Blog

Theaortic valve is the formation that normally allows the smooth passage of oxygenated blood from the heart to the circulation of the whole body. Normally, this passage occurs effortlessly with the contraction of the heart, while at the same time the closure of the valve prevents the flow of blood back towards the heart. Severe aortic valve stenosis occurs when, for various reasons, the aortic valve cannot open and close properly. This results in the “thickening” of the heart muscle to “push” blood into the circulation and over time the “weakening” of the heart.

What are the causes of severe aortic valve stenosis?

Severe aortic valve stenosis is usually associated with age and the deposition of calcium in the valve or its annulus, which in turn ultimately causes stenosis (degenerative stenosis). Other causes include a history of rheumatic fever at a young age, congenital valve abnormality, previous radiation to the chest, medications, rare metabolic or autoimmune diseases, very high cholesterol levels (hereditary hypercholesterolemia), end-stage renal failure. 

What are the symptoms of severe aortic valve stenosis?

The symptoms of severe aortic stenosis are associated with the heart’s inability to supply blood to its coronary vessels and circulation, especially in cases of increased demands such as e.g. to some physical effort. These are mainly angina (chest pain), shortness of breath on exertion and a feeling of fainting or fainting. 

Epidemiological studies have shown that the frequency of aortic stenosis increases with age. Over the age of 75, one in eight people has moderate or severe aortic stenosis, while 4% of the population suffers from symptoms due to severe aortic stenosis. As life expectancy increases, so does the incidence of the disease. This constitutes a significant and growing public health problem. Essentially, once symptoms begin, and if untreated, one in two patients lives for two years and only one in five for five years. 

What is the treatment for severe aortic valve stenosis?

There is no drug therapy that can reverse or slow the progression of aortic stenosis. Surgical aortic valve replacement was for many years the treatment of choice for the treatment of symptomatic aortic stenosis. However, several patients, due to age (over 75 years) have an intermediate surgical risk, while others, due to medical problems, have a high or even prohibitive risk for surgical treatment.

Also, several patients have already undergone aortic valve replacement in the past with a biological valve, which has progressively degenerated and requires reoperation. These patients can be treated with an alternative method: transcatheter aortic valve replacement (TAVI or TAVR). All patient data are evaluated by the Interventional Cardiologists – Cardiac Surgeons – Anesthesiologists – Vascular Surgeons (Heart Team) for the indication of the operation, but also for the method of valve placement.

TAVI: Transcatheter aortic valve replacement valve

The new biological valve is placed in place of the old one through a catheter (tube) usually from the femoral artery or the subclavian artery. The valve consists of biological material, fixed to astent. During the implantation of the valve, thestent is deployed and the new valve is placed over the old one which is compressed, allowing normal passage of blood from the heart to the rest of the circulation.

Percutaneous placement (replacement) of the aortic valve has clearly lower risks than the classic surgical treatment of aortic stenosis. For this reason, based on recent studies, it is the treatment of choice today in patients with moderate or high surgical risk.

At the Athens Medical Center, the percutaneous aortic valve implantation program for both native and degenerated aortic valves that had been surgically implanted in the past has been active for over a decade and all types of percutaneous valves are implanted, depending on the need for each patient, with excellent in-hospital and long-term results.