A Guide to Treatments for Aortic Stenosis

Medically Reviewed By Uzochukwu Ibe, MD, MPH

The aortic valve controls the flow of blood from the heart to the bloodstream. If the valve opening narrows, it results in a condition called aortic stenosis. Doctors can treat the condition with procedures like aortic valve replacement or balloon valvuloplasty. Your blood enters and exits each chamber via your valves, which open and close to control blood flow and keep the blood going in one direction. When the opening of the aortic valve narrows, the blood flow through the valve slows, and your heart reacts by pumping harder as it tries to compensate.

Read on to learn more about the treatment options for aortic stenosis.

Surgical aortic valve replacement

A paper cutout of the human heart
Yaroslav Danylchenko/Stocksy United

Surgical aortic valve replacement (SAVR) is a type of open heart surgery and one of the standard treatments Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for aortic stenosis. SAVR is a major procedure performed under general anesthesia, allowing doctors to replace the aortic valve.

After your cardiac surgeon makes an incision down the center of your chest, your breastbone is divided so your surgeon can access your heart. The narrowed aortic valve is removed, and the replacement is inserted.

The surgery can take a few hours, and recovery may take a long time. Not everyone will be a candidate for this procedure. Depending on your situation, your doctor may decide on another treatment option.

Learn more about what to expect after heart valve repair.

Transcatheter aortic valve replacement

Transcatheter aortic valve replacement (TAVR) is a less invasive procedure that can replace Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source open heart surgery for some people. It may also be called transcatheter aortic valve implantation (TAVI).

This procedure was previously approved only to treat patients at intermediate or high risk of complications from open heart surgery. However, doctors may now use it to treat those with severe, symptomatic aortic stenosis, even if they’re at low risk of complications.

TAVR can be done with or without general anesthesia.

First, your doctor will make a small incision in your groin to reach an artery, most commonly Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source the femoral artery. The doctor will then insert a long tube called a catheter into the incision and thread it up through your artery to your heart and the aortic valve.

The doctor will insert a new valve over the old one using the catheter. The new valve will immediately push the old valve’s flaps out of the way and begin working. The replacement valve may be synthetic or biologic, made from human or animal tissue.

Recovery from this procedure is generally shorter than the recovery period for SAVR.

Learn more about foods for heart health after TAVR.

Balloon valvuloplasty

This procedure opens the narrowed valve as opposed to replacing it. It’s done the same way as TAVR, through a catheter threaded to your heart.

A balloon is inflated when the catheter reaches the aortic valve, pushing the opening wider. Because the effect of the balloon valvuloplasty isn’t permanent and the narrowing usually returns, it may be done Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source to allow for more time before valve replacement.

Determining your treatment path

If you’ve been diagnosed with aortic stenosis, your cardiologist will determine how severe your condition is to direct your treatment.

Replacing the valve is necessary to treat the condition, as no medications can manage Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  or slow down the narrowing. However, your cardiologist may prescribe medications to treat related issues, such as high cholesterol or high blood pressure.

In many cases, the valve isn’t replaced until an individual experiences symptoms and the aortic stenosis is considered severe. Common symptoms include shortness of breath, fatigue, and chest pain.

If you don’t have symptoms yet, but your doctor has noticed your valve is narrowing, you will likely have regular checkups and echocardiograms of your heart to monitor the stenosis. If you’re experiencing symptoms, talk with your doctor about valve replacement as soon as possible.

Learn more about symptoms to never ignore if you have aortic stenosis.

Care after valve replacement

If you’ve had a mechanical valve implanted, the likelihood of it failing is small. Still, you may be at risk for developing blood clots. To reduce this risk, your doctor may prescribe Trusted Source AHA/ASA Journals Peer reviewed journal Go to source anticoagulants, or blood thinners. Biologic valves have a higher failure rate over the long term, but the risk of blood clots is lower.

Speak with your doctor about your options. They can help you understand the risks and benefits so you can understand which type of procedure and valve is right for you.

Learn more about the outlook and life expectancy for people with aortic stenosis.

Summary

Doctors may treat aortic stenosis with procedures like SAVR, TAVR, or balloon valvuloplasty. Depending on their situation, some people may be candidates for some procedures but not others.

Talk with your doctor about aortic stenosis treatment options that may be right for you.

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  1. Kleczynski, P., et al. (2021). Balloon aortic valvuloplasty for severe aortic stenosis as rescue or bridge therapy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8538854/
  2. Mahmaljy, H., et al. (2022). Transcatheter aortic valve replacement. https://www.ncbi.nlm.nih.gov/books/NBK431075/
  3. Otto, C. M., et al. (2020). 2020 ACC/AHA guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000923
  4. Overview: Aortic valve replacement. (2021). https://www.nhs.uk/conditions/aortic-valve-replacement/
  5. Pujari, S. H., et al. (2022). Aortic stenosis. https://www.ncbi.nlm.nih.gov/books/NBK557628/
  6. Tsigkas, G., et al. (2018). Transcatheter versus surgical aortic valve replacement in severe, symptomatic aortic stenosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5803541/

Medical Reviewer: Uzochukwu Ibe, MD, MPH
Last Review Date: 2023 May 9
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