What is Aortic Stenosis?
Aortic stenosis is the narrowing of the aortic valve, which may be caused by degeneration and calcium deposits or congenital aortic valve disease, such as bicuspid aortic valve. The heart supplies the rest of the body with oxygenated blood through the aortic valve.
What are the Symptoms of Aortic Stenosis?
- Shortness of breath
- Difficulty walking short distances
- Lightheadedness, dizziness, and fainting
- Swollen ankles and feet
- Rapid heartbeat
- Chest pain
They may be no outward symptoms.
These could also be symptoms of heart failure. If you have any of these symptoms and have been diagnosed with heart failure, ask your doctor to also test for aortic stenosis.
What are the Risk Factors for Aortic Stenosis?
Factors associated with aortic disease include:
- Increase in age
- High blood pressure
- High cholesterol
- Deformed aortic valve
- Family history
What Causes Aortic Stenosis?
Calcium build up on the valve: With age, heart valves may accumulate calcium deposits
Birth defect: Some people are born with an aortic valve that has only one or two leaflets instead of three. This may not cause any problems until adulthood, at which time the valve may begin to narrow or leak.
Rheumatic fever: This may result in scar tissue on the aortic valve, which can narrow it or can create a rough surface where calcium deposits can collect.
Radiation therapy: In rare cases, calcification of the aortic valve can occur more quickly in patients who have received radiation treatment to the chest.
Who is Affected by Aortic Stenosis?
Aortic stenosis is a common public health problem affecting millions of people around the world. It is estimated that up to 12.4% of people over age 75 have aortic stenosis. About 80% of adults with symptomatic aortic stenosis are male.
What Happens When Someone Has Aortic Stenosis?
Overtime, the leaflets of your aortic valve become stiff, reducing their ability to fully open and close. When the leaflets don’t fully open, your heart must work harder to push blood through the aortic valve to your body. Eventually, your heart gets weaker, increasing the risk of heart failure (your heart cannot supply enough blood to your body).
Severe Aortic Stenosis Has a Worse Prognosis Than Many Metastatic Cancers
5-year survival rate (distant metastasis) of lung cancer, colorectal, breast cancer, overian cancer and prostate cancer compared to severe inoperable aortic stenosis.
What Tests are Used to Diagnose for Aortic Stenosis?
Auscultation: Your cardiologist will use a stethoscope to listen to the sounds of your heart.
Electrocardiogram (ECG): Sensors are attached to your skin to measure the electrical impulses given off by your heart, displayed as waves on a monitor or printed on paper.
Chest X-ray: An X-ray Image of your chest allows your doctor to check the size and shape of your heart. A chest X-ray can also reveal calcium deposits on the aortic valve.
Echocardiogram: This is also known as an ultrasound; it uses sound waves to produce an image of your heart, which helps your doctor closely examine the aortic valve.
Cardiac Catheterization: In this test, a dye is injected into your heart through your arm or groin to make you heart more visible on an X-ray.
What are the Treatment Options for Aortic Stenosis?
Treatment for aortic stenosis depends on how far yourdisaes has progressed. If you stenosis is mild, medication may be prescribed to help regulate your heartbeat and prevent blood clots. However, if the severity of your stenosis progresses, it may be recommended that the diseased aortic valve needs to be replaced. Severe aortic stenosis cannot be treated with medication. The only effective treatment is to replace your aortic valve.
Today there are two options to replace your diseased aortic valve.
Transcatheter Aortic Valve Implantation (TAVI)
TAVI may be a better option for people who have been diagnosed with severe aortic stenosis depending on their risk for open-heart surgery. TAVI (sometimes called transcatheter aortic valve replacement of TAVR), is a less-invasive procedure than open-heart surgery. This procedure uses a catheter to implant a new valve within your diseased aortic valve. TAVI can be performed through multiple approaches, however the most common appoach is the transfemoral approach (through a small incision in the leg). Only professionals who have received extensive training are qualified to perform the TAVI procedure.
Open Heart Surgical Aortic Valve Replacement
Aortic valve replacement through open heart surgery is another option for treating severe aortic stenosis. Most open heart sugeries are performed through an incision across the full length of the breast bone, or sternum. Occasionally open heart surgeries can be performed through smaller incisions.
Open heart surgeries, including those performed through smaller incision, both require the use of a heart lung machine which temporarily takes over the function of the heart. During the procedure, the surgeon will completely remove the diseased aortic valve and insert a new valve. There are two different types of surgical valves: mechanical (man-made material) and biological (animal or human tissue).