
Know about Aortic Valve Stenosis (AS)
Complete knowledge about any disease is important! Aortic Stenosis (AS) is one of common heart valve disease that occurs due to shrinking, narrowing and calcification of the aortic valve. This leads to mechanical obstruction for the blood that is ejected out by the main chamber of the heart.
The heart then needs more effort to pump out blood against this narrowed valve. The heart muscle starts tiring because of increased work and consequentially, the pumping capacity decreases and heart starts failing to pump adequate amount of blood to the vital organs. The patient then starts getting symptoms of chest pain, shortness of breath and dizzy spells.
This disease is generally caused due to aging of the valve and presents beyond the age of sixty years. More than 50% cases fall in this category. With better mean survival age of ours, the geriatric population will increase in coming years of life and more of this disease will be encountered in the population . Other causes are calcification of a congenital defective aortic valve that constitutes 30-40% of cases and present with symptoms between 4th to 6th decades of life. Infants and children can also have this problem with symptoms at young age itself. There are also some rare causes that includes Fabry disease, Paget disease, Lupus Erythematosus, metabolic disorders and some infections.
Early detection, follow up and needful treatment can be best sorted out at our "Center of Valve therapy" dedicated for Heart Valve treatment.
What are the symptoms of AS?
- Breathlessness with exertional activities like faster walking or climbing stairs.
- Chest pain, choking or feeling heaviness in chest with exertional activities, more than the routine.
- Palpitations or a feeling or pounding heartbeats
- Dizzy spells and of black outs or passing out like sensation
- Detected on a screening test for non-cardiac surgery clearance or a heart murmur heard by a doctor
If you observe any of these above, how do you proceed next?
- Get yourself examined clinically by a physician or a cardiologist.
- Consult your physician and get an ECG and Echocardiography done.
- Normal echo would rule out the Aortic Stenosis.
- If echo confirms this problem, then consult the cardiologist to know how severely narrowed the valve is and,
- If it needs to be replaced, understand the options available for replacement.
In case you don't have any symptoms despite the condition being diagnosed, visit the cardiologist at Center of Valve therapy for further guidance, tests and needful advise.
You will be subjected to some more tests eg stress test, serial echos and the exact severity of your disease will be discussed and guidance on required treatment will be offered. In case one is advised to be under follow up, "Centre of Valve therapy" would do the best follow up.
What is the treatment of Aortic Stenosis?
Transcatheter Aortic Valve Replacement (TAVR) is the treatment of Aortic Stenosis and it is a minimally invasive catheter-based angioplasty like interventional technique to implant a transcatheter tissue valve to treat heart valve disease under X-Ray visualization in the Cath lab. It is a nonsurgical procedure that helps to treat this heart valve disease. Conventionally it is done through the groin artery and sometimes through alternate arteries.
The new valve is called "Transcatheter heart valve" which is a tissue valve with very good durability and does not need powerful blood thinner medicines . It is implanted with the help of a very innovative catheter based delivery system.
TAVR is safe, but none the less some manageable complications can rarely happen as seen with any treatment modality. After the procedure the patient is ready to be discharged in the next two days of time.
Patients undergoing TAVR have a great mental comfort of not having their chest opened surgically and no requirement of long convalescence period as happens in conventional open-heart surgical valve replacement.
TAVR in the beginning had approval for inoperable and high operability mortality risk patients needing valve replacement, but today enough scientific data is available supporting the technique for patients who have intermediate and low operability risk.
Patient's choice of therapy for valve replacement should be respected in choosing TAVR over an open heart surgical replacement in the light of many studies showing equally good results.