Aortic stenosis means your aortic valve does not open widely enough to allow adequate blood flow from your heart to your aorta.
At the UPMC Heart and Vascular Institute, we offer the full range of treatments for aortic stenosis including surgical and minimally invasive valve replacement. In fact, we were one of the first medical centers to perform transcatheter aortic valve replacement (TAVR) — a minimally invasive treatment for severe aortic stenosis.
Request an appointment online, call 412-647-4745, or email us.
Your heart has four valves that work to keep blood flowing in the right direction. Your aortic valve is located where your heart's lower left chamber — the left ventricle — meets your body's largest artery, the aorta. Your aortic valve has three flaps, called leaflets, which are connected to a ring called the annulus.
In a normal heart, when the left ventricle squeezes, blood flows out of it and the flaps of the aortic valve open to allow blood to flow through. When the heart relaxes, the flaps of the valve snap shut to prevent blood from flowing backward.
Stenosis means narrowing.
In aortic stenosis, because the valve does not open widely enough, not enough blood flows from the heart into the aorta. In response, your heart works harder to pump enough blood to meet your body's needs.
Over time, this can cause your heart to weaken and can lead to heart failure.
At the UPMC Heart and Vascular Institute, we take a team-based approach to develop the right treatment for your aortic stenosis, based on your unique circumstances.
Aortic stenosis is common, and affects about 5 percent of people over the age of 70. Although there are cases where aortic stenosis can be present at birth (congenital), this heart condition is more commonly seen among older adults.
Aortic stenosis occurs when the aortic valve narrows. As you age, deposits of calcium, a mineral found in blood, may deposit within your valve, causing it to stiffen and not properly open. This narrowing may lead to heart failure and a variety of other issues.
Children born with bicuspid aortic valve or congenitally deformed valve which may go unnoticed during development, may not cause problems until adulthood at which point the aortic valve may get tight and/or leaky.
Factors that increase your risk of developing aortic stenosis include:
Complications of aortic stenosis include:
For an appointment at the Heart and Vascular Institute, complete an appointment request form or call 412-647-4745.
The effects of aortic valve stenosis range from mild to severe, and symptoms can be difficult to recognize.
Signs of aorthic stenosis include:
Aortic stenosis can weaken the heart and lead to heart failure. It can also cause everyday health problems including shortness of breath, swollen ankles and feet, chest pain, and fatigue. Aortic stenosis symptoms are sometimes only noticeable during physical activity.
While listening to your heart with a stethoscope, your primary care doctor can detect the condition by hearing abnormal valve sounds called murmurs.
Your UPMC heart and vascular specialist may recommend tests to confirm the diagnosis, as well as to diagnose other conditions such as heart rhythm problems or atherosclerosis.
These diagnostic tests include:
To make an appointment at the Heart and Vascular Institute, complete an appointment request form or call 412-647-4745.
Your doctor at UPMC's Heart and Vascular Institute will recommend a treatment plan, such as medication or a transcatheter aortic valve replacement (TAVR), that will aim to control any other medical problems associated with your aortic stenosis.
For example, if you have symptoms of heart failure, your doctor may prescribe medications to:
Treating other conditions can help you feel better, but they do not help aortic stenosis itself.
To address aortic stenosis directly, your UPMC doctor may recommend replacing the valve, either through surgery or a minimally invasive procedure.
Surgical valve replacement has long been the standard treatment for aortic stenosis.
During this open-heart procedure, your UPMC surgeon makes a long incision in the middle of your chest and separates the breastbone (sternum). This exposes the heart and enables the surgeon to remove your aortic valve and replace it with a mechanical valve or a tissue valve.
Mechanical valves last a long time, but people with mechanical valves need to take an anti-clotting medication, such as warfarin (Coumadin®) to prevent blood clots from forming. Tissue valves do not last as long as mechanical valves, but people with tissue replacement valves do not need to take anti-clotting medications.
Your UPMC doctor will help you decide which type of valve is right for you.
People with severe aortic stenosis who are not candidates for open-heart valve replacement may be candidates for a minimally invasive procedure called transcatheter aortic valve replacement or TAVR.
Your vascular surgeon can gain access to your aortic valve, via a catheter, in one of several ways:
He or she will recommend the best option for you.
During your TAVR procedure, your surgeon:
For the Ozaki procedure, doctors use your own tissue to build a new aortic valve.
During the Ozaki procedure, your surgeon will:
The open-heart procedure can take 3 to 4 hours and requires a hospital stay of 5 to 7 days afterward. Most people fully heal within 1 to 2 months and don't need to take blood thinners beyond a baby aspirin for 3 months after surgery.
The Ozaki procedure is an innovative treatment that has shown positive results compared to mechanical valves and animal tissue valves. It has a more long-term impact than animal tissue valves, with few reported complications.
Since the new valve comes from your own tissue, your body won't react to it as a foreign object. And the new valve closely resembles a natural aortic valve, which means there should be little to no resistance in blood flow.
Most people are candidates for the Ozaki procedure unless they've already had heart surgery.
To make an appointment at the Heart and Vascular Institute, complete an appointment request form or call 412-647-4745.
The UPMC Heart and Vascular Institute offers educational information and videos about aortic stenosis and other heart and vascular diseases and treatments.
Many people find these resources helpful in answering their questions about their condition and preparing them for their procedure or diagnostic test.
The links below will open a new browser window.
To make an appointment at the Heart and Vascular Institute, complete an appointment request form or call 412-647-4745.