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Aortic Valve Disease: Treatment, Cost and Side Effects

Last Updated: Apr 25, 2024

What is the Aortic Valve Disease?

Aortic valve disease refers to conditions where the valve between the left ventricle of your heart and the main artery to the abdomen called aorta, stops functioning properly. This valve is called the aortic valve and plays a very vital role in the circulation of the blood. Typically there are two kinds of aortic valve diseases – aortic stenosis and aortic regurgitation.

The aortic valve has three leaflets whose opening and closing regulates blood flow. In Case of aortic stenosis may become thickened due to age related calcification or may fuse together. Sometimes people are born with 2 leaflets only. These things result in the narrowing of the opening of aorta thus blocking blood flow to your body. On the other hand, in case of aortic regurgitation the valve fails to close properly resulting in backward flow of blood into the left ventricle. Due to this, the heart has to work extra harder in pumping blood. Hence becomes exhausted easily during strenuous activities and in severe cases this can lead to heart failure.

Depending on the severity and medical history the treatment can range from medications to surgery. In case, there are no severe symptoms following a health lifestyle and prescribed medication is enough to control. However in case of severe problems where the valve is deformed due to birth defects, calcium deposits as result of aging or rheumatic fever; valve replacement or valvotomy surgeries are performed

How is the Aortic Valve Disease treatment done?

The diagnosis and treatment of aortic valve diseases is very dependent on the severity of the problem and whether your condition is becoming worse. Initially a cardiologist may check your medical history and the signs and symptoms followed by medical examinations. The medical examinations usually involve studying the activities as well as the conditions of the heart through means of echocardiograms, electrocardiograms, Chest x-rays, MRI and CT scan of the heart.

Based on the severity determined the cardiologist determines whether surgery is an immediate requirement or medications are enough. In case of mild severity, medications like calcium blockers as well as drugs that lower blood pressure and cholesterol levels are prescribed. Apart from maintaining a healthy lifestyle, regular visits to cardiologist are recommended so that the cardiologist can track your condition and decide if a surgery might be needed in future.

In severe cases a heart valve replacement or heart valvotomy may be done. Usually both of these operations take around 3 to 5 hours during which the patient is put under general

anesthesia and a heart lung machine which pumps fresh oxygenated blood to rest of the body is attached. In case of heart valve replacement surgery the defective valve is removed and replaced by a mechanical ceramic valve or tissue valve developed from animal heart organs. Valvotomy is usually done in case of aortic stenosis. In this surgery a balloon like thin tube is inserted in the aortic valve to widen the valve opening. Post surgey the patient is kept under observation for 5-6 hours and is removed from the heart lung machine once the heart regains strength.

Who is eligible for the treatment? (When is the treatment done?)

In mild severity cases, medications are enough to take care of the aortic valve conditions. Cardiologists usually conduct extensive examinations and study of patient’s medical history to see if surgery is needed. You should thus consult a cardiologist before opting for a surgery

Who is not eligible for the treatment?

If you have a history of diabetes, kidney problems, bleeding disorders or are taking any anti blood coagulation medicines you might have complications during surgery. Thus you should consult specialists regarding this and if they suggest, only then you should go for the surgery

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Are there any side effects?

with a 95% survival rate post surgery for 5 years this is one of the most reliable surgery there is. However the surgery has certain side effects, which may or may not occur. In case, proper infection prevention measures both through medication and lifestyle habits are not taken, there may be infection at the new valve implanted through bloodstream. This is called endocarditis and is more common in valve replacement surgeries. Sometimes the replaced valves also fail and there might be a need for another replacement. If you continuously feel short of breath, lightheaded and chest pain post surgery this might be a reason and you should seek medical assistance. Additionally there have been few cases of pneumonia, unstable heart rhythm reported as the side effects of a aortic valve surgery

What are the post-treatment guidelines?

Usually, cardiologists specify the lifestyle habit and exercises you should do post surgery but incase , they do not you can enroll in cardiac rehabilitation programs. These programs are specifically developed to help recover from cardiac surgeries. You should follow a diet that is healthy for heart. Avoid foods having unsaturated fats, high Cholesterol, high sweetness or saltiness. Apart from that you should do gentle exercise like deep breathing, meditation, brisk walking, etc. which help you manage your stress levels and improve blood circulation. In case you are smoker, you should also quit smoking as it does severe damage to arteries and dis direct cause of coronary blockages.

How long does it take to recover?

Usually a person has to remain hospitalized for a week after surgery. But , cardiologists suggest to resume work only after 4-6 weeks as sufficient rest is needed for the heart to heal and recover.

What is the price of the treatment in India?

Usually the cost of surgeries varies between 1.5 lakh to 6 lakh across India. The average cost is around 3.5 lakhs and the fluctuations are usually due to artificial valve costs and hospital charges.

Are the results of the treatment permanent?

The results may be permanent ot temporary based on what kind of artificial valve is used for replacement. Mechanical valves are made of ceramic and last for a lifetime. However, the tissue valves usually last for 12 -15 years and hence there might be a need for another surgery

What are the alternatives to the treatment?

An alternative to the traditional heart valve surgeries is TAVR or Trans catheter Aortic Valve Replacement where a replacement valve is fixed over the actual aortic valve. The advantages of this method are that there is no need to stop the heart and no major chest incisions are required.

References

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Written ByDr. Pankaj Verma ACLS,POST GRADUATE COURSE IN RHEUMATOLOGY,Fellowship in Diabetes,MBBS,Post Graduate Course In Rheumatology,MD - Medicine,Masters in Psychotherapy and CounsellingInternal Medicine
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