Treatment Options for Aortic Valve Stenosis

Aortic valve stenosis is a serious condition that requires prompt treatment, especially when the transvalvular pressure gradient exceeds 50mmHg. In severe cases, intervention is crucial to prevent complications such as heart failure, arrhythmias, and sudden cardiac death. For congenital aortic stenosis, less invasive options such as balloon valvuloplasty may be considered. Alternatively, open-heart surgery with valvotomy and valve repair can be performed, aiming to preserve the native valve structure while restoring proper function. These procedures focus on improving leaflet mobility so the valve can open more fully during systole.

Understanding Aortic Valve Function

The aortic valve serves as a critical gateway between the heart's left ventricle and the ascending aorta. Its primary function is to allow unobstructed blood flow from the heart into the aorta during systole and to prevent backflow during diastole. In a healthy individual, the aortic valve typically consists of three thin, flexible leaflets that open widely during ventricular contraction, ensuring efficient blood circulation.

Causes and Types of Aortic Stenosis

Aortic stenosis generally occurs in two main forms. The first is congenital, where the valve leaflets develop abnormally, often leading to thickening and fusion. This results in a smaller opening during heart contractions, restricting blood flow. The second type is more common in older adults and involves calcification and stiffening of the valve leaflets. Over time, calcium buildup reduces leaflet mobility, preventing the valve from opening fully and leading to progressive narrowing.

When the aortic valve becomes severely narrowed and cannot be repaired effectively, surgical valve replacement becomes the most viable treatment. This typically involves replacing the diseased valve with either a mechanical or biological prosthesis. The choice between these options depends on the patient's age, overall health, and lifestyle factors. Modern techniques such as transcatheter aortic valve replacement (TAVR) offer less invasive alternatives for high-risk patients, improving outcomes and recovery times.