Aortic Valve Disease

Treatment

Patients with heart valve disease are at increased risk for getting bacterial endocarditis, an infection of the lining of the heart and its valves, which can progress rapidly and be fatal. They must take antibiotics prior to any dental and surgical procedures that might introduce bacteria into the bloodstream.

Regular follow-up by healthcare providers is important. Actively observing the stability or the progression of aortic valve disease is important so that the right treatment can be started at the right time. Valves need to be repaired or replaced before irreversible damage occurs.

Monitoring

If tests reveal a mild to moderate condition and there are no symptoms, the physician will suggest scheduled checkups to carefully monitor the valve so medications can be prescribed or surgery done at the appropriate time.

Medications

People with heart valve disease are at increased risk for getting bacterial endocarditis, an infection of the lining of the heart and its valves, which can progress rapidly and be fatal. They must take antibiotics prior to any dental and surgical procedures that potentially could introduce bacteria into the bloodstream.

Medications are available to control pain, reduce the workload on the heart and regulate the heart's rhythm, and in some cases may slow the progression aortic valve disease. However, no medications can cure heart valve disease. Mayo Clinic is involved in clinical trials studying the use of statin drugs to slow or prevent the progression of aortic valve stenosis.

Depending on the nature of the aortic valve disease, the following medications may be prescribed:

• Digitalis, which reduces the heart's workload and eases some symptoms
• Diuretics, which can lower the salt and fluid levels in the body, lowering the pressure at which blood passes through the valves. Diuretics also reduce swelling and ease the heart's workload.
• Anticoagulant medicines, which prevent blood clots.
• Beta-blockers, which control the heart rate and lower blood pressure.
• Calcium channel blockers, which affect the contractions of muscle tissue in the heart. By lowering blood pressure and reducing the heart's workload, calcium channel blockers may put off the need for heart valve surgery.
• ACE inhibitors, which widen blood vessels, lower blood pressure and decrease the heart's workload.

Surgery

Aortic Stenosis
When aortic stenosis is severe, it can be life threatening. Severe pressure builds up in the left ventricle, which can injure the heart. When this occurs, open-heart surgery is required to repair or replace the valve.

Rarely, a more complex surgery is needed with valve replacement to enlarge the part of the left ventricle that leads to the aortic valve.

The stenotic aortic valve can be replaced safely in almost all patients, even people in their 80s who are otherwise in good health.

Replacement of a stenotic aortic valve is sometimes recommended in patients who have not developed symptoms but have very tight valves. The rationale is that the first manifestation of aortic stenosis can be sudden death.

Mayo Clinic heart surgeons replace more than 475 aortic valves each year, making Mayo Clinic one of the largest and most experienced medical centers for this surgery.

Aortic regurgitation
Regurgitation may be corrected by altering the cusps to allow the valve to close tightly. Aortic valve regurgitation usually requires valve replacement.