Aortic stenosis (AS) is a narrowing of the aortic valve opening. This valve controls the flow of blood from the heart to a large artery called the aorta. This artery carries blood from the heart to the rest of body.
AS makes it difficult for blood to flow out of the heart. It can decrease the amount of blood that goes to the body and cause a back-up of blood into the heart. This back-up can increase pressure in the heart and lungs. AS can range from mild to severe.
The aortic valve has 3 flaps that should open and close smoothly. AS is caused by a defect or damage to these flaps. Common causes include:
A birth defect of the aortic valve, where the valve has 2 parts (cusps) instead of 3
A 2-part aortic valve that becomes stenotic with progressive wear and tear
An aortic valve that has only 1 cusp or has stenosis from birth
Progressive hardening of the valve and calcium build-up associated with aging
If you have mild AS, your condition will be monitored, but you may not need immediate treatment.
If you have more severe AS:
Your doctor may advise you to avoid strenuous physical activity.
You may be given medicine to decrease pressure on the heart and help prevent heart failure.
Surgery may be needed to repair the valve.
You may be prescribed medicine to help decrease pressure on the heart. Vasodilators may be given to widen your blood vessels and decrease blood pressure. Statins can help to lower cholesterol.
Surgical options include:
Balloon valvuloplasty—A balloon device is passed through the arteries to open or enlarge the stenotic aortic valve. This may provide temporary relief of symptoms. But since the valve can become blocked again, this treatment is not a permanent solution.
Aortic valve replacement—Open surgery to replace the aortic valve. It may be replaced with a donor valve, tissue valve (from animal tissue), or a manufactured valve.
Transcatheter aortic valve replacement (TAVR)—Minimally invasive surgery to replace the aortic valve. A small incision is made in the leg or chest. A wire is passed through the incision to the heart. The replacement valve is sent through the wire and is placed within the original valve.
Aortic Valve Replacement—Mechanical and Bioprosthetic Valve Shown
Antibiotic prophylaxis for heart patients. Mouth Healthy—American Dental Association website. Available at: http://www.mouthhealthy.org/en/az-topics/a/premedication-or-antibiotics. Accessed September 13, 2019.
Grimard BH, Safford RE, et al. Aortic stenosis: diagnosis and treatment. Am Fam Physician. 2016;93(5):371-378.
Infective endorcarditis. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCongenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp#.WblNnbKGNQI. Accessed September 13, 2019.
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