The human heart has four valves—two on the left and two on the right. The aortic valve—the main outflow valve for the left heart—is the valve between the heart and the body. The aortic valve opens when the left ventricle squeezes to pump out blood, and closes in between heart beats to keep blood from going backward into the heart.
Normally, the aortic valve has three flaps (leaflets) that regulate blood flow by opening and closing, allowing blood to flow throughout your body.
Aortic valve disease occurs when the aortic valve doesn’t work properly; it either fails to close tightly (aortic regurgitation or insufficiency) or gets too tight (aortic stenosis).
TYPES OF AORTIC VALVE DISEASE
In a healthy aortic valve, valve leaflets open wide to let blood through and close tightly to keep it from going backward. The valve leaflets are thin and pliable.
There are two main types of aortic valve disease:
- Aortic Regurgitation (also known as aortic insufficiency) — the valve does not close completely, allowing blood to leak backward into the heart
- Aortic Stenosis — the valve is too tight and does not open enough to allow blood to leave the heart and spread to the body
Your doctor can usually diagnose aortic valve disease based on your medical history, risk factors, a physical exam, and with results from tests and procedures.
DIAGNOSIS AND TREATMENT OPTIONS
There is no one test that can diagnose aortic valve disease, so your doctor may recommend one or more of the following: electrocardiogram (EKG), echocardiogram (echo), chest x-ray, blood tests, and coronary angiography. For more information on these tests, visit our common diagnostic tests page.
Currently, NO MEDICATION can cure aortic valve disease, so it is most commonly treated with surgery.
Aortic stenosis can only be treated with aortic valve replacement. Sometimes, aortic valves that are leaking (regurgitant) can be repaired. Your Heart Team—you, your medical team, and your cardiothoracic surgeon—will determine the best treatment option for you based on your symptoms and test results. You can print these sample questions to use as a basis for discussion with your doctor.
You also can access the STS Risk Calculator, which can help calculate your risk of death or other complications from open heart surgery. The results can help you and your doctor to determine the best course of treatment.
SURGICAL TREATMENT OPTIONS FOR AORTIC VALVE DISEASE
Aortic Valve Repair
While the aortic valve is usually replaced, repair may be an option in certain cases.
Minimally invasive AVR is not appropriate for all patients, but your cardiothoracic surgeon will review the recommended approach to surgery that is safest for you based on your individual symptoms and circumstances.
Most aortic valve surgeries have a very low rate of complications; however, potential complications of all surgical options include bleeding, infection, irregular heart rhythm, need for a pacemaker, stroke, heart attack, or death.
Immediately after AVR surgery, you likely will have a tube in your throat so your breathing can be assisted by a ventilator.
The tube will be removed once you are able to breathe on your own. This usually happens within a few hours, but your cardiothoracic surgeon and Heart Team will determine when it is safe. You should anticipate spending several days, but likely not more than a week, recovering in the hospital, although the total length of time depends on your overall health, as well as the specific procedure you underwent.
Once you’re home, it may be several more weeks until you are able to go back to work. Everyday activities such as driving and lifting heavy objects may be restricted for a period of time. Typically, lifting and activity restrictions are 4-6 weeks for traditional AVR and 1-2 weeks for TAVR.
Blood thinning medication may be prescribed after surgery, but your need for this medication will be determined by your doctor.
After your wounds have healed, you should be able to get back to your normal activities. Always tell a doctor about your valve surgery before any medical procedure. In particular, you may require preventative antibiotics when having dental work.
Reviewed by: V. Seenu Reddy, MD, MBA, and Kendra J. Grubb, MD, MHA