Aortic Stenosis

Dr. Patel explains what aortic stenosis is and how it can be treated.

 

What is aortic stenosis?

As a cardiologist or as a heart doctor, we deal with the blockages in the arteries, rhythm problems, and heart failure. Aortic stenosis affects the main exit valve, which is called the aortic valve. When we're born, the valve is paper thin. It opens and closes with every beat, every minute, every hour, every day, all of your life. As we age, this valve can have a build up of calcium. When this happens, rather than being paper thin, it becomes cardboard. So rather than opening all the way, it opens much less. Just imagine a door that's open all the way. Going through is very easy. If a door is only slightly open though and you're trying to get through, it's much harder or impossible. Aortic stenosis is a condition where the valve thickens with calcium and doesn't open, so you don't get enough blood flow to your body. It's just a pin hole. People feel tired. They feel fatigued. Some people will have chest pain. Some people will present when they pass out or will hear a murmur. We'll get an ultrasound, and it will see that thickened valve. That's called aortic stenosis.

How do you treat aortic stenosis?

Typically if aortic stenosis is there, we also want to make sure there are no blockages along with it. If they're young and healthy, they do very well with a surgery where we open up the chest, you replace the valve with a pig or metallic valve and also bypass the blockage at the same time. They do very well. Now in the last eight to 10 years, we have developed a new procedure where we don't have to necessarily open up the chest. With a catheter that is the size of your pinky, a new valve is clipped onto it. We go through the groin, position it across from that narrowed or diseased valve that's there, and put the new one right over it, expand it, and take the catheter out. We close the groin up with just a small stitch or a plug. People can sit up and walk the same day. There has been a lot of development in the last 10 years, particularly individuals who were 80, 85, or 90 years old or individuals who have lung disease where they weren't surgical candidates. We weren't treating them 15-20 years ago, but now we can easily treat them with a minimally invasive procedure, transcatheter aortic valve implantation.