Last Updated on November 27, 2025 by Bilal Hasdemir

At Liv Hospital, we know how complex heart conditions can be. Aortic stenosis is when the heart valve gets narrower, making it hard for blood to flow. We take a detailed approach to manage this condition.

We see that every patient’s story is different. Our team of experts works together to create tailored treatment plans. International guidelines suggest transcatheter aortic valve implantation (TAVI) for those over 70 or at high risk for surgery.

We’re dedicated to top-notch healthcare, supporting patients from around the world. We use the latest research and our knowledge to guide you through your care. This ensures you get the best treatment possible.

Key Takeaways

• Personalized treatment plans for aortic stenosis
• TAVI recommended for patients over 70 or high surgical risk
• Multidisciplinary approach to heart care
• World-class healthcare for international patients
• Combining expertise with the latest evidence

Understanding Aortic Stenosis: Causes, Symptoms, and Progression

It’s important to understand aortic stenosis to manage its symptoms and slow its progression. This condition is when the aortic valve narrows. This can cause serious heart problems if not treated.

What is Aortic Stenosis?

Aortic stenosis is a heart disease where the aortic valve narrows. This valve controls blood flow from the heart to the body. When it narrows, the heart has to work harder to pump blood. This can make the heart muscle thick and may lead to heart failure if not treated.

Common Causes and Risk Factors

The main causes of aortic stenosis are:

• Calcification of the aortic valve, often seen in older people
• Congenital heart defects, where the valve is abnormally formed
• Rheumatic fever, a complication of streptococcal infection that can damage heart valves

Factors that increase the risk of aortic stenosis include older age, being male, smoking, high blood pressure, high cholesterol, and diabetes. Knowing these risk factors helps in early detection and management.

Symptoms and Disease Progression

Symptoms of aortic stenosis can vary but often include chest pain, shortness of breath, and fatigue. As the condition gets worse, these symptoms can get worse too. In severe cases, it can lead to heart failure, arrhythmias, and even sudden death.

“Early diagnosis and treatment of aortic stenosis are critical to preventing long-term cardiac damage and improving patient outcomes.” –

A leading cardiologist

Managing symptoms is key in aortic stenosis care. Regular check-ups with a healthcare provider are important. They help track the disease’s progress and decide when to do surgery.

Diagnosing Aortic Stenosis: From Symptoms to Severity Assessment

Diagnosing aortic stenosis is a detailed process. It starts with noticing symptoms and ends with advanced imaging. Accurate diagnosis is key to choosing the right treatment. This could be medication or the TAVR procedure.

Initial Diagnosis and Physical Examination

The first step is a detailed medical history and physical exam. We look for symptoms like chest pain and shortness of breath. These signs can point to aortic stenosis.

During the exam, we listen for a heart murmur. This murmur is a key sign of the condition. It’s heard best at the second right intercostal space.

Diagnostic Testing and Imaging

To confirm the diagnosis, we use several tests. Echocardiography is the main tool. It shows the heart’s structure and function, including the aortic valve.

Doppler echocardiography measures blood flow across the valve. This helps us understand how severe the stenosis is.

We also use other tests to evaluate the condition. These include:

• Cardiac Catheterization: To check for coronary artery disease and measure pressure.
• Computed Tomography (CT) Scan: To look at the aortic valve and root, and check for coronary artery calcification.
• Magnetic Resonance Imaging (MRI): To measure the severity of aortic stenosis and check left ventricular function.

Grading Aortic Stenosis Severity

After confirming the diagnosis, we grade the severity of aortic stenosis. We look at the valve area, mean pressure gradient, and peak jet velocity. This helps us decide the best aortic stenosis treatment.

The severity is classified into four stages: normal, mild, moderate, and severe. Those with severe stenosis often need immediate treatment to prevent further damage.

The Evolution of Aortic Stenosis Treatment Approaches

Treatment for aortic stenosis has changed a lot over time. We’ve moved from old surgical methods to new, less invasive ways. This change is thanks to better understanding of the disease and new technology.

Historical Treatment Methods

Before, doctors mainly used medicine to manage symptoms of aortic stenosis. Surgery was not as common or effective. The start of surgical aortic valve replacement (SAVR) was a big step forward. It gave a solid treatment option for severe cases.

Early surgeries were risky and took a long time to recover from. But, SAVR became a key treatment for many. It helped save lives.

Modern Treatment Paradigms

Transcatheter aortic valve implantation (TAVI) has changed how we treat aortic stenosis. It’s a less invasive option for those at high risk or who can’t have open-heart surgery. TAVI cuts down on recovery time and lowers the chance of complications.

At the same time, surgery has gotten better. New, less invasive methods and advanced valve designs have opened up more treatment choices.

The Role of Multidisciplinary Heart Teams

The need for multidisciplinary heart teams has grown. These teams include cardiologists, surgeons, and imaging experts. They work together to find the best treatment for each patient.

They look at many things, like the patient’s health and how severe their aortic stenosis is. This way, they can create a treatment plan that fits each person’s needs. It helps improve care and results.

Treatment Option 1: Medical Management for Aortic Stenosis

Medical management is key in treating aortic stenosis. It focuses on controlling symptoms and improving heart function. This method is best for those who can’t have surgery or other treatments right away.

Medications for Symptom Control

Several medications help manage aortic stenosis symptoms. Diuretics help reduce fluid and ease heart failure symptoms like shortness of breath. ACE inhibitors or angiotensin receptor blockers (ARBs) control high blood pressure and reduce heart workload, but use them with caution.

Beta-blockers might be used to manage chest pain or irregular heartbeats. But, they must be used carefully to avoid making heart failure worse.

Limitations of Medical Therapy

Medical management can improve life quality and relieve symptoms. But, it’s important to know its limits. It doesn’t fix the valve problem and can’t stop the disease from getting worse.

As the disease gets worse, medical therapy might not work as well. Then, other treatments like surgery or a new valve might be needed. Regular check-ups with a cardiologist are key to knowing when to switch to these options.

A team effort is essential in managing aortic stenosis. Cardiologists, surgeons, and other experts work together. This ensures patients get care that fits their needs.

Treatment Option 2: Surgical Aortic Valve Replacement (SAVR)

For many patients with aortic stenosis, Surgical Aortic Valve Replacement (SAVR) is the best treatment. SAVR replaces the diseased aortic valve with a new one. This is done through open-heart surgery or less invasive methods.

Traditional Open-Heart SAVR Procedure

Traditional SAVR uses a sternotomy, opening the chest to reach the heart. This method has been used for decades and works well. The heart is stopped, and a heart-lung machine keeps blood flowing. Then, the old valve is replaced with a new one.

Minimally Invasive Surgical Approaches

Minimally invasive SAVR is a newer option compared to traditional surgery. It uses smaller cuts, which can lead to faster recovery. Different surgeons and hospitals use different methods, all aiming to be less invasive while keeping the procedure effective.

Valve Types and Selection Criteria

The choice between mechanical and bioprosthetic valves depends on several factors. These include the patient’s age, lifestyle, and other health conditions. Mechanical valves last longer but need lifelong blood thinners. Bioprosthetic valves don’t need blood thinners but don’t last as long. The choice is based on the patient’s specific situation.

Ideal Candidates for SAVR

SAVR is best for younger patients and those at low risk for surgery. It’s also recommended for those with severe aortic stenosis who are showing symptoms or have heart muscle problems. A heart team decides if SAVR is right for each patient, considering their health and the specifics of their condition.

Heart surgery can seem scary. But for many, SAVR greatly improves their quality of life and survival chances. Our team is dedicated to giving you the best care and support during your treatment.

Treatment Option 3: Transcatheter Aortic Valve Implantation (TAVI)

TAVI has opened new doors for treating aortic stenosis, mainly for the elderly or those at high surgical risk. It’s a groundbreaking, less invasive method compared to traditional surgery. TAVI, or transcatheter aortic valve replacement, is a key alternative for many.

The TAVI Procedure Explained

The TAVI process starts with a catheter inserted through an artery in the leg. It’s then guided to the heart. A new valve is then deployed to replace the old one. This is done under imaging, like fluoroscopy and echocardiography, for accurate placement.

Key benefits of TAVI include:

• Minimally invasive, reducing the need for open-heart surgery
• Shorter recovery times compared to traditional SAVR
• Less risk of complications for patients at high surgical risk

Access Routes for TAVI

TAVI can be done through different routes, but the most common is the transfemoral approach. This involves inserting the catheter through the femoral artery in the leg. Other routes, like transapical and transaortic, are less common.

Valve Types Used in TAVI

There are several valves used in TAVI, including balloon-expandable and self-expandable ones. The choice depends on the patient’s anatomy, the severity of aortic stenosis, and the doctor’s preference.

Ideal Candidates for TAVI

TAVI is best for those at high risk for surgery or deemed inoperable due to health issues. Age is also a factor, with TAVI often recommended for those over 70. A heart team decides if TAVI is right for each patient.

Knowing about TAVI, its benefits, and who’s a good candidate helps both patients and doctors make better choices for treating aortic stenosis.

Treatment Option 4: Balloon Aortic Valvuloplasty

Aortic stenosis treatment has evolved to include balloon aortic valvuloplasty as a viable option for certain patients. This procedure involves using a balloon to widen the aortic valve. This improves blood flow from the heart to the rest of the body.

Procedure Overview and Technique

Balloon aortic valvuloplasty is performed in a catheterization laboratory. We use a catheter, a thin, flexible tube, to deliver a balloon to the aortic valve. Once in position, the balloon is inflated to widen the valve opening.

The procedure is typically done under local anesthesia and moderate sedation to ensure patient comfort. The technique involves accessing the heart through an artery in the leg. We guide the catheter through the artery to the heart using imaging technologies like fluoroscopy.

The balloon is then positioned across the aortic valve and inflated to relieve the stenosis.

Benefits and Limitations

The primary benefit of balloon aortic valvuloplasty is its minimally invasive nature. This reduces the risk of complications compared to open-heart surgery. It is beneficial for patients who are at high risk for surgical complications or are not ideal candidates for surgical aortic valve replacement.

Yet, balloon aortic valvuloplasty has its limitations. The procedure may not be as durable as surgical valve replacement. The valve can become stenotic again over time. It is often used as a bridge to more definitive treatments like surgical aortic valve replacement or transcatheter aortic valve implantation.

Role as a Bridge to Definitive Treatment

For some patients, balloon aortic valvuloplasty serves as a temporary solution or a bridge to more definitive treatments. It can help alleviate symptoms and improve the patient’s condition. This makes them more suitable candidates for subsequent surgical or transcatheter interventions.

“Balloon aortic valvuloplasty can be a valuable tool in the management of aortic stenosis, particular for patients who are not immediate candidates for more definitive treatments.”

-Cardiologist

In conclusion, balloon aortic valvuloplasty is a valuable treatment option for aortic stenosis. It offers a less invasive alternative to traditional surgical methods. While it has its limitations, its role as a bridge to more definitive treatments makes it an important consideration in the management of this condition.

Treatment Option 5: Watchful Waiting and Lifestyle Modifications

Watchful waiting and lifestyle changes are good for some with aortic stenosis. This is true for those who don’t have symptoms or have mild ones.

Monitoring Asymptomatic Aortic Stenosis

For those without symptoms, regular checks are key. We suggest getting echocardiograms and health checks often. This helps us catch any changes early.

“Keeping an eye on asymptomatic aortic stenosis is vital,” says a top cardiologist. “Regular visits help us spot any issues and adjust treatment plans.”

Lifestyle Recommendations

Changing your lifestyle is important for managing aortic stenosis. We tell patients to eat well, stay active, and don’t smoke. A healthy lifestyle can help manage symptoms and slow the disease.

• Eat a diet full of fruits, veggies, and whole grains
• Do regular exercise like walking or swimming
• Use stress-reducing activities like meditation or yoga

When to Transition to Interventional Treatment

Even with watchful waiting, sometimes more treatment is needed. We watch for signs that it’s time for a more serious approach. This includes new symptoms or a worsening valve.

Choosing when to move to more treatment depends on many factors. These include the patient’s health, how severe their condition is, and what they prefer.

“The right time for intervention is important. We aim to act before symptoms appear or the condition gets worse,” says a cardiothoracic surgeon.

Recovery and Long-Term Care After Aortic Stenosis Treatment

The road to recovery after aortic stenosis treatment is complex. It includes immediate care and ongoing monitoring. We stress the need for a detailed care plan to get the best results.

Immediate Post-Procedure Care

After aortic valve repair or cardiac surgery for aortic stenosis, patients are watched closely in a recovery unit. We manage risks like bleeding or irregular heartbeats. We also focus on keeping the patient comfortable and stable.

Key parts of immediate care are:

• Keeping an eye on vital signs
• Managing pain
• Stopping blood clots in deep veins
• Moving patients early to avoid problems

Rehabilitation and Activity Guidelines

Rehab is key to getting back to normal. We give personalized advice on what activities to do and how to exercise. This helps patients recover smoothly.

Long-Term Monitoring and Follow-Up

Long-term care is vital for those who’ve had aortic valve repair or cardiac surgery for aortic stenosis. Regular check-ups help us keep an eye on the patient’s health. We adjust medications and address any issues quickly.

Managing Anticoagulation and Other Medications

Patients might need to take blood thinners and other meds after treatment. We teach them how to manage these, including dosage and side effects. It’s important to stick to the treatment plan.

By sticking to a detailed recovery and care plan, patients can do well after aortic stenosis treatment. Our team is dedicated to supporting them every step of the way.

Conclusion: The Future of Aortic Stenosis Treatment

The field of heart medicine is growing fast, and so is the treatment for aortic stenosis. New options like Transcatheter Aortic Valve Replacement (TAVR) and Surgical Aortic Valve Replacement (SAVR) are making a big difference. These advancements are helping patients get better faster.

Looking ahead, the future of treating aortic stenosis is bright. More research is underway to make these treatments even better. We’re moving towards less invasive methods, like TAVR, which means patients can recover quicker and with similar results to traditional surgery.

We’re all about giving the best care to those with aortic stenosis. By keeping up with the latest in treatment, we make sure patients get the best care for their condition. This is our commitment to you.

The growth of TAVR and other treatments will be key in the future of aortic stenosis care. We’re here to provide top-notch healthcare, helping patients from around the world on their path to recovery.

References

European Society of Cardiology (ESC): Guidelines for the Management of Valvular Heart Disease

European Heart Journal (Oxford Academic): Advance Article Abstract on Cardiovascular Research (Specific DOI)