Background

The heart has 4 valves that regulate the flow of blood.  These include the aortic, mitral, tricuspid, and pulmonic valve.  Valves are designed so that blood travels in one direction.  Valves prevent the backward flow of blood.  There are 2 things that can go wrong with valves:

1) They can narrow and get tight.  The medical term for this is “stenosis”

2) Or valves can become leaky and blood flows backward.  This is called “regurgitation”

Learn more about aortic stenosis by watching this video:

AORTIC VALVE

 
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Aortic stenosis is caused by either a buildup of calcification, a birth defect known as a bicuspid aortic valve, rheumatic fever, or radiation therapy.  In all cases, the opening for flow is small and blood has a hard time reaching the rest of the body.  The heart has to work harder to get blood to the rest of body and with time, the heart begins to fail. 

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Common symptoms of aortic stenosis include:

  • Chest pain

  • Shortness of breath

  • Fatigue

  • Dizziness, fainting

Diagnosis

The most common ways of diagnosing aortic stenosis are by either listening to the heart with a stethoscope or by performing an ultrasound of the heart.

Here’s what aortic stenosis sounds like with a stethoscope >

Click the link below to learn more about aortic stenosis:

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Treatment Options

Patients with aortic stenosis initially do well, but once symptoms develop, are at risk for sudden death.  Without treatment, 50% of patients with severe symptomatic aortic stenosis die within 2 years.  Fortunately, there are a lot of good treatment options for aortic stenosis.  Many patients are high risk and over 80 years old, but do well with treatment.

 

The most common treatment options for aortic stenosis include the following.  Your doctor can determine which is the best option.

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Minimally Invasive Valve Surgery

A small 5cm incision is made either on the right or upper chest with direct access to the aortic valve without having to open the chest (i.e. sternotomy).  Advantages include reduced surgical trauma, less blood loss, less chance of infection, and faster recovery

Here’s a testimonial of a minimally invasive aortic valve replacement performed by Dr. Tom C. Nguyen (posted with permission from the patient). 

Patient testomonial after surgery (posted with permission)

Here's a video of a patient after minimally invasive valve surgery:

Here's a video of a minimally invasive aortic valve

replacement:

Here’s a video of about everything you need to know about TAVR:

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Transcatheter Aortic Valve Replacement (TAVR)

A small incision is made either in the groin, left chest, or upper chest and a new aortic valve is placed while the heart is still beating without having to open the chest (i.e. sternotomy).  The most common approach for TAVR is through the groin.

Edwards LifeSciences S3 TAVR

Medtronic EvolutR TAVR

 
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Traditional Open Heart Surgery

The chest is opened (i.e. sternotomy) with direct access to the aortic valve. 

Here’s a video of a traditional aortic valve replacement through a sternotomy:

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Email: tuyen.nguyen@uth.tmc.edu

© 2020 Dr. Tom C. Nguyen, MD

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MINIMALLY INVASIVE VALVE SURGERY

Minimally Invasive Aortic and Mitral Surgery, TAVR and MitraClip