Aortic stenosis
This is a malformation of the aortic valve that progresses over time and obstructs blood flow out of the left ventricle. Aortic stenosis is often associated with more than one kind of obstruction, such as mitral valve stenosis, coarctation of the aorta, and supravalvular aortic stenosis. This means it can occur as part of hypoplastic left heart syndrome.
Who is affected by aortic stenosis?
Aortic stenosis makes up 3% to 6% of congenital heart diseases detected during childhood. In occurs in 3% to 4% of men and women.
Diagnosis
Patients are usually children who do not show any symptoms and develop normally but who are discovered to have a heart murmur during a routine examination. Aortic stenosis may also be detected through the following tests:
Echocardiogram: this is the most effective way to confirm diagnosis. This also enables the valve morphology to be defined and the level of severity evaluated.
Stress test or ergometry: this shows whether the child has symptoms such as high blood pressure, angina, syncope and signs of ischemia, which help to determine the severity of the condition.
Typical treatment
The type of treatment will depend on the severity of the condition.
- Mild or moderate stenosis: conservative treatment will be carried out.
- Severe stenosis: percutaneous or surgical valvotomy is recommended even if the patient shows no symptoms. In this case, the atomic characteristics of the valve must be examined.
If the percutaneous or surgical valvotomy does not manage to stop the insufficiency or obstruction, then valve replacement is performed. This replaces the aortic valve with a graft from the same patient’s pulmonary valve, or one from a donor.
Patients who have undergone this treatment have a similar quality of life to the rest of the population. Despite this, however, around 20 % will live with mild stenosis for 30 years and 20 % will require surgery on the valve.
