Aortic Valve Disease

About the Aortic Valve

The aortic valve is one of four heart valves. It separates the left ventricle (which pumps blood to the body) from the aorta. It opens and closes automatically, based on pressure changes in your heart.

Illustration of heart showing normal aortic valve open and closed

When you have damage to the aortic valve, it does not open and close properly. The two main types of aortic valve disease are aortic stenosis and aortic insufficiency/regurgitation.

Bicuspid Aortic Valve

A normal aortic valve has three leaflets, but some people are born with two leaflets, which is known as a bicuspid aortic valve. This irregular valve can lead to aortic stenosis or other complications. Visit our Bicuspid Aortic Valve page to learn more.

Aortic Stenosis

Aortic Stenosis is is a thickening of the valve leaflets, making it difficult for them to open and close. The condition may cause your heart to work harder to pump blood. Approximately 100,000 people in the United States have been diagnosed with severe aortic stenosis. This is often unpreventable and may be related to:

  • Age
  • A buildup of calcium deposits which causes narrowing
  • Radiation therapy
  • Medications
  • A history of rheumatic fever or high cholesterol

Patients with aortic stenosis may have no symptoms or may experience:

  • Chest discomfort
  • Shortness of breath
  • Lightheadedness
  • Dizziness
  • Fainting

Visit our Aortic Stenosis page to learn more.

Aortic Insufficiency or Regurgitation

With aortic insufficiency or regurgitation, the valve leaflets do not close properly and blood leaks back into the heart, causing an overload of blood in the heart which may lead to heart failure. Symptoms include shortness of breath, fatigue, low energy level and possible lightheadedness.

Treatment Options for Aortic Valve Disease

Aortic valve disease can be treated either medically or surgically depending on severity and/or symptoms. Surgical treatment may consist of repair of the valve leaflets or replacement of the valve. Surgery can be either an open repair or minimally invasive, based on your individual case.

Open-Heart Surgery

Historically, open surgical aortic valve replacement (SAVR) has been the standard treatment for severe aortic stenosis. For more than 25 years, the  Frankel Cardiovascular Center has been a leader in aortic valve replacement in both volume and outcomes. The Frankel CVC is one of only a few sites in the nation to conduct the TRANSFORM clinical trial for the INTUITY valve system developed by Edwards Lifesciences. This trial (currently in follow-up stages and not currently recruiting new subjects) offers a potentially significant advancement in valve replacement surgery because it allows the surgeon to implant the valve with only three sutures, substantially decreasing the time required for the surgical intervention.

The Ross procedure (also known as the pulmonary autograft procdure) is an option for select patients with aortic valve disease. During this highly specialized open-heart surgical procedure, the damaged aortic valve is removed and replaced with the patient’s own pulmonary valve. A second pulmonary valve, typically a human homograft valve or occasionally an animal tissue valve, is then attached where the initial pulmonary valve was removed.

Because the aortic valve is replaced with the patient’s own pulmonary valve, this valve usually lasts much longer than a tissue aortic valve and the need for long-term blood thinners can be avoided.

This procedure is a potential option for any patient with a life expectancy of 15 years or greater. It can also be performed in a patient who previously had open-heart surgery. However, careful assessments are required to determine whether it is the right option for a patient. These include the patient’s potential lifespan in comparison with the lifespan of the valve, type of aortic valve disease, overall health, quality of the pulmonic valve and necessity for other simultaneous heart procedures.

Minimally Invasive Valve Replacement 

Transcatheter aortic valve replacement (TAVR) is a minimally invasive, catheter-based procedure to replace the aortic valve in patients with severe aortic stenosis. It is an alternative to SAVR. Originally developed for high-risk patients who were not candidates for an open-heart procedure, TAVR is now available to patients at intermediate and low risk for surgery. This is due to excellent clinical trial results showing equal or better patient outcomes compared to SAVR.

Michigan Medicine is one of the only health systems in the region to offer the full spectrum of valve options available through clinical trials as well as FDA-approved devices. U-M is also the only center in Michigan to test a novel TAVR valve for the treatment of aortic regurgitation. 

TAVR technology is also being used to restore the function of failing bioprosthetic valves in what is known as a “valve-in-valve” procedure. This may be the best valve replacement option for high-risk patients. 

With new clinical trials focused on the treatment of aortic regurgitation as well as fourth-generation devices anticipated in the next few years, we hope to provide all patients with options for the latest available technological advances for aortic valve disease.

Patient Resources

Make an Appointment

To make an appointment to discuss your aortic valve disease and whether you are a candidate for a heart valve replacement, call us at 888-287-1082 or visit our Make a Cardiovascular Appointment page for more information about what to expect when you call us.