What causes aortic valve disease?
The aortic valve is the main outflow valve from the left sided pumping chamber of the heart (the left ventricle). The left ventricle pumps blood to the brain and the rest of the body (including the kidneys, liver, arms and legs) through the aortic valve. The aortic valve is a normally a thin, flexible structure with three leaflets that opens to let blood through and closes to stop blood coming back (acting as a one-way valve).
When the aortic valve narrows this is termed ‘aortic stenosis’ (see Figure 1 below) and when it leaks it is called ‘aortic regurgitation’ or ‘aortic incompetence’. This can occur for many reasons:
- Part of the ageing process
- Related to genetic / inherited factors
- Abnormalities from birth (such as a ‘bicuspid valve’) that are associated with premature wearing out of the valve
- Traditional cardiovascular risk factors such as diabetes, high blood pressure, high cholesterol and tobacco smoking
- Infections include Rheumatic fever
- Previous radiation therapy to the chest
- Degeneration of previously placed surgical aortic valve replacement
What treatments are available?
Treatment of aortic valve disease has several potential management options. Once aortic valve disease is advanced (and this assessment is made by your treating doctors, including your general practitioner, your cardiologist in addition to other treating specialists) the outlook can be poor without an intervention such as TAVR / TAVI or surgical aortic valve replacement (SAVR).
However, and importantly, for less advanced disease the most appropriate treatment is often ongoing medication treatment and close observation by your care team. Also of special note, the assessment and exploration potential management options are performed by your treating doctors.
One potential management option for the treatment of aortic valve disease for patients who at elevated risk of complications because of co-existent health conditions and or advanced age is transcatheter aortic valve replacement / implantation (TAVR / TAVI).
Figure 1: Aortic stenosis (narrowing of aortic valve akin to a narrowing hose nozzle)