What is the treatment for aortic stenosis?
There are different options to treat the narrowing of the aortic valve and it is important to analyse in detail the characteristics of each patient in order to choose the best option, considering the degree of severity and the rest of the characteristics (age, associated diseases, medical and surgical background, etc).
Conservative plan or correction of the valve disease.
In many cases, once the valvular lesion is diagnosed, its grade of narrowing is mild or moderate, or it has little impact at cardiac level or there are no symptoms. In these cases, the specialist in charge is likely to advise for regular check-ups until the degree of severity is greater than or there are more manifestations, and at that moment the surgical treatment would be proposed in order to correct the aortic stenosis.
Aortic stenosis correction
Once there are enough reasons to treat aortic stenosis invasively, we would have to choose the best scope for each patient, considering risks and benefits for each patient. Current techniques of general application for adults:
Aortic valve repair
In some cases, depending on the anatomy and the degree of thickening of the valves, it is possible to surgically repair the aortic valve without implanting a prosthesis. However, the most frequent technique on aortic valve when correction is needed is to use a valve prosthesis.
Valve substitution with “open surgery”
In recent decades, the most frequent surgical frequent for aortic stenosis has been the extracorporeal valve substitution through sternotomy. An opening of the chest cavity is performed through section on the sternum, stopping the heart and deriving the blood flow to an extracorporeal circulation machine (also known as heart-lung machine). It is commonly known as “calcific aortic stenosis”.
Through this technique, the diseased valve is removed and a biological or mechanical valve prosthesis (“artificial valve”) is implanted.
Transcatheter aortic valve implantation
Over the years, a less invasive process for aortic stenosis correction has been extended: transcatheter aortic valve implantation.
This proceeding is also known as TAVI or TAVR: transcatheter aortic valve implantation or transcatheter aortic valve replacement.
In order to collate all the information about this technique, the Working Group on TAVI and Transcatheter Valvular Techniques of the Spanish Society of Thoracic and Cardiovascular Surgery has developed the TAVISPAIN portal, which is a point of reference about TAVI in Spanish and it contains information for patients and professionals, as well as a map of the endorsed centres by such Society.