Aortic valve stenosis is a condition in which the heart's aortic valve narrows, preventing the valve from opening fully. The narrowed heart valve obstructs blood flow, causing the heart to have to work harder. Over time the heart becomes weakened from being overworked, leading to symptoms of fatigue and dizziness. Medications sometimes can relieve symptoms of aortic valve stenosis. However, the only way to eliminate aortic valve stenosis is to repair or replace the valve and open up the passageway.
Balloon Valvuloplasty
Balloon valvuloplasty uses a soft, thin catheter, tipped with a balloon. The catheter is guided through a blood vessel of either the arm or groin to the heart and into the narrowed aortic valve. Once in its proper location, the balloon is inflated, pushing open the aortic valve while stretching the valve opening, according to the Mayo Clinic. This procedure improves blood flow to the heart and to the rest of the body.
Balloon valvuloplasty may relieve aortic stenosis and its symptoms, especially in infants and children, according to MayoClinic.com. However, for adults this procedure is less successful, because in adults the valve often narrows again.
Aortic Valve Repair
Aortic valve repair, also known as valvotomy, is a minimally invasive surgery on the aortic valve, according to MedlinePlus. Only performed when the aortic valve is still thin and pliable, the repair involves trimming, shaping or rebuilding one or more of the three aortic leaflets. The three aortic leaflets are flaps that work together to open and close the heart valve.
Candidates for aortic valve repairs typically involve people who are too ill to undergo aortic valve replacement surgery, according to Leonard Lilly, M.D. However, the Mayo Clinic notes that people with aortic valve repairs tend to need additional repairs later in life.
Aortic Valve Replacement
The primary surgical treatment for aortic stenosis, aortic valve replacement involves a surgeon removing the narrowed aortic valve and replacing it with a mechanical device or a biological valve. A physician will discuss with patients the two types of replacement valves, mechanical and biological, to ensure the patient chooses the most appropriate valve.
Durable and made of metal, a mechanical heart valve is intended to last for many years. However, it carries the risk of blood clots developing on or near the valve. Therefore, individuals with a mechanical heart valve must take anticoagulant medication to prevent blood clots. Anticoagulant medications may cause problems during pregnancy and pose a risk of bleeding.
Commonly from pigs or cows, a biological heart valve does not require long-term use of anticoagulants. However, it typically wears out over time and must be replaced later in life. Biological heart valves are most commonly installed in elderly patients.
References
- MedlinePlus: Aortic Stenosis
- MayoClinic.org: Aortic Stenosis Treatment
- MayoClinic.com: Aortic Valve Stenosis
- MedlinePlus: Aortic Valve Surgery- Minimally Invasive
- "Pathophysiology of heart disease. 4th edition;" Lilly; 2007
