Dr. Taweesak Chotivatanapong, Vejthani Hospital’s cardiothoracic surgeon mentioned that aortic valve stenosis and regurgitation occur because of age-related degeneration, and that causes calcified heart valve that could reduce the heart valves’ effectiveness. Besides the age-related degeneration factor, a congenital heart disease like the Bicuspid Aortic Valve and a rheumatic heart disease are also the factors that can cause heart valve stenosis and regurgitation because of the streptococcus bacteria that can cause damages to the heart valve.
Basically, the symptom of aortic valve stenosis and regurgitation will not show up in the early stage, but it could be diagnosed by an annual health check-up. If it is getting more severe, the patient will have dyspnea, chest pain, breathing difficulty, syncope symptoms, and heart failure in severe cases.
For the patient who has mild symptoms, the surgeon will follow-up the patient’s symptoms and perform echocardiogram periodically. But for the severe cases, the surgeon will consider providing surgical treatment. There are two types of surgical treatment for aortic valve diseases which are Heart valve replacement surgery and Heart valve repair surgery .
1. Aortic Valve Replacement: Heart valve replacement surgery is a safe procedure that could provide a good treatment outcome, especially the elective type of procedure. An artificial heart valve will replace the damaged valve. There are two types of artificial valve available which are as follows:
- A metal heart valve: This type of an artificial heart valve is made of metal, and its lifespan is around 20 – 30 years but the patients need to take anticoagulant medication for the rest of their lives.
- An tissue or bioprosthetic heart valve: This type of artificial heart valve is made of pig’s or cow’s heart valve, its lifespan is around 10 – 15 years in aortic valve position in elderly patients. The patients will also need to take anticoagulant medication but in a shorter period of time compared to those who have been replaced with a metal heart valve.
Nowadays, there is a new and innovative non-surgical treatment for heart valve replacement, called Transcatheter Aortic Valve Implantation (TAVI). This procedure allows an aortic valve to be replaced by using a long narrow catheter inserted into a large blood vessel to get into the heart. Patients who underwent this procedure are more selected and must be assessed by a team of cardiologist, cardiac surgeon and other related specialists, so called a Heart Team. The fate of this new valve in long-term aspects and complications is still a debate and need closed follow-up. Currently, This TAVI procedure is still for high risk aortic valve patients. The moderate and low risk patients are still a debating topic.
2. Aortic Valve Repair: The Heart valve repair surgery will be performed on selected patients because the surgeon needs to consider and evaluate the patient’s condition and symptoms precisely.
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