Aortic Valve Disease

aortic valve disease photo

Aortic valve disease affects more than a million Americans – and if left untreated, can result in heart failure, severe infection or sudden death. The Advanced Cardiac Valve Center is committed to bringing you the most advanced and effective techniques for treating this disease.

  • Aortic Stenosis is a common health problem in the United States; in fact, up to 7% of the population over the age of 65 is diagnosed each year. The aortic valve connects the heart and aorta, the large artery that carries blood away from the heart to the rest of the body. The aortic valve opens so blood can flow out of the heart, and closes to keep blood from returning to the heart. Aortic stenosis occurs when your aortic valve becomes narrowed and does not allow for normal blood flow.Aortic stenosis can become severe with or without symptoms. Common symptoms include chest pain, fatigue and shortness of breath. Severe aortic stenosis is a very serious problem. Studies show that people who have developed symptoms from severe aortic stenosis have about a 50% chance of dying within 2 years and 80% within 5 years without aortic valve replacement.
  • Aortic Insufficiency or Regurgitation is a condition where the valve does not close properly due to the valve leaflet tissue becoming weakened or floppy over time. This allows blood to leak back into the left ventricle, the main pumping chamber of the heart, decreasing the efficiency of the heart and causing it to work harder.

Aortic valve disease treatment options

Open heart surgery is any type of surgery where the chest is cut open and surgery is performed on the muscles, valves, or arteries of the heart.

Minimally invasive aortic valve surgery allows the surgeon to access the valve through much smaller incisions causing less trauma and reduced recovery time. The Advanced Cardiac Valve Center offers two different minimally invasive surgical options, mini-thoracotomy and mini-sternotomy.

  • Mini-thoracotomy requires a 5 cm incision between the ribs with no need to cut the breastbone. Patients with a mini-thoracotomy can return to driving immediately and return to normal activities after one to two weeks.
  • Mini-sternotomy requires a small incision through the breastbone. These patients can typically return to driving in one month and return to normal activities after three months.


Transcatheter Aortic Valve Replacement (TAVR) is the newest and least invasive approach for treating severe aortic stenosis. This procedure currently is restricted to patients who are considered high risk or are not eligible for surgery. The procedure is performed with general anesthesia in the Bon Secours Cardiac Hybrid Operating Room. During the TAVR procedure, interventional cardiologists and cardiac surgeons use fluoroscopy and echocardiography to guide the valve to the site of implantation/replacement. A balloon at the end of the catheter, with a replacement valve folded around it, delivers the new valve to take the place of the old. The catheter is then removed and the valve is left in place. TAVR currently is approved for patients at intermediate and high surgical risk. The ACVC is the only center in central Virginia participating in the Low Risk TAVR Trial. This gives patients at low surgical risk the opportunity to receive a transcatheter aortic valve replacement utilizing the latest generation of transcatheter valves.

Signs and symptoms of aortic valve disease

Since aortic valve disease is a progressive condition, you may not experience any symptoms until the heart is no longer capable of compensating for the decreased heart function. When symptoms are present, they may include:

  • Fatigue and weakness, especially when you increase your activity level
  • Shortness of breath with exertion or when you lie down
  • Swollen ankles and feet (edema)
  • Chest pain (angina), discomfort or tightness
  • Lightheadedness or fainting
  • Irregular pulse
  • Heart murmur
  • Sensations of a rapid, fluttering heartbeat

Severe aortic stenosis is a very serious problem. Without valve replacement, research has demonstrated that patients may have about a 50% chance of dying within 2 years and 80% at 5 years. (Otto CM. Timing of aortic valve surgery. Heart. 2000;84:211-218)