Aortic Valve Disease
The aortic valve is one of four valves in the heart. A healthy aortic valve is like a one-way door that opens to let blood leave the heart chamber (left ventricle) and closes to stop blood from flowing back into it.
There are two types of aortic valve disease:
- Aortic regurgitation
- Aortic stenosis
Aortic regurgitation, also known as aortic valve regurgitation, is a type of valve disease in which the valve does not close properly in between each heartbeat. Each time the lower-left heart chamber (ventricle) relaxes, blood leaks back into it through the aortic valve. This leaking may increase the pressure in the left ventricle. Over time, the heart chamber can get bigger, making it harder for the heart to pump blood. Regurgitation can also weaken the aorta and lead to an aortic aneurysm. As people age, aortic valve tissue can weaken, which can lead to aortic regurgitation. Other common causes of this condition include high blood pressure, endocarditis, valve injury or a condition where someone is born with only two aortic valve cusps (biscuspid valve) instead of the normal three cusps.
Aortic stenosis, or aortic valve stenosis, is a serious heart condition resulting from a narrowing of the aortic valve. As a result of this narrowing, it is more difficult for the heart to pump blood out and the heart gradually grows weaker, which could lead to heart failure and possibly death. Aortic stenosis can be caused by calcium buildup, the presence of a bicuspid aortic valve or less commonly by a history of rheumatic fever.
Aortic valve disease is a common yet serious condition. The following factors can contribute to aortic valve disease.
- As people age, calcium or scar tissue builds up on the aortic valve. Over time, the valve can thicken and become stiff.
- Some cases are congenital, meaning valves do not form properly at birth (biscuspid valve).
- Rheumatic fever can be a cause, resulting in valve scarring.
- Infective endocarditis (also known as bacterial endocarditis) is an infection of the valve.
- High blood pressure (hypertension) also can contribute to aortic valve disease.
Untreated aortic valve disease can result in heart failure, severe infection and even sudden death.
Symptoms of Aortic Valve Disease
Not all patients with aortic stenosis or aortic regurgitation have apparent symptoms. When aortic valve disease is severe, the following symptoms may appear:
- Chest pain, pressure or tightness
- Dizziness or fainting
- Palpitations, noticeable heartbeats or a heavy, pounding feeling in the chest
- Fatigue and lower activity levels than usual
Diagnosing and Treating Aortic Valve Disease
Physicians at Houston Methodist use several tests and procedures to diagnose aortic valve disease:
- Physical exam
- Listening to your heart with a stethoscope
- Electrocardiogram (EKG)
- Chest X-ray
- Echocardiogram (also called an echo)
- Cardiac catheterization
- Stress testing
- Cardiac magnetic resonance imaging (MRI)
In patients with mild aortic valve disease, treatment may involve medications, lifestyle changes (such as diet, exercise and quitting smoking) and routine monitoring. In patients with severe aortic valve disease, treatment usually involves open surgery or catheter-based intervention to repair or replace the valve. A transcatheter aortic valve replacement (TAVR) procedure may be recommended, where a bioprosthetic valve is implanted using a catheter.
The heart team at Houston Methodist is a leader in performing TAVR for patients who are at least at moderate risk for surgical aortic valve replacement. More than 30 percent of the aortic valve procedures our specialists perform are by catheter rather than open surgery, which can keep patients out of the intensive care unit, improve recovery times and reduce hospital stays.
In addition, Houston Methodist has been selected to participate in several different FDA-approved clinical trials to study the treatment of aortic stenosis by transcatheter aortic valve replacement (TAVR) using the newest valve devices and implantation techniques.
Perhaps the best way to learn about our valve specialists is through our patients. We invite you to read these inspiring stories.
- Jesse Aldrich, a WWII Veteran, wins another battle with a transcatheter aortic valve implantation (TAVI).
- Rose Joubert is back to singing and cooking after a successful heart valve repair for aortic valve stenosis.
- Gilbert Swagger is back on the farm after an aortic valve replacement.
- J. Rob Walker is an active senior through the help of a new valve replacement through TAVR.