Aortic Valve Defects (Stenosis and Insufficiency)
What are Aortic
Valve Defects?
Blood from the heart’s left ventricle
flows through the aortic
valve into the aorta
for distribution to the body. After each
heartbeat, the aortic valve closes. This
keeps blood from leaking back into the left
ventricle. Normally the heart's aortic valve
has three leaflets (tricuspid). Defective
aortic valves usually have only two leaflets
(bicuspid). This is called a bicuspid aortic
valve.
Most bicuspid valves will function normally
throughout life. In some cases, however,
the valves deteriorate. They may become
thick and narrowed (stenosis) or curled
at the edges and leaky (insufficient).
Aortic stenosis is the most common valve
disorder in the U.S. About one in 50 boys
and 1 in 100 girls are born with the defect.
Some of the defects are the result of a
rare disorder called Marfan’s
syndrome. Aortic valve disease is most
common in men between the ages of 30 and
60.
Symptoms
Aortic valve stenosis and insufficiency
may result in the following symptoms:
- Shortness of breath
- Chest pain during exercise
- Dizziness or fainting
- Arrhythmia
- Reduced ability for physical activity.
If an aortic valve defect is suspected,
an echocardiogram [link glossary\echocardiogram
] can help confirm the diagnosis. A chest
X-ray may show calcium deposits in the
narrowed aortic valve.
Additional tests may include:
Treatment Options
Mild to moderate valve disease may need
no treatment. It also may be managed with
medications that may slow or halt degeneration
of the valve and relieve symptoms. In some
cases, however, the valve will need to be
surgically repaired or replaced.
Surgical Treatment - If stenosis severely
restricts blood flow from the heart, pressure
builds up in the heart’s left ventricle.
The heart has to work harder. When this
occurs, the valve must be widened through
catheterization or surgically replaced.
- Balloon valvotomy catheterization. In
this procedure, a thin flexible tube (catheter)
is inserted through an artery in the groin
or arm and threaded into the heart. Once
the tube reaches the aortic valve, a balloon
device on the end of the catheter is inflated.
This stretches the narrowed valve leaflets
and permits blood to flow more freely.
- If the aortic valve has become severely
insufficient, it will probably need to
be replaced. There are several ways to
surgically replace the valve:
- The Ross procedure. In this procedure,
the aortic valve is removed and replaced
by the pulmonary valve. The pulmonary
valve is then replaced with a donor
pulmonary valve.
- Aortic valve replacement with a
donor valve.
- Aortic valve replacement with a
mechanical valve.
Ongoing Care
Routine follow-up is important for adults
with aortic valve disease. Valve status
can change as patients age, regardless of
whether they have had catheterization or
valve replacement. All patients with congenital
aortic valve defects are at risk for bacterial
endocarditis,
an infection of the heart’s valves
or inner lining (endocardium). Before having
certain dental or surgical procedures performed,
it may be necessary to take preventive antibiotics.
Need an appointment? Request one online 24
hours a day, 7 days a week; or call 800-789-PENN (7366) to speak to a
referral counselor.
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