Treatment Options for Aortic Valve Stenosis

Understanding Mild Aortic Stenosis

For patients diagnosed with mild aortic valve stenosis, symptoms may be minimal or even absent. In such cases, regular monitoring is typically recommended. Follow-up appointments should occur at least every six months, or more frequently—every three to six months—if the patient's condition allows for closer observation. Some individuals may remain stable for years without significant changes. However, over time, the heart's left ventricle may begin to thicken (a condition known as left ventricular hypertrophy), and electrocardiogram (ECG) readings may show increased ventricular voltage. Some patients may also experience fatigue or shortness of breath during physical exertion, such as climbing stairs or engaging in more intense physical activity.

Moderate to Severe Stenosis Without Symptoms

When moderate aortic stenosis is diagnosed, decisions regarding treatment are often based on objective measurements rather than symptoms. Many patients with moderate stenosis feel perfectly fine and experience no discomfort. However, if an echocardiogram reveals a transvalvular pressure gradient exceeding 50 mmHg, 60 mmHg, or even reaching above 70 mmHg, further intervention may be necessary. Normally, the velocity of blood flow through a healthy aortic valve measures below 1.5 m/s. When this velocity increases beyond 3 m/s or even 4 m/s, it indicates significant narrowing of the valve. In addition, increasing ventricular voltage on ECG may signal worsening heart strain. Since echocardiography is non-invasive and can be repeated safely, it is a valuable tool for tracking disease progression.

Managing Severe Aortic Stenosis

Severe aortic valve stenosis requires prompt medical attention. If left untreated, it can lead to serious complications including heart failure, arrhythmias, or sudden cardiac death. In most cases, surgical intervention is necessary. This typically involves aortic valve replacement (AVR), which can be performed using either traditional open-heart surgery or minimally invasive techniques such as transcatheter aortic valve replacement (TAVR). The goal is to restore normal blood flow from the heart to the rest of the body and to prevent life-threatening complications.

Conclusion

Whether you're dealing with mild, moderate, or severe aortic valve stenosis, early diagnosis and appropriate management are crucial. Regular follow-ups, accurate measurements, and timely intervention can significantly improve outcomes and quality of life. Always consult with a cardiologist or cardiac surgeon to determine the best treatment plan for your specific case.