Procedure

Aortic Stenosis Treatment- Cardiology

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Doctors: Cardiologist, cardiothoracic surgeon

What is aortic stenosis?

Aortic stenosis is the utmost predominant valvular heart disease. Aortic stenosis occurs when the heart's aortic valve becomes narrow. This narrowing of the aortic valve decreases or blocks blood flow from heart into the aorta. Hence, the blood supply to rest of the body gets also decreased or blocked.

What are the treatment options?

Depending on the patient’s condition, the treatment of aortic stenosis is decided. Treatment options include medical treatment as well as surgical treatment.

Medical treatment: It includes different types of medicines.

  • Statins: They help to lower low-density lipoprotein (LDL) cholesterol which is also known as “bad” cholesterol
  • Angiotensin converting enzyme (ACE) inhibitors: These medicines help to open the blood vessels more fully
  • Β-blockers: They help to slow the heart rate
  • Diuretics: They help to reduce the quantity of fluid in the body and helps to lessen the stress on heart

Surgical treatment: Surgical treatments include balloon valvuloplasty and aortic valve replacement.

  • Balloon valvuloplasty: During this surgery, the damaged valve is repaired. The surgeon makes an incision on groin. A flexible, thin tube (catheter) tipped with a deflated balloon is inserted through this incision into the artery and is guided to the patient’s heart. Once the tube is near the valve, the balloon is inflated to stretch the narrowed aortic valve. Once the leaflets of the valve are open, the balloon is deflated and the catheter with the deflated balloon is taken out.  This procedure opens the valve temporarily.
  • Aortic valve replacement: This surgery involves replacing the damaged valve with a mechanical valve or biological valve by performing an open-heart surgery. Another type of surgery known as transcatheter aortic valve replacement (TAVR) is also an option in which a valve is replaced without open-heart surgery. During TAVR, c catheter is inserted into an artery to patient’s heart. This catheter carries a deflated balloon as well as a folded replacement valve, folded, on the tip. Once the catheter is at the correct place, the balloon is inflated which opens up the replacement valve and makes it fit tightly inside the damaged valve. After the new valve is in correct position, the balloon deflates and the catheter is removed.

References:

  • https://www.ncbi.nlm.nih.gov/pubmed/27895025
  • https://www.webmd.com/heart-disease/aortic-stenosis-treatments#1
  • https://www.mayoclinic.org/diseases-conditions/aortic-stenosis/symptoms-causes/syc-20353139
About the Author:

Dr. Anand Lakhkar is a physician scientist from India. He completed his basic medical education from India and his postgraduate training in pharmacology from the United States. He has a MS degree in pharmacology from New York Medical College, a MS degree in Cancer/Neuro Pharmacology from Georgetown University and a PhD in Pharmacology from New York Medical College where he was the recipient of the Graduate Faculty Council Award for academic and research excellence.  His research area of expertise is in pulmonary hypertension, traumatic brain injury and cardiovascular pharmacology.  He has multiple publications in international peer-reviewed journals and has presented his research at at prestigious conferences.

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