What It Is
The aortic valve lets blood flow from the heart's left ventricle into the aorta. (The aorta is the main artery and distributes oxygen-rich blood throughout the body.) The aortic valve closes after each heartbeat, to keep blood from leaking back into the left ventricle. A normal aortic valve has three leaflets or cusps (tricuspid). Aortic valves abnormal from birth usually have two leaflets (bicuspid), but other variations occur. Only about 2 percent of the population have biscuspid valves. Most bicuspid valves work normally for a long time — sometimes a lifetime. But some can become thick and narrowed (stenotic) or curled at the edges and leaky (insufficient).
Surgical Treatment
If the valve becomes very stenotic, severe pressure builds up in the left ventricle, which can injure the heart. When this occurs, the valve must be opened either 1) in the catheterization lab with a balloon valvotomy catheter or 2) in the operating room by open-heart surgery. You may have had one or both of these procedures as an infant or child.
If the valve becomes very stenotic, severe pressure builds up in the left ventricle, which can injure the heart. When this occurs, the valve must be opened either 1) in the catheterization lab with a balloon valvotomy catheter or 2) in the operating room by open-heart surgery. You may have had one or both of these procedures as an infant or child.
Valvotomy by either technique doesn't repair the valve. Instead, it helps to lessen the stenosis and pressure in the left ventricle. Some valve leakage is likely to develop after balloon or surgical valvotomy. If your aortic valve no longer responds to valvotomy or has become severely insufficient (leaky), it will probably need to be replaced.
Your aortic valve can be surgically replaced in three ways:
- The Ross procedure, a surgery in which your aortic valve is removed and replaced by your pulmonary valve. Then your pulmonary valve is replaced with a preserved donor pulmonary valve.
- Aortic valve replacement with a preserved donor valve.
- Aortic valve replacement with a mechanical valve.
your cardiologist, cardiac surgeon or both.
When serious stenosis persists by itself or with valve leakage, a more complex surgery may be needed. It will enlarge the part of the left ventricle that leads to the aortic valve (left ventricular outflow tract) when the valve is replaced. This surgery is often called the Konno procedure.
Medical
Everyone with aortic valve disease needs routine follow-up. The severity of your valve problem will dictate how often you'll need to visit the doctor. Stenosis and insufficiency can change as you age, whether or not you've had surgery or catheterization. Your doctor can check for this and other problems that sometimes coexist with aortic valve abnormalities. Medical therapy usually doesn't help people with aortic stenosis. However, medications can help reduce leakage and maintain left ventricle health in some patients with serious aortic valve insufficiency.
Everyone with aortic valve disease needs routine follow-up. The severity of your valve problem will dictate how often you'll need to visit the doctor. Stenosis and insufficiency can change as you age, whether or not you've had surgery or catheterization. Your doctor can check for this and other problems that sometimes coexist with aortic valve abnormalities. Medical therapy usually doesn't help people with aortic stenosis. However, medications can help reduce leakage and maintain left ventricle health in some patients with serious aortic valve insufficiency.
Activity Restrictions
If you haven't required aortic valve replacement but have ongoing valve stenosis or insufficiency, your cardiologist may tell you to limit your activity. For instance, heavy weightlifting and other extreme "isometric" exercises excessively strain your aortic valve and left ventricle. Depending on the state of your aortic valve, you
If you haven't required aortic valve replacement but have ongoing valve stenosis or insufficiency, your cardiologist may tell you to limit your activity. For instance, heavy weightlifting and other extreme "isometric" exercises excessively strain your aortic valve and left ventricle. Depending on the state of your aortic valve, you
Each option has advantages and disadvantages. Discuss them with may need to limit such exercise. Ask your cardiologist about your exercise limits.
Endocarditis Prevention
People with even mildly abnormal aortic valves are at risk for bacterial endocarditis.
People with even mildly abnormal aortic valves are at risk for bacterial endocarditis.
Pregnancy
You should handle pregnancy well if you have mild aortic stenosis or insufficiency. Your risk level depends on the severity of the valve obstruction or leakage. Women who have artificial or mechanical aortic valves, who receive warfarin (Coumadin) anticoagulation, or who receive blood vessel dilators (vasodilators such as Vasotec, Zestril, etc.) to treat severe aortic valve leakage must consult their physician
You should handle pregnancy well if you have mild aortic stenosis or insufficiency. Your risk level depends on the severity of the valve obstruction or leakage. Women who have artificial or mechanical aortic valves, who receive warfarin (Coumadin) anticoagulation, or who receive blood vessel dilators (vasodilators such as Vasotec, Zestril, etc.) to treat severe aortic valve leakage must consult their physician
Problems You May Have
Symptoms
Aortic stenosis and insufficiency usually don't have symptoms. However, when either becomes severe, activity may bring shortness of breath, exercise
Aortic stenosis and insufficiency usually don't have symptoms. However, when either becomes severe, activity may bring shortness of breath, exercise
arrhythmias (such as ventricular tachycardia). These can produce the symptoms described above. If you have any of these symptoms, report them to your physician.
congenital heart defects
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