Learn more about diseases that affect the valve between the heart's main pumping chamber and the body's main artery (aorta).
Aortic valve disease is a type of heart valve disease. In aortic valve disease, the valve between the lower left heart chamber (left ventricle) and the main artery to the body (aorta) doesn't work properly.
The aortic valve helps keep blood flowing in the correct direction through the heart. A damaged or diseased aortic valve can affect blood flow to the rest of the heart and body.
Aortic valve disease includes:
Aortic valve disease may be present at birth (congenital heart disease), or it may occur later in life due to other health conditions.
Treatment for aortic valve disease depends on the type and severity of disease. Some people may need surgery to repair or replace the aortic valve.
In aortic valve regurgitation, the aortic valve doesn't close properly, causing blood to flow backward from the body's main artery (aorta) into the lower left heart chamber (left ventricle).
Some people with aortic valve disease may not notice symptoms for many years. Signs and symptoms of aortic valve disease may include:
If you're having sudden chest pain, get emergency medical help.
Make an appointment with a health care provider if you have signs or symptoms of valve disease, such as shortness of breath, fatigue after activity, or sensations of a pounding or an irregular heartbeat. Sometimes the first signs of aortic valve disease are related to heart failure. See a health care provider if you have fatigue that doesn't get better with rest, shortness of breath, and swollen ankles and feet, which are common symptoms of heart failure.
Aortic valve disease may be caused by a heart defect present at birth (congenital heart defect). Other causes of aortic valve disease later in life include:
To better understand the causes of aortic valve disease, it may be helpful to know how the heart valves typically work.
The heart has four valves that keep blood flowing in the correct direction. These valves are:
Each valve has flaps (cusps or leaflets) that open and close once during each heartbeat. Sometimes, a valve doesn't open or close properly. This can reduce or block blood flow through the heart to the rest of the body.
In aortic valve disease, the valve between the lower left heart chamber (left ventricle) and the body's main artery (aorta) doesn't work properly. The valve may be thickened and stiff (stenosis) or it may not close properly, causing blood to flow backward.
A typical heart has two upper and two lower chambers. The upper chambers, the right and left atria, receive incoming blood. The lower chambers, the more muscular right and left ventricles, pump blood out of the heart. The heart valves, which keep blood flowing in the right direction, are gates at the chamber openings.
Many things can raise the risk of aortic valve disease, including:
Potential complications of aortic valve disease may include:
Proper diagnosis and treatment can help reduce the risk of complications.
To diagnose aortic valve disease, a health care provider will usually do a physical exam and ask questions about your signs and symptoms and medical history.
A health care provider may hear a whooshing or swishing sound (heart murmur) when listening to your heart with a stethoscope. If so, you may be referred to a doctor trained in heart diseases (cardiologist).
Several tests may be done to diagnose aortic valve disease, including:
Echocardiogram. An echocardiogram is an ultrasound of the heart. Sound waves are used to create pictures of the heart in motion. An echocardiogram provides a closer look at the condition of the aortic valve and the aorta. It can help determine the cause and severity of aortic valve disease.
In a standard echocardiogram, a wandlike device (transducer) that gives off sound waves is gently pressed against the skin of the chest above the heart. Sometimes, a transesophageal echocardiogram may be done to get a closer look at the aortic valve. In this type of echocardiogram, a small transducer attached to the end of a tube is inserted down the tube leading from the mouth to the stomach (esophagus).
After testing confirms a diagnosis of aortic or other heart valve disease, your health care provider may tell you the stage of disease. Staging helps determine the most appropriate treatment.
The stage of heart valve disease depends on many things, including symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs.
Heart valve disease is staged into four basic groups:
Treatment for aortic valve disease depends on:
Treatment may include monitoring, lifestyle changes, medications, or surgery or other procedures. If you have aortic valve disease, consider being evaluated and treated at a medical center with a multidisciplinary team of heart disease specialists (cardiologists) and others trained and experienced in evaluating and treating heart valve disease.
If aortic valve disease is mild or moderate or if you aren't having symptoms, you may only need regular medical checkups to monitor the condition.
Heart-healthy lifestyle changes and medications may be recommended to treat symptoms of aortic valve disease or reduce the risk of complications. For example, medications may be used to:
Eventually, surgery or a catheter procedure may be needed to repair or replace the diseased aortic valve. Some people with aortic valve disease need surgery even if it's not severe or when it's not causing symptoms.
Surgery to repair or replace an aortic valve is often done with open-heart surgery. Sometimes, the valve can be replaced during minimally invasive heart surgery, which uses smaller incisions than those needed for open-heart surgery, or with a catheter-based procedure.
During aortic valve repair, the surgeon may do one or all of the following:
Aortic valve repair often requires open-heart surgery. However, less invasive options may be available. For example, a catheter procedure may be used to insert a plug or device to repair a leaking replacement aortic valve.
In infants and children with aortic valve stenosis, a less invasive procedure called balloon valvuloplasty may be done to temporarily open a narrowed valve. During this procedure, the doctor inserts a thin, hollow tube (catheter) into a blood vessel, usually in the groin, and threads it to the heart. A balloon is inflated to widen the valve opening, and then deflated and removed. This valve repair procedure may also be done in adults who are too sick for surgery or who are waiting for a valve replacement.
In aortic valve replacement, a surgeon removes the damaged valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).
Sometimes, the aortic valve is replaced with your own lung (pulmonary) valve. Then your pulmonary valve is replaced with a biological lung tissue valve. This more complicated surgery is called the Ross procedure.
You and your health care provider will discuss the benefits and risks of each type of valve to choose the best option for you.
Aortic valve replacement typically requires open-heart surgery, which involves a cut (incision) in the chest. Sometimes, surgeons can use a minimally invasive procedure called transcatheter aortic valve replacement (TAVR) to replace a narrowed aortic valve with a biological tissue valve. TAVR uses smaller incisions than those used in open-heart surgery. TAVR may be an option for people at increased risk of heart valve surgery complications.
In a biological valve replacement, a biological or tissue valve replaces the damaged valve.
After diagnosis or treatment of aortic valve disease, you'll need regular health checkups to monitor your condition. Your health care provider may suggest making heart-healthy lifestyle changes, including:
For women with aortic valve disease, it's important to talk with a health care provider before becoming pregnant. Your health care provider can discuss with you which medications you can safely take and whether you may need a procedure to treat your valve condition prior to pregnancy.
Women with aortic valve disease likely require close monitoring by a health care provider during pregnancy. Health care providers may recommend that women with severe heart valve disease avoid pregnancy to avoid the risk of complications.
If you have aortic valve disease, here are some steps that may help you manage the condition:
If you think you have aortic valve disease, make an appointment to see your health care provider. Here's some information to help you prepare for your appointment.
For aortic valve disease, some basic questions to ask your health care provider include:
Don't hesitate to ask other questions you have.
Your health care provider is likely to ask you a number of questions, including: