic valve
calcification) which result in stiffening of the valve cusps.
Genetic Predisposition
Genetic predisposition comes from genetic variations that are
passed down from parent to child.
Rheumatic Heart Disease
This complication of strep throat infection may result in scar
tissue forming on the aortic valve. Scar tissue narrows the aortic valve
opening or creates a rough surface which enables calcium deposition.
Radiation Exposure
Exposure to heavily radio-active substance may cause chances of
Aortic Stenosis.
How to Early Diagnose
the Aortic Stenosis
A
disorder of the heart valve usually leads to an abnormal heart sound (murmur).
In case your doctor hears such a murmur during physical examination, he/she
will recommend tests such as ECG, Echocardiography and a six-minute walk test.
To confirm further, a CT scan and few other blood tests will be done.
Once confirmed the
further management of Aortic valve stenosis will depend on its severity and
associated symptoms.
Electrocardiogram
(ECG or EKG)
This
painless test detects and records your heart's electrical activity using small
sensors (electrodes) attached to your chest and arms and, sometimes, legs.
AnEKGcan detect enlarged chambers of your heart, heart disease and
abnormal heart rhythms.
Chest X-Ray
It
will help to determine whether your heart is enlarged, which can occur in
aortic valve stenosis. It can also show calcium buildup on your aortic valve
swelling of the aorta.
Exercise Tests or
Stress Tests
It
helps to determine whether signs and symptoms of aortic valve disease occur
during physical activity and can help to determine the severity of your
condition. If you are unable to exercise, medications that have similar effects
as exercise on your heart may be given to complete the test.
Cardiac
Computerized Tomography (CT) Scan
A
cardiacCTscan combines several X-ray images to provide a more
detailed cross-sectional view of the heart. Doctors may use
cardiacCTto measure the size of your aorta and look at your aortic
valve more closely.
Cardiac
MRI
A
cardiacMRIuses magnetic fields and radio waves to create detailed
images of your heart. This test may be used to determine the severity of your
condition and evaluate the size of your aorta.
Cardiac
Catheterization
This
test isn't often used but it may be used if other tests aren't able to diagnose
the condition or to determine its severity. It may also be used before aortic
valve surgery to make sure the arteries that feed the heart muscle (coronary
arteries) are not blocked.
Don't Worry it is
Curable!
Treatments of Aortic
Stenosis
Modern
Science has made it possible to treat the most complex structural heart issues,
including Aortic Stenosis.
Treatment
for aortic valve stenosis depends on your signs and symptoms and the severity
of the condition.
Here
is a list of treatments:
1 Medications
If you are having no or mild symptoms, your doctor may prescribe
you some medications along with periodic check-up. The medications will act for
short term and will make you feel better, but ultimately you will require
further evaluation and possible intervention.
Aortic valve repair.To repair an aortic valve, surgeons
separate valve flaps (cusps) that have fused. However, aortic valve repair is
rarely considered a primary treatment to treat aortic valve stenosis
2 Balloon Valvuloplasty (BAV)
This method is performed in patients severely ill for surgery or
awaiting a valve replacement. A long, thin tube (catheter) with a little
balloon on its tip is inserted into an artery. Valve opening is expanded by
guiding and inflating this balloon to the aortic valve. The balloon is then
deflated, and the catheter and balloon are finally removed. However, this
approach only provides temporary relief.
If the Aortic valve stenosis is severe, your doctor may advise
either open heart surgery (SAVR) or Transcatheter Aortic Valve Replacement
(TAVR)
3
Surgical Aortic Valve Replacement (SAVR)/Open Heart Surgery
Aortic valve replacement is often needed to treat aortic valve
stenosis. In this, 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).
Most open-heart surgeries are performed through sternotomy. The
patient is placed under general anesthesia and the breast bone is cut open. The
heart is stopped and a heart lung machine takes over the function of the heart
temporarily. The surgeon will then completely remove the diseased aortic valve
and place a new valve. The heart is then restarted and the chest incision is
closed.
Biological tissue valves break down 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.
4 TAVR System
Transcatheter Aortic
Valve Replacement (TAVR)
TAVR
procedure is minimally invasive, can be done without general anesthesia and
does not require stopping the heart or opening the chest cavity. It is a
catheter-based technique during which the doctor replaces the patient’s
diseased valve with a bioprosthetic valve. Once in place, the valve immediately
begins functioning. You will be discharged from the hospital within a few days
and will have a much shorter recovery period compared to open heart surgery.
This novel, interventional technique is somewhat similar to angioplasty and is
done in the Cardiac Catheterization Lab (Cath-lab)