Aortic Valve Stenosis

Aortic valves are the main doors of the heart and keep your oxygenated blood flowing or circulating forward out from your heart to the rest of the body. After all of the blood leaves the heart, the aortic valve then closes to keep blood from going in the wrong direction back to your heart.

Causes of Aortic Valve Stenosis

Aortic Valve Stenosis
A normal open aortic valve (left). A stenotic valve – partially blocked aortic valve (right).credit: Scott Weldon

Your aortic valve can harden or calcify and become narrow, which is called aortic valve stenosis.

Heart valve stenosis can occur in any of the heart’s four valves, but is most common in your aortic valve. A healthy aortic valve when open is about as big as a half dollar, but sometimes the opening becomes narrowed due to wear and tear or aging. As you age, calcium can form on the aortic valve’s leaflets. As calcium builds up the opening can become narrower and limit blood flow. If the blood flow restriction becomes severe enough, the aortic valve must be replaced.

What Happens to the Heart with Aortic Valve Stenosis

Both aortic valve stenosis and leakage make the heart work harder. With stenosis, the heart has to work harder to pump blood through a narrowed valve. This extra work can make the wall or muscle of the heart thick or even cause enlargement of the heart’s chambers. This prevents the heart from working as it should and over time can lead to serious or even life-threatening problems.

About Aortic Valve Surgery

At Baylor St. Luke’s Medical Center in Houston, we specialize in minimally invasive heart valve surgery to repair or replace your aortic valve if you develop valve stenosis.

During aortic valve surgery, your surgeon will remove the unhealthy valve and replace it with either a biologic valve or a mechanical valve. A biologic valve made from animal tissue typically lasts 15 to 20 years and reduces the risk of clotting compared to a mechanical valve. A biologic valve eliminates the need for blood thinning medication. Mechanical values are extremely durable and will usually not need replacement in the future but will require lifelong anticoagulation therapy with blood testing (it is crucial to have a detailed conversation with your surgeon and cardiologist about this). To reduce the risk of clotting and excessive bleeding complications with mechanical valves, you will need to take blood thinning medication (Coumadin) for the rest of your life. It is extremely important for you to be fully aware, very careful and completely on board with the care and consideration required to maintain adequate levels of this medication.

Outlook after Aortic Valve Surgery

Following aortic valve surgery, you will stay five to seven days in the hospital. As soon as the first day after surgery, you will be ready to walk with the help of a nurse or physical therapist. Once you are discharged, you will be encouraged to continue walking and slowly resume normal activities. Since your recovery will be accelerated, and you will feel better than you expected, it is still important to pace yourself. Many patients exceed their normal activities and suddenly feel worse. It is very important to pace yourself in the recovery period. Your day will come where you will feel better and get back to your normal life. To get there, you must cautiously moderate your activities and allow yourself to recover.

It will take approximately 14 days for you to recover, but an additional healing and recovery period continues for about two months. During this time, you should plan to be away from work while regaining your strength. You can plan to return to work in about one month’s time.

The Baylor College of Medicine team will advise you on post-operative restrictions and when it’s safe to drive again (about two to three weeks after surgery although if you are not taking pain medication, which can make you sleepy, you can drive once you feel comfortable). Participating in a heart rehabilitation program or home exercise program may speed up your recovery. Your team will discuss this and schedule your follow-up visits to our clinic before you leave Baylor St. Luke’s Medical Center.