Treatments - Aortic Stenosis

If the valve becomes very stenotic, severe pressure builds up in the left ventricle, which can damage the heart. When this occurs, the valve must be opened usually with one of the following techniques:

• in the catheterization lab with a balloon valvotomy catheter
• in the operating room by open-heart surgery (see below).
• In selected cases, the valve may be replaced by inserting a device via the vessels in the leg (percutaneous AVR). This technique is still in the developmental stage.

The aortic valve can usually be surgically replaced in one of three ways:

• The Ross procedure, an operation where the aortic valve is removed and replaced by the pulmonary valve. Then the pulmonary valve is replaced with a preserved donor pulmonary valve.
• Aortic valve replacement with a biological valve.
• Aortic valve replacement with a mechanical valve.

Each option has advantages and disadvantages. Discuss them with your cardiologist and/or cardiac surgeon.

Ongoing Care

Medical
Everyone with aortic valve disease needs routine follow-up. The severity of the valve problem will dictate how often to visit the doctor. Stenosis and insufficiency can change with age. Medical therapy usually doesn't help people with aortic stenosis. However, medications can help reduce leakage and maintain good functioning of the left ventricle in some patients with aortic valve insufficiency.

Activity Restrictions
If you haven't required aortic valve replacement but have ongoing valve stenosis or insufficiency, your cardiologist may tell you to limit your activity. For instance, heavy weightlifting and other extreme "isometric" exercises excessively strain your aortic valve and left ventricle. Depending on the state of your aortic valve, you may need to limit such exercise. Ask your cardiologist about your exercise limits.