Consultant Cardiologist, Mr Mike Mullen and Cardiac Surgeon, Mr John Yap explain the latest treatment options for replacing a damaged heart valve. This is an important combination of heart specialists, because it helps to provide the broad view from the patient perspective and not just the approach adopted by a particular type of specialist.
During the course of our lives, our hearts will beat 2000 Million times. That is alot of beats for delicate structures and so it is perhaps not surprising that they do sometimes get worn out or damaged.Valve tissue can either become too narrow 'stenosed', or blood leaks around them and this is called 'regurgitation' or 'incompetence'.
To begin with the pathology can be dealt with quite well, but symptoms then develop including:
- Breathlessness on walking
- Chest pains
- Collapse
Heart Murmur
Aortic stenosis is diagnosed by the presence of a heart murmur, which can be heard by a doctor using a stethoscope. The murmur is caused by turbulent blood not being competently passed through the valve. The diagnosis can be confirmed by heart ultrasound or echocardiogram.
Valve Replacement Treatments Treatments
Aortic stenosis cannot be treated by medicines. The traditional treatment is by open heart surgery to remove the narrowed valve and replace it. The authors explain the pros and cons with this approach. However, new minimally invasive methods now include Trans Catheter Valve Implantation or TAVI, and Balloon Aortic Valvuplasty (BAV). In addition there are a selection of different types of articial and biological valves.
When deciding on the most appropriate option it is important for the patient to be included in the multidisciplinary team decision process.
The authors conclude by saying, "Aortic stenosis is the most common form of valvular heart disease and if untreated is often fatal. Timely intervention to replace the valve can both improve symptoms and increase lifespan and therefore, in general, should not be delayed once symptoms develop. There are many treatment options for patients including open heart surgery and transcatheter aortic valve implantation (TAVI). A multidisciplinary heart team is essential to consider the most appropriate treatment for each patient."
Read full, plain English article - Treating Aortic Stenosis
