Our Summary

Aortic valve stenosis is a type of heart disease where the valve that controls the flow of blood from the heart to the rest of the body starts to narrow, making it harder for the heart to pump blood. This is the most common reason for heart valve surgery or replacement in the United States, and it’s becoming even more common as the population ages. Recently, there’s been a big increase in a treatment called transcatheter aortic valve replacement. This is a less invasive procedure where a new valve is inserted into the heart through a small cut in the skin rather than through open-heart surgery. This increase is due to advancements in technology and successful clinical trials. This paper reviews the latest research on this procedure.

FAQs

  1. What is the most common primary valvular heart disease leading to valve replacement in the US?
  2. What has led to the rise in prevalence of aortic valve stenosis?
  3. What has caused the exponential rise in transcatheter aortic valve replacements in recent years?

Doctor’s Tip

One helpful tip a doctor might tell a patient about aortic valve replacement is to follow up regularly with their healthcare provider to monitor their heart health and ensure the valve replacement is functioning properly. It’s important to attend all scheduled appointments and screenings to catch any potential issues early on. Additionally, maintaining a healthy lifestyle with regular exercise, a balanced diet, and avoiding smoking can help support overall heart health and the success of the valve replacement surgery.

Suitable For

Aortic valve replacement is typically recommended for patients with severe aortic valve stenosis or regurgitation who are symptomatic and have evidence of left ventricular dysfunction. These patients may experience symptoms such as chest pain, shortness of breath, fatigue, dizziness, or fainting. Additionally, patients with severe aortic valve disease who are asymptomatic but have evidence of left ventricular dysfunction or significant valve deterioration on imaging studies may also be considered for aortic valve replacement. Patients with severe aortic valve disease who are undergoing other cardiac surgeries, such as coronary artery bypass grafting, may also undergo concomitant aortic valve replacement. The decision to recommend aortic valve replacement is made on a case-by-case basis by a multidisciplinary team of cardiologists, cardiac surgeons, and other healthcare providers.

Timeline

Before aortic valve replacement:

  • Patient undergoes diagnostic tests such as echocardiogram, cardiac catheterization, and stress tests to determine the severity of aortic valve stenosis.
  • Patient may experience symptoms such as shortness of breath, chest pain, fatigue, and dizziness due to aortic valve stenosis.
  • Patient may be prescribed medication to manage symptoms and prevent complications.
  • Patient meets with a cardiac surgeon and cardiologist to discuss treatment options and risks associated with aortic valve replacement.

After aortic valve replacement:

  • Patient undergoes surgery to replace the damaged aortic valve with a mechanical or bioprosthetic valve.
  • Patient is monitored in the intensive care unit post-surgery for a few days to ensure proper recovery.
  • Patient undergoes cardiac rehabilitation to regain strength and endurance.
  • Patient may need to take blood thinners or other medications to prevent blood clots and infection.
  • Patient follows up with healthcare providers regularly for monitoring and adjustments to medication as needed.
  • Patient gradually resumes normal activities and lifestyle, with improvements in symptoms such as improved energy levels and exercise tolerance.

What to Ask Your Doctor

  1. What are the risks and benefits of aortic valve replacement surgery versus transcatheter valve replacement?
  2. How long is the recovery time for each type of procedure?
  3. What are the success rates for aortic valve replacement surgery and transcatheter valve replacement?
  4. What are the potential complications or side effects of aortic valve replacement?
  5. How long can I expect the replacement valve to last?
  6. Will I need to take medication or make lifestyle changes after the procedure?
  7. Are there any restrictions on physical activity or diet following the procedure?
  8. How often will I need follow-up appointments after the procedure?
  9. What signs or symptoms should I watch for that may indicate a problem with the replacement valve?
  10. Are there any alternative treatment options for aortic valve replacement?

Reference

Authors: Jiang T, Hasan SM, Faluk M, Patel J. Journal: Curr Probl Cardiol. 2021 Mar;46(3):100600. doi: 10.1016/j.cpcardiol.2020.100600. Epub 2020 May 3. PMID: 32522375