Overview of the Condition

What is Aortic Valve Stenosis?

Aortic valve stenosis is a heart valve condition in which the aortic valve becomes narrow and does not open properly. This reduces blood flow from the heart to the rest of the body. Severe cases may require valve repair or replacement. Without treatment, it can lead to serious complications.

Why is it Important?

Severe aortic stenosis can make the heart work harder and may lead to chest pain, breathlessness, fainting, heart failure, or serious complications if untreated. The prevalence of aortic stenosis in India is around 29%. If left untreated, it can lead to heart failure, severe tiredness, breathlessness, and swelling in feet or ankles.

Who is Commonly Affected?

• Older adults
• People born with heart valve defects
• Patients with long-term kidney disease
• Individuals with diabetes, high cholesterol, or high blood pressure
• People with infections affecting the heart
• Patients who have received radiation therapy to the chest

Common Causes

• Heart valve defects present from birth
• Calcium buildup on the aortic valve with ageing
• Rheumatic fever causing damage and scarring of the valve

Common Symptoms

• Chest pain or tightness
• Dizziness or fainting
• Shortness of breath
• Tiredness during activity
• Fast or fluttering heartbeat

Treatment Options Before the Procedure

• Blood tests
• ECG (Electrocardiogram)
• Chest X-ray
• Temporary discontinuation of certain medications
• Fasting for several hours before the procedure

Procedures

• Aortic valve repair or replacement
• Cardiac catheterisation
• Transcatheter aortic valve implantation/replacement (TAVI/TAVR)

Procedure Overview and Preparation

What is TAVI/TAVR and Why is it Done?

TAVI/TAVR is a minimally invasive procedure in which a new valve is placed inside the damaged aortic valve using a catheter. The new valve takes over the function of controlling blood flow and is used to treat severe aortic stenosis.

Before the Procedure

• Inform your healthcare team about all medicines, supplements, and allergies
• Follow instructions about stopping food, drinks, or certain medicines before the procedure
• Bring comfortable clothing and personal items if needed
• Avoid wearing jewellery, contact lenses, dentures, or nail polish during the procedure

Preparation Guidelines

• An IV line will be inserted to give medicines and fluids
• Medicines may be given to help you relax and prevent pain, infection, or blood clots
• Sedation or anaesthesia will be used during the procedure
• Hair around the procedure area may be shaved if needed

Step-by-Step

• A thin tube called a catheter is inserted through a blood vessel, usually in the groin
• The catheter is guided to the heart using imaging guidance
• A new artificial valve, usually made from animal tissue, is placed inside the damaged aortic valve
• The new valve is expanded and begins working immediately
• The catheter is removed, and the healthcare team closely monitors the patient

Time Required

Few hours (typically 1–3 hours).

Risks, Benefits and Hospital Stay

Risks and Complications

• Bleeding
• Blood vessel injury
• Valve leakage or movement
• Stroke
• Irregular heartbeat or need for a pacemaker
• Kidney problems
• Heart attack
• Infection

Benefits and Expected Outcomes

• Minimally invasive procedure with a small incision
• Faster and easier recovery
• Less pain after the procedure
• Shorter hospital stay compared with open-heart surgery

Duration of Hospital Stay

Usually 1 day.

Recovery, Lifestyle and Follow-up

Recovery and Aftercare

• You may need to stay in bed for a few hours after the procedure
• Medicines may be given to prevent infection or blood clots
• Most patients go home within 1–2 days
• Normal daily activities can usually be resumed within a few days

Diet

• Stop smoking
• Eat a healthy diet rich in fruits and vegetables and low in salt and unhealthy fats

Long-Term Care

• Exercise regularly as advised by your doctor
• Maintain a healthy body weight

Follow-up

• Cardiac rehabilitation may be advised to improve heart strength and recovery
• Regular follow-up visits are important to monitor your heart and valve function
• Check-ups are usually done after one month and then yearly as advised by your doctor

Myths vs Facts

Frequently Asked Questions