Aortic Stenosis Treatment

Treatment for aortic stenosis depends on how far the disease has progressed. If the patient's stenosis is mild, medication may be prescribed to regulate the heart, prevent blood clots, and manage symptoms. However, medication is a palliative therapy and is not an effective treatment for severe aortic stenosis. The only effective treatment for severe aortic stenosis is to replace the diseased aortic valve. This can be done with open heart surgery or transcatheter aortic valve replacement (TAVR).

TAVR Procedure - Transcatheter Aortic Valve Replacement

TAVR is less invasive than open heart surgery. It uses a catheter to replace the heart valve instead of opening up the chest and completely removing the diseased valve. The bioprosthetic valve used during TAVR is inserted within the diseased aortic valve. The valve is crimped onto a balloon that is expanded and pushes the leaflets of the diseased valve aside.

Open Heart Surgery

During open heart surgery, the surgeon removes the diseased aortic valve and replaces it with either a mechanical valve (made from man-made materials) or a biological valve (made from animal or human tissue), through a median sternotomy or a small right anterior thoracotomy (minimally invasive approach).

The TAVR screening process utilizes a patient-focused multidisciplinary team approach. Not only will the patient meet with an interventional cardiologist, but they will see two separate surgeons to help determine the right approach. Other members of the team include the TAVR nurse coordinator, anesthesiology, cath lab and operating room staff, and imaging specialists. CHI St. Vincent’s interdisciplinary heart team meets weekly to review cases and plan the best approach for each patient.

The screening process for TAVR is extensive, and includes a complete medical history, an EKG, and an echocardiogram. If the patient is deemed to be a good candidate for surgery or TAVR, cardiac catheterization is performed to exclude significant coronary artery disease. A CT of the chest is performed to evaluate the anatomy of the heart.

Other tests may include a CT of the abdomen and pelvis, a chest x-ray, ultrasound of the arteries in the neck, and pulmonary function studies. Additional studies may be ordered by the physicians based on an individual’s specific conditions.

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