What is Aortic Valve Stenosis?

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Aortic valve stenosis is a disease in which the aortic valve cannot be fully opened during systole due to congenital or acquired factors. Aortic valve disease accounts for a large proportion of hospitalized patients, but only a small number of patients with simple disease, often combined with other valve disease. Aortic valve stenosis is a disease that develops slowly and has a long asymptomatic period, but the prognosis is poor. After heart failure occurs, the condition will deteriorate rapidly and even lead to sudden death of the patient.

Treatment of aortic stenosis

For the disease of aortic valve stenosis, conservative medical treatment has a high mortality rate, and surgical treatment can be cured.

The key to surgical treatment of the disease is to relieve aortic valve stenosis and reduce the pressure gradient across the valve. Commonly used surgical methods are:

1.Aortic valve commissure dissection under direct vision. It can effectively improve hemodynamics, and the operative mortality rate is less than 2%, but after more than ten or twenty years, valve calcification and restenosis can occur, requiring reoperation. This surgical treatment is suitable for children and adolescents with congenital aortic valve stenosis without calcification, who have symptoms; or who are asymptomatic but have significant left ventricular outflow tract stenosis; normal cardiac output but the maximum systolic pressure gradient exceeds 50mm.

2.Percutaneous aortic valve balloon dissection. Can immediately reduce the transvalvular pressure difference, increase cardiac output and improve symptoms. The indications for this procedure are: children and young adults with congenital aortic stenosis, inoperable patients, severe stenosis life-threatening, marked stenosis with severe left ventricular dysfunction in preoperative transition.

3.Artificial valve replacement. The indications for this procedure are: severe aortic stenosis; calcific aortic stenosis; aortic stenosis with insufficiency. The long-term effect of surgery before the onset of clinical symptoms is better, and the mortality rate of surgery is lower. Prosthetic valve replacement should be performed as soon as possible even if clinical symptoms such as angina pectoris, syncope, or left ventricular decompensation are present. Although surgical risk is relatively high, symptom improvement and long-term outcomes are better than nonsurgical treatment. When aortic valve stenosis is complicated with coronary artery disease, aortic valve prosthetic valve replacement and coronary artery bypass grafting should be performed at the same time.

In addition, medical treatment of the disease should allow patients to properly avoid excessive physical labor and strenuous exercise, prevent infective endocarditis, and regularly follow up and review echocardiography.

All in all, the mortality rate of heart disease is so high, not only the patients, but also the normal population should have a sense of vigilance. It is always better to treat this disease sooner rather than later. If the disease is diagnosed, it is very important to be admitted to the hospital as soon as possible.