Heart & Vascular

Aortic Stenosis

Aortic stenosis (hardening of the aortic valves) can be a problem that develops as the result of a birth defect or, more commonly, that occurs with age. It is harmful to your health in several ways. The heart has to work harder which can cause it to weaken. And, if blood doesn't flow easily through the narrowed valve it can build up in the heart chambers, sometimes even backing up into the lungs.

At Carilion our cardiovascular surgeons treat a high volume of patients with aortic stenosis and have the expertise to handle the most complex cases. We are proud to be one of the only hospitals in western Virginia that is able to treat patients with severe aortic stenosis with an effective, potentially life-saving minimally invasive procedure calledTrans-catheter Aortic Valve Replacement (TAVR), also referred to as TAVI (implantation). The catheter-based procedure avoids some of the risks associated with conventional surgical aortic valve replacement.

Symptoms of aortic stenosis include:

Aortic Stenosis

Above is a diagram explanation of how Aortic Stenosis effects the heart.

  • Shortness of breath with exertion
  • Chest pains/pressures with exertion
  • Leg swelling
  • Lightheadedness or loss of consciousness (syncope)

Tests used to diagnose aortic stenosis include:

  • Physical exam, to listen for the characteristic heart murmur heard during the contracting phases of the cardiac cycle (systole)
  • Echocardiography, a heart ultrasound test to measure the severity of the narrowing and look for problems with the other heart valves and the function of the pumping chambers.
  • Heart catheterization, an invasive procedure used to evaluate the severity of the narrowing. This is done as a same day procedure in the cardiac catheterization.
  • Transesophageal echocardiography, an invasive procedure looking at the heart with an ultrasound probe in the esophagus. This is typically done as a same day procedure with a heart catheterization.

Treatment options for aortic stenosis include:

  • Open aortic valve replacement, which is considered the gold standard treatment for aortic stenosis, delivering excellent short- and long-term results
  • Transcatheter aortic valve replacement/implantation (TAVR/TAVI), a new, less invasive treatment strategy reserved for high risk or inoperable patients
  • Balloon aortic valvuloplasty, an alternative for patients without other options, this is a minimally invasive procedure that temporarily opens the valve, relieving the obstruction and improving symptoms
  • Medical management with medications to treat symptoms of aortic stenosis, including diuretics to eliminate excess fluid