Reviewed by Dr. James Whynot
AVS is one of the most common congenital heart disorders. It is also one of the most common valve diseases.Aortic stenosis is an obstruction between the left ventricle and the aorta. The most common location for the obstruction is in the aortic valve, which separates the ventricle and aorta.
The problemIn a healthy heart, the left atrium fills with oxygenated blood from the lungs and passes it to the left ventricle. It is the job of the left ventricle to pump the blood through the rest of the body. When the left ventricle contracts, it pushes the blood through the aorta. From the aorta, the blood branches off to the different parts of the body. The aortic valve connects the ventricle to the aorta.
Usually, the aortic valve has three leaflets that separate easily to allow the blood to pass. In AVS, various abnormalities can occur. There may be only two leaflets, which are then thicker and stiffer than normal, and do not separate easily. This common abnormality is caused a bicuspid aortic valve. The ventricle has to work harder to compensate, and enlarges, resulting in hypertrophic cardiomyopathy. In other cases, the obstruction is so severe that the ventricle cannot compensate, and heart failure results. This is rare, and occurs only in infants with severe cases of AVS. AVS is not likely to lead to heart failure in older children.
Symptoms
Except in the serious cases that can lead to heart failure within a few days of birth, AVS usually has no symptoms. There may be a mild heart murmur, which the doctor will detect, but the child will feel normal. Treatment may still be necessary, however, because there is a risk of developing complications later in life.
Once he or she detects a heart murmur, the doctor will use two standard non-invasive diagnostic tools, echocardiography and electrocardiography, to further examine the problem. If a more detailed analysis is needed, cardiac catheterization may be performed. Cardiac catheterization is used to examine the degree of the abnormality. In many cases, however, the echocardiogram can serve the same function. If treatment is necessary, balloon dilation valvuloplasty is the first step. This procedure can be performed with cardiac catheterization and is much less invasive than open heart techniques. If stenosis is too serious for balloon dilation to be effective, heart valve replacement surgery may be necessary. Both of these procedures have high success rates.
