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Disease and treatment of the Aortic Valve

Posted by Xanit Internacional Xanit Internacional | Posted in cardiology with heart | Posted on 16-02-2017

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Today we are entering the world of Cardiology. We are speaking to Dr. Gómez Doblas, Head of the Heart Unit at Vithas Xanit International Hospital, who will be discussing the aortic valve.  One of 4 heart valves, the aortic valve communicates between the left ventricle and the aorta and is responsible for one of the most commonly occurring cardiovascular problems amongst the general population.

According to the specialist, the problems which can occur in this valve are:

  • Stenosis (poor opening)
  • Regurgitation (poor closing)

Aortic stenosis is currently the most common valve disease in our country due to a process of valve calcification, especially in the elderly.

How is an Aortic Valve problem identified?

Mainly on auscultation by a Cardiology Specialist and by having an echocardiogram for assessment of any significant abnormality, such as aortic stenosis.

What are the symptoms?

Severe aortic stenosis manifests itself with three symptoms:

  1. Heart failure, generally with dyspnoea on exertion
  2. Loss of consciousness with exertion
  3. Chest pain on exertion.

When these symptoms appear they are indicative that there is a valve problem.

 

What is the cause of this disease? Is it genetic?

The cause in the majority of cases is degenerative, that is to say, due to age. But when we find it in younger patients it is often because the aortic valve has been deficient since birth. Instead of being a valve with three leaflets it only has two, this is known as a Bicuspid Aortic Valve. With these congenital valve abnormalities the valve becomes damaged earlier and gives symptoms at an earlier age.

 

 

Can it be treated?

Treatment will depend on age and other concomitant diseases (diseases which occur during the same period of time). As a general rule it is treated by “valve replacement.” But in patients who have a high surgical risk, or who are very elderly, it can be treated with percutaneous, transcatheter prosthesis implantation, with no need for surgery (a procedure known as TAVI).

 

What is the permanent solution?

Normally treatment with medication only achieves a temporary improvement in symptoms. Definitive treatment is always surgical or with transcatheter prosthesis implantation (TAVI).

If the prosthesis implanted is mechanical it can last a lifetime with appropriate anticoagulation. In the case of a bioprosthesis, the prosthesis can last from 10 to 12 years.

Lifestyle modification

As with any valve disease it is important to avoid salt consumption, lose weight and perform moderate exercise as well as to avoid smoking and follow a healthy diet.

What survival rates can be achieved?

Both surgery and TAVI have low perioperative mortality, except when there is significant concomitant disease affecting the patient’s life.

Is post-operative monitoring required?

Yes, any type of prosthesis requires at least yearly monitoring with an echocardiogram.

Is exercise beneficial?

Always, it just has to be adapted to the patient’s ability and condition. It is especially beneficial after Aortic Valve Replacement to maintain good postural tone and adequate functional capacity.