Aortic Valve Stenosis 

Aortic valve stenosis or aortic stenosis is a disease that affects the aortic valve, which is one of four valves within the heart.

Usually, the valves help pump blood through the heart via tissue leaflets that open and close with each heartbeat. The leaflets make sure blood flows in the right direction through the heart’s four chambers and the rest of the body.

Aortic stenosis occurs when the aortic valve's leaflets stiffen and cannot open or close completely. As a result, the valve narrows (stenosis) and limits blood flow, or if the valve does not close, blood leaks into the heart, causing the heart to enlarge.

The narrowed opening of the valve causes the heart to work harder, and therefore the heart muscle thickens. As stenosis progresses, the heart does not work efficiently, resulting in more severe complications such as shortness of breath, chest discomfort, drop attacks or heart failure.

Aortic stenosis may be mild, moderate, or severe, depending on how much blood is blocked. The condition may get worse over time and may occur with other heart problems. You may need valve repair or replacement surgery. Severe aortic stenosis can lead to heart failure.

Moderate to severe aortic stenosis may affect the heart and blood vessels in these ways:

  • Over time, the left ventricle enlarges and can’t pump blood to the body very well.
  • The aorta may also become larger.
  • The coronary arteries that send blood to the heart muscle may not get enough blood.

The aortic valve is one of four heart valves that keep blood flowing through the heart in the correct direction. The four heart valves include: 

  • Aortic valve
  • Mitral valve
  • Pulmonary valve
  • Tricuspid valve

During every heartbeat, each valve’s leaflets (also referred to as cusps or flaps) should open and close once, acting as a one-way door that makes sure blood flows in the right direction through the heart’s four chambers and to the rest of the body. If a valve doesn’t properly open or close, blood flow can be reduced or blocked.

Causes and Symptoms of Aortic Stenosis

Aortic stenosis can have multiple causes and various symptoms ranging from mild to life-threatening depending on the patient’s age and severity of the blockage. For example, a child with mild aortic stenosis may have few or no symptoms but may begin experiencing symptoms in adulthood.

  • Aortic valve calcification (calcium buildup in the valve)
  • Congenital heart defect such as bicuspid aortic valve (the valve has only two cusps/leaflets instead of the usual three)
  • Progressive wear and tear of the aortic valve in the elderly 
  • Scarring of the aortic valve from rheumatic fever caused by untreated strep (rheumatic fever is rare in the United States now, but some older adults were affected by it)

Symptoms of aortic stenosis may include:

  • Abnormal heart sound (murmur) through a stethoscope
  • Bluish discoloration around the lips or skin indicating low oxygen levels (cyanosis)
  • Chest pain (angina), pressure or tightness with physical activity 
  • Dizziness or lightheadedness, especially with physical activity 
  • Fainting (syncope) 
  • Fatigue or tiredness, especially with physical activity
  • Irregular heartbeats or feeling the heartbeat (palpitations)
  • Not eating enough / not enough weight gain (mainly in children)
  • Shortness of breath or rapid breathing, especially with activity 

Severe aortic stenosis may lead to heart failure. Heart failure symptoms include fatigue, shortness of breath, and swollen ankles and feet. 

Treatments for Aortic Stenosis

Inova offers the full spectrum of treatment options for patients based on the severity of their disease and evaluation of their needs. 

Medication can be used as an early treatment to help control aortic stenosis symptoms but will not cure it.

Valve replacement is the most effective treatment for severe aortic stenosis. We offer the most advanced aortic valve replacement options available, including open surgical and minimally invasive techniques:

Balloon Valvuloplasty (minimally-invasive) if the aortic valve isn’t too damaged, balloon valvuloplasty can stretch the aortic valve to repair it.

Learn More about Balloon Valvuloplasty

Transcatheter Aortic Valve Replacement (TAVR) (minimally-invasive)
TAVR uses a catheter to insert a bioprosthetic valve through the skin to replace the original valve.

Learn More about TAVR

When patients cannot have TAVR, we replace the aortic valve surgically using: 
A biological valve typically created from swine or bovine tissue that can last 15 to 20 years. Blood-thinning medication is not needed as a result.

  • Mechanical titanium valves that can last more than 20 years. Patients who receive mechanical valves must take a blood-thinning medication to prevent blood clots for the rest of their lives.
  • A stentless tissue valve that widens the opening for enhanced blood flow.
  • A homograft valve from a donated human heart. It is best for patients with endocarditis, an infection of the heart valves.