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Aortic valve disease

The heart normally has four valves in it. They all act as one way valves--opening fully allowing the heart to push blood forward when the heart contracts and -- closing completely stopping the blood from leaking backwards when the heart relaxes.
 
The Aortic valve
This valve separates the left ventricle (the main pump chamber of the heart) from the aorta (the main blood vessel-- supplying blood to the rest of the body).
 
The aortic valve can become narrowed (aortic stenosis). This restricts the blood flow out of the heart. Patients may have- no symptoms, or chest pain, shortness of breath and even dizziness and collapse. An echocardiogram can usually distinguish the degree of narrowing. In some patients the degree of narrowing is monitored and it does not require any intervention such as a surgical valve replacement. However if the degree of narrowing becomes severe and the patient has symptoms then an operation on the heart valve may be deemed necessary.
 
The aortic valve can become leaky (aortic regurgitation or incompetence). This means that when the heart contracts only a portion of the blood goes forward. The rest leaks backwards. Patients may have no symptoms or have increasing shortness of breath when they exercise or difficulty in breathing even at rest. If the degree of leakiness is sufficiently bad the valve may need to be surgically replaced.
 
Traditionally the replacement of the valve is done by surgery however when the risk of surgery is very high some patients have had the procedure done via a tube inserted in the leg (a percutaneous procedure). The reason for not offering this to everyone is that the long term results of this are not certain.
 
If you are being worked up for an aortic valve replacement you may need an coronary angiogram to look at the blood vessels of the heart (the coronary arteries). Please previous blog on coronary angiograms.
 
If you have any questions about your case please drop me an email.

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