Aortic valve disease common condition but it’s still serious

A noninvasive procedure improves patients’ chances.

The heart’s main job is to pump oxygen-rich blood throughout the body to the vital organs that help keep someone alive.

This important process, however, can be stunted when a person develops aortic valve disease, a condition that causes narrowing of the heart valve between the left ventricle and the aorta. Aortic valve disease affects the last valve through which the blood flows before it is carried to other parts of the body.

This narrowing of the valve restricts the blood flow through the vessel, and in some cases, causes the blood to leak back into the heart rather than leaving it. The disease is one of the most common and serious valve diseases, according to the American Heart Association (AHA).

“As stenosis (or narrowing) becomes more severe over time, it places more strain upon the heart,” said Vincent Nardy, DO, a cardiothoracic surgeon with Cardiothoracic Surgery Associates. “The more strain that is placed on the heart, the harder it has to work. Ultimately, this can lead to heart failure.”

Aortic valve disease is an age-related disease with about two percent of the population aged 65 and above developing it. The probability of a person developing the disease increases as they age. There is a small portion of individuals who develop the disease at a younger age. This is known as congenital aortic valve disease, meaning the narrowing is due to the way in which a person’s valves were shaped at birth.

“Other individuals who may develop this disease outside of being older in age are those who have certain diseases such as rheumatic heart disease, high cholesterol, hypertension, and kidney disease,” said Dr. Nardy, who practices with Premier Physician Network. “Certain lifestyle choices such as smoking also play a role.”

Not everyone who has aortic valve disease will experience symptoms until the amount of restricted blood flow becomes significantly reduced. Those who are symptomatic may experience breathlessness, chest pain, fainting, palpitations, a heart murmur or a decline in activity level. Some individuals may not complain of their symptoms, which is why it’s important for loved ones to take note of any decline in a loved one’s physical activities or an increase in fatigue, according to the AHA.

The disease is diagnosed through multiple steps, including looking at a patient’s family history, listening for a heart murmur, and conducting an echocardiogram. A person’s disease can be diagnosed as mild, moderate or severe. Determining the severity of the disease is an important first step, Dr. Nardy said.

“Patients who are in the mild or moderate category typically are treated with medication to help manage some of the risk factors,” he said. “Once you start progressing into more moderate to severe cases, we start looking at valve replacement procedures.”

A valve can be replaced through one of two procedures: surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR). Valve replacement is critical to patients who fall into the severe category because the five-year mortality rate for these patients becomes extremely high if nothing is done to correct the problem, Dr. Nardy said.

This is why the TAVR procedure is so important. TAVR allows surgeons and cardiologists to replace the valve in patients who otherwise could not withstand open heart surgery required with SAVR. TAVR is a less invasive procedure that allows surgeons access to the valve by entering the body through the arteries in the groin.

The procedure used to be available only to those who were too weak to undergo open heart surgery, but it is now an option for most patients who have developed severe aortic valve disease. This includes those who may need a second valve replacement for a previous replacement that may no longer work.

“Every patient is a unique case, which is why it’s important that they are evaluated through a collaborative effort of cardiologists and heart surgeons,” Dr. Nardy said. “This way a patient is given the most effective procedure to provide the best outcome for their health.”

In an emergency, a person should go to the local emergency room or call 911 immediately, as that is the safest way to get care in an emergent health situation.

Premier Physician Network is one of the largest groups of pediatrics, family medicine, internal medicine, and urgent care practices in southwest Ohio. For more information, go online to www. premierphysiciannet.com.