The Facts About Valve Disease

The most common cause of aortic stenosis is excessive wear on the aortic valve. This usually develops with age, but the process may be expedited in patients who are congenitally predisposed to disease.

Calcium buildup can also expedite the development of AS by stiffening the valve and limiting movement. These calcium deposits, which originate from the blood’s calcium supply as it flows through the aorta, accumulate over many years and are therefore more common in elderly patients.

Rheumatic fever can also cause aortic stenosis by producing scar tissue on the aortic valve and forcing the aortic valve to narrow. Rheumatic fever, though rare in developed countries, arises from complications of scarlet fever or strep throat. AS can take years to manifest in patients who have had rheumatic fever.

Symptoms include:

• Fatigue
• Dizziness
• Chest pain/pressure
• Heart murmur
• Shortness of breath during activity
• Heart palpitations
• Fainting

Treatment for patients diagnosed with AS is typically managed by a team of experienced cardiologists, cardiac surgeons and other medical specialists who collaborate to determine the most appropriate care for each patient. Medications are sometimes prescribed to help control symptoms, maximize heart function, control blood pressure and control heart rhythm disturbance. Today, those who have moderate, symptomatic AS undergo periodic monitoring with transthoracic echocardiography every one to two years (or with any change in symptoms or findings).

Patients who suffer from severe, symptomatic AS often receive a minimally invasive, catheter-based procedure known as transcatheter aortic valve replacement (TAVR) to replace and reopen their aortic valve. TAVR is less invasive than open-heart surgery, and the procedure typically takes less than one hour. During a TAVR procedure, a physician guides a thin, flexible tube with the heart valve into a patient’s artery and the diseased valve. Then the TAVR heart valve is placed in the disease valve and the physician removes the tube and closes the cut. Throughout the procedure, the physician views images of the patient’s heart.

After the TAVR procedure, most patients spend a few hours in the intensive care unit before being transferred back to their hospital room. Patients typically begin walking the same day as their TAVR procedure, are discharged within one to two days and can care for themselves and resume everyday activities. Before patients leave the hospital, their physician explains what types of physical activity they are permitted to do, what types of medications they need to take and when they will need to return for medical reevaluation, typically 30 days and one year after the procedure and as recommended by the physician. Most patients start feeling better immediately following a TAVR procedure and report having more energy, breathing normally, experiencing less pain and fewer symptoms, and feeling less anxious.