Valvular heart disease (aortic valve stenosis)
This is a narrowing of the opening of the aortic valve. It is due to abnormalities or aging of the valve.
About 5% of heart defects are due to aortic valve stenosis. However, there may be many cases that are not diagnosed. It is likely that this is the most common cardiac defect.
The normal aortic valve has three moving cusps that move flexibly to control the flow of blood from the left ventricle into the aorta.
The bicuspid aortic valve is the most common congenital heart defect. It is estimated to exist in 1 to 2 % of the population, predominating in males.
Symptoms of aortic stenosis
Severe narrowing may cause chest pain or feeling a loss of consciousness with activity. Usually aortic stenosis occurs in adult life and the valve becomes progressively narrowed over years.
Aortic Stenosis can also occur in infancy and childhood.
Causes of aortic stenosis
The narrowing may occur in the valve, below it or above it.
Diagnosing aortic stenosis
An echocardiogram is used to assess the aortic valve and can measure the severity of the narrowing +/- leak, abnormalities of the other heart valves as well as the left ventricle.
An electrocardiogram (ECG) can show changes and signs of thickening of the left ventricle.
An X-ray may show a widening of the aorta as it rises.
Treating valvular heart disease
Treatment will vary depending on the severity of the problem. Severe aortic stenosis is treated by an operation to replace the valve. If the patient is deemed to be high risk for open heart surgery then a keyhole procedure (TAVI) may be preferable. TAVI has compared favourably against conventional surgery in a randomised trial.