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How is aortic valve stenosis treated?

Mild cases of aortic valve stenosis usually do not require treatment. However, ongoing monitoring is important to determine any changes. If aortic valve stenosis is moderate or severe, a heart specialist known as an interventional cardiologist may be able to use a thin, flexible balloon-tipped tube called a dilation catheter to separate the fused valve flaps (the leaflets). As the balloon expands, its pressure stretches the valve tissue to create a wider passage. This process increases blood flow through the aortic valve and to the rest of the body. This procedure is performed in the cardiac catheterization laboratory (or “cath lab”) of the hospital.

Critical aortic stenosis requires immediate medical attention. This usually involves treating the infant with a medication that keeps open the patent ductus arteriosis (PDA), a passage between the two major arteries of the heart that is present in all babies before birth. The PDA normally closes by itself shortly after birth after the baby begins to breathe air. The medication (prostaglandin E1) keeps the PDA open, allowing the aortic valve to be bypassed until the aortic valve can be widened to establish normal circulation.

For people with severe aortic valve stenosis who have symptoms, the traditional treatment is minimally invasive aortic valve replacement (AVR), either surgical or transcatheter. Clinical guidelines from the American Heart Association and the American College of Cardiology recommend “active surveillance” in people with asymptomatic aortic stenosis, unless stress testing can expose symptoms. Historically, the management for asymptomatic aortic stenosis includes the accepted practice of watchful waiting (WW) and delaying AVR until the development of symptoms. However, minimally invasive AVR reduces the risks associated with open heart surgery and decreases the recuperation time, making it a viable option for earlier treatment of people who have no symptoms.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.