General Information About Aortic Valve Stenosis
Disease Details and Frequently Asked Questions
It is the calcification and freezing of the hinges of the main exit door (Aortic Valve) that allows the heart to shoot blood to all organs (and the brain), narrowing the door to leave only a tiny gap (slit).
The biggest cause is Old Age (Calcification). After the age of 65, just like the calcification of joints, the valves also turn to stone with calcium accumulation.
The biggest cause seen in young people is the Congenital Bicuspid Aorta (the valve being born with 2 leaflets instead of 3), which deteriorates early (in the 40s). In addition, Acute Rheumatic Fever (Heart Rheumatism) caused by throat infections during childhood causes the valve to stick together and narrow over the years.
While the stenosis is mild, there are no complaints. When the valve area drops below 1 cm² (Critical stenosis), three classic symptoms COME SHOUTING:
1. Angina (Chest Pain): Because the heart muscle has thickened, its own blood is insufficient; the patient feels a stabbing pain in their heart (like a heart attack) while walking.
2. Shortness of Breath: Blood pools in the lungs; the patient cannot climb stairs and feels like they are suffocating.
3. Syncope (Fainting): This is the most critical one! When the patient exerts effort (walking up a hill), because the blood going to the brain cannot pass enough through that narrow door, the patient suddenly loses consciousness and COLLAPSES (Faints). Most of those who do not have surgery after these symptoms start die from Sudden Cardiac Arrest within 2-3 years.
When the doctor listens to the heart with a stethoscope, they hear a very loud (turbulent) MURMUR (hissing) sound made by the blood as it forcefully squirts through that tiny hole. The Gold Standard is Echocardiography (Heart Ultrasound). The ECHO sees the calcification on the valve, calculates the opening area of the valve millimeter by millimeter, and measures the blood's passage speed (pressure) to CONFIRM the degree of the stenosis (Mild, Moderate, Severe).
In the past, the elderly and very sick were left to die because they could not withstand open surgery. TAVI (Transcatheter Aortic Valve Implantation) IS ONE OF THE BIGGEST REVOLUTIONS IN MEDICINE.
The chest IS NOT CUT open, the heart IS NOT STOPPED. While the patient is awake (or in a light sleep), the inside of the heart is reached with a wire through the artery in the groin. At the end of the wire is a deflated 'Biological Bovine Pericardium Valve'. When it reaches the exact center of that calcified, broken valve, the balloon is inflated; the new valve opens like an umbrella, crushes the narrow door, and sits in its place. The procedure takes 1 hour, and the patient walks home 2 days later with a completely healthy new heart.
If the patient is very young (under 70) and not suitable for TAVI, the Gold Standard is Open Heart Surgery (Valve Replacement/AVR). The chest is opened, and the heart is connected to a heart-lung machine. The broken, calcified valve is cut out and thrown away. Depending on the patient's age, a Mechanical (Metal) Valve or Biological (Animal) Valve is sewn in its place. Those who receive a metal valve must use blood thinners for life.
Our health library contents are prepared for informational purposes only and with scientific data available at the time of recording. For all your questions, concerns, diagnosis, or treatment regarding your health, please consult your doctor or a healthcare institution.
