If your condition is severe enough, your doctor may recommend surgery or statins to control your LDL (“bad”) cholesterol. These medications have many benefits for the heart, but they also carry some risks. Aggressive treatments may also include surgical procedures, which replace or repair the faulty valve.
Transcatheter aortic valve replacement (TAVR)
TAVR is a minimally invasive procedure for aortic valve replacement that can be an effective treatment for severe aortic stenotic disease. It replaces the diseased valve through a catheter, which avoids open heart surgery. Compared to traditional valve replacement surgery, TAVR is safer and has similar or better outcomes. Most patients can undergo TAVR with minimal side effects.
TAVR has some disadvantages, though. For one, there is the potential for blood to leak through the replacement valve, which can cause blood clots to form. This could lead to stroke.
Balloon valvuloplasty
In critically ill patients, balloon valvuloplasty is a life-saving intervention to improve cardiac output. It was first proposed in 1986 by Cribier as an alternative to surgical aortic valve replacement. Unfortunately, it was associated with significant morbidity and mortality. The procedure’s use was stopped, but interest in it has recently resumed with the development of transcatheter aortic valve replacement.
Although the results of balloon valvuloplasty are not as good as those of surgical valve replacement, this treatment is an effective option for people with severe aortic stenosic symptoms. It can help prevent restenosis, delay the onset of valve mineralization, and improve quality of life. In addition, it is less invasive and can be repeated as necessary.
ACE inhibitors
ACE inhibitors are not a cure for aortic stenosis, but they are an alternative therapy for patients with severe aortic stenosing. These drugs work by decreasing coronary perfusion pressure and have also been shown to be safe for patients with aortic stenosis. Although aortic valve surgery remains the best treatment option for severe aortic stenoses, there are still some contraindications to this treatment.
ACE inhibitors work by inhibiting the renin-angiotensin-aldosterone (RAAS) system. Activation of the RAAS system increases systemic blood pressure, increases the likelihood of thrombosis, and causes remodeling of the heart. ACE inhibitors blunt these effects by inhibiting the RAAS in the local and peripheral blood. However, it is unclear whether the drugs can have beneficial effects on aortic stenosis or other cardiovascular conditions.
TAVR
TAVR is a newer alternative treatment for severe aortic stenosis, and it may mean the end for open heart surgery. It uses a catheter to replace the diseased aortic valve. This procedure is less invasive than traditional surgery, and patients can usually recover quickly. It is also safer than open heart surgery.
The total TAVR procedure can take between one and two hours. The surgeon and a team of specialists determine the best approach based on the patient’s medical history, artery condition, and body structure. Because of the potential risk, this procedure is not appropriate for everyone. The heart team may consist of a primary care physician, cardiologist, and cardiothoracic surgeon.
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