Aortic Valve Disease

What is aortic valve disease?

Aortic valve disease is characterized by a damaged and dysfunctional aortic valve.  The aortic valve is one of four valves that control the flow of blood into and out of the heart.

The main function of the aortic valve, however, is to control the flow of oxygenated blood pumped out of the heart from the left ventricle into the aorta (the main artery of the heart that pumps blood to the rest of the body). 

Aortic valve disease can occur as a result of an infection, a congenital heart defect, rheumatic heart disease, or the aging process. 

Aortic valve disease in its early stages does not usually present any obvious symptoms.  However, as the disease advances it could produce shortness of breath, angina (chest pain), light-headedness, dizziness, and even fainting. 

Aortic valve disease can be broken down into two types:

Aortic stenosis (abnormally narrow aortic valve) 

Severe cases of aortic stenosis occur when the opening of the aortic valve becomes narrowed, which can be life threatening. When pressure builds up in the left ventricle, the heart can be injured. To prevent this, surgery is performed to replace the aortic valve, which may not be opening fully. Since the procedure is proven and safe, it is a fairly routine option in treating aortic stenosis.

Aortic regurgitation (backflow of blood if the valve does not close properly)

If blood is leaking through the valve and flows back into the left ventricle, it will lead to eventual heart failure. The heart must work harder and grow larger to handle the additional workload. This is known as aortic regurgitation or insufficiency. To correct this, surgeons will either alter the cusps of the valve so it will close tightly, preventing leakage, or they will replace the valve.

What is aortic valve replacement?   

Aortic valve replacement is a surgical procedure whereby a prosthetic valve is implanted in the place of a damaged aortic valve.

Aortic valve replacement is performed when aortic stenosis or aortic regurgitation becomes severe. Aortic valve replacement may be done with a mechanical valve (made of metal, polymers and other materials) or biological valve (made of donated human tissue or animal tissue).

Medical Management

While some medications can control the pain, reduce the stress on the heart or regulate its rhythm, there are no medications that can cure heart valve disease. However, there are some clinical trials in progress that are studying the use of statin drugs to either slow or halt the progress of aortic valve disease.

The following drugs can control some aspects of the disease:

ACE inhibitors: Expand the blood vessels, reduces blood pressure and decreases the heart’s workload.

Anticoagulant medicines: Prevent blood clots.

Beta-blockers: Control the heart rate and reduces blood pressure.

Calcium channel blockers: Can lower blood pressure and reduce the heart’s workload so heart valve surgery can be delayed.

Digitalis: Eases some of the symptoms and reduces the workload placed on the heart.

Diuretics: Removes excess sodium and fluid levels from the body, lowering blood pressure in the process. Diuretics can also reduce the workload on the heart and decrease swelling