Man in a hospital bed

The aortic valve is the exit door of the heart, and all oxygen-rich blood that keeps us alive gets pumped through it. This door opens every time the heart beats — roughly 80 times per minute — beginning the day we are born. It closes again as the heart refills.

However, this valve can wear out. To prevent the valve from failing, the body reinforces it with a cement-like substance, which makes the valve very stiff and narrows the opening. This is known as aortic stenosis.

Aortic Stenosis Symptoms

When treating conditions of the heart, time matters. Aortic stenosis happens slowly, but it’s important to recognize the symptoms.

For individuals with a heart valve issue like stenosis, heart muscle thickens over time to force blood through the tight, narrow opening. The pressure needed to fill this thickened heart creates congestion in the lungs, which can cause shortness of breath.

As the valve worsens, symptoms progress. The heart muscle itself can get damaged and cause chest pain. It also can cause an inadequate blood supply to the brain and cause you to pass out.

Aortic stenosis leads to heart failure. Left untreated, it can lead to death. The symptoms of aortic stenosis can include:

  • Lack of energy.
  • Shortness of breath.
  • Chest pain (angina).
  • Fainting (syncope).
  • Heart failure.

While you may think that lack of energy or shortness of breath is due to age, these could be early signs of a bigger problem. If you are experiencing these symptoms, it’s important that you talk to your health care provider.

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Valve Replacement Surgery

Treatments for aortic valve disease have improved over the years thanks to valve replacement surgery.

“Before valve replacement procedures were common, a diagnosis of valve disease was often grim,” says Michael Lazar, MD, a cardiothoracic surgeon and executive medical director of UPMC’s Heart and Vascular Institute in North Central Pa. “With the advancements we’ve made in valve replacement surgeries over the years, we can now reverse the effects of aortic stenosis and extend both your life expectancy and, perhaps most importantly, your quality of life.”

Replacing the faulty aortic valve with a new valve can return the heart to normal size and relieve the symptoms of stenosis. In the past, most patients with aortic stenosis would have had an open-chest procedure through the breastbone to have the heart valve replaced. While it saved many lives, such surgery can be taxing on the body.

Over the years, doctors have developed new techniques, approaches, and technology to help reduce the trauma to the patient’s body. The incisions are smaller and the breastbone rarely is opened.

When considering treatment options, especially for older individuals with intermediate to high risk of surgery, there is an even less traumatic option. It’s known as transcatheter aortic valve replacement (TAVR).

TAVR is an innovative, minimally invasive procedure that was developed to provide an option for high-risk patients. Due to careful research and its successes over the years, it is now an option for most people with this disease.

What Is TAVR?

TAVR is performed by threading a new, collapsed heart valve mounted inside a metal stent across the old diseased aortic valve and expanding it. As the new valve opens, it pushes aside the old one and starts to function immediately.

To perform TAVR, surgeons don’t have to stop the heart or open the chest. It’s usually done through a puncture or small incision in the groin as doctors watch on a live x-ray. The procedure doesn’t involve open-heart surgery or a heart-lung bypass machine.

In most cases, the whole procedure lasts only 90 minutes and can be performed under sedation without general anesthesia. Many patients are discharged the following day and are usually back to normal activity within a week.

“Because TAVR is a minimally invasive procedure, recovery times are dramatically shorter,” Dr. Lazar says. “Patients spend less time in the hospital and are often back to normal activity without limitations. Many patients feel they have a new lease on life and go on to enjoy activities they didn’t think possible.”

While the traditional minimally invasive valve replacement method is still considered safer and more durable for younger candidates, TAVR provides an option for treating aortic stenosis for most people with the disease.

The UPMC Heart and Vascular Institute in North Central Pa. treats patients for a broad spectrum of heart conditions, including valve disease. For more information on our services in north central Pennsylvania, visit UPMC.com/HeartNCPA.

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.

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