Aortic Valve Stenosis

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.

Contact the UPMC Center for Aortic Valve Disease

Request an appointment online, call 412-647-4745, or email us.

What Is Aortic Stenosis?

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.

What is stenosis?

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.

Causes of aortic stenosis

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.

Aortic stenosis risk factors

Factors that increase your risk of developing aortic stenosis include:

  • Age older than 65 years
  • Atherosclerosis — hardening of the arteries
  • Bicuspid aortic valve
  • Diabetes mellitus
  • High cholesterol
  • Rheumatic fever — an infection that can cause scarring of the heart's valves

Aortic stenosis complications

Complications of aortic stenosis include:

  • Heart failure
  • Endocarditis, an infection of the lining of your heart

For an appointment at the Heart and Vascular Institute, complete an appointment request form or call 412-647-4745.

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Aortic Stenosis Symptoms and Diagnosis

Aortic stenosis symptoms

The effects of aortic valve stenosis range from mild to severe, and symptoms can be difficult to recognize.

Signs of aorthic stenosis include:

  • Chest pain, or angina, and feelings of tightness in the chest.
  • Feeling faint or fainting with exertion, also called syncope.
  • Arrhythmias, or heart palpitations, fluttering heart or rapid heartbeat.
  • Shortness of breath, particularly with exertion.
  • Heart murmur.
  • Fatigue.

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.

Diagnosing aortic stenosis

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:

  • Echocardiogram, which uses sound waves to create images of your heart and valves.
  • Electrocardiogram, which measures your heart's electrical activity.
  • Chest x-ray, to see the size and shape of your heart.
  • Cardiac catheterization, which enables your doctor to see blood flow through the heart and its arteries.
  • Magnetic resonance imaging (MRI) scan, which uses a magnetic field and radio waves to create images of your heart.

To make an appointment at the Heart and Vascular Institute, complete an appointment request form or call 412-647-4745.

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Aortic Stenosis Treatment

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.

Medication

For example, if you have symptoms of heart failure, your doctor may prescribe medications to:

  • Prevent the build-up of excess fluids.
  • Help to decrease resistance to blood flow in your blood vessels.
  • Prevent the production of hormones that cause the heart to work harder.

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 aortic valve replacement for aortic stenosis

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.

Transcatheter aortic valve replacement

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:

  • Through a small incision in an artery in your leg.
  • Through a space in your ribs.

He or she will recommend the best option for you.

During your TAVR procedure, your surgeon:

  • Uses special moving x-ray imaging — called fluoroscopy — to guide the catheter containing the replacement valve to your aortic valve.
  • Places the replacement valve over your own aortic valve.

To make an appointment at the Heart and Vascular Institute, complete an appointment request form or call 412-647-4745.

Learn More About Aortic Stenosis Treatments

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Aortic Stenosis Educational Materials

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.

From our Health Library

To make an appointment at the Heart and Vascular Institute, complete an appointment request form or call 412-647-4745.