Materiały źródłowe

• #1 Aortic valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-disease/diagnosis-treatment/drc-20355122

  Treatment for aortic valve disease depends on: The severity (stage) of aortic valve disease. Whether the disease is causing symptoms. Whether the condition is getting worse. […] Treatment may include regular health checkups, lifestyle changes, medicines, or surgery or other procedures. If you have aortic valve disease, consider being evaluated and treated at a medical center with a multidisciplinary team of heart doctors called cardiologists and other care professionals trained and experienced in evaluating and treating heart valve disease. […] Eventually, surgery or a catheter procedure may be needed to repair or replace the diseased aortic valve. Some people with aortic valve disease need surgery even if it’s not severe or when it’s not causing symptoms. […] Surgery to repair or replace an aortic valve is often done with open-heart surgery. Sometimes, the valve can be replaced during minimally invasive heart surgery, which uses smaller incisions than those needed for open-heart surgery, or with a catheter-based procedure.

• #2 Aortic Valve Disease > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/aortic-valve-disease

  Treatment involves surgery, minimally invasive procedures, and medication. […] Fortunately, effective treatments are available that can help alleviate symptoms and even restore normal blood flow. […] While medications and avoidance of physically demanding activities can help to control symptoms, they cannot cure aortic valve disease. The disease is caused by changes to the physical structure of the valve (it becomes narrowed or can no longer open or close completely). Thus, the main treatments for aortic valve disease are repair or replacement of the valve. […] Techniques for repairing or replacing the aortic valve include: Surgery. Aortic valve repair and replacement has been done via open-heart surgery for decades. It’s a well-established approach, and has proven to be safe. […] Balloon valvuloplasty. This is a repair procedure in which a doctor inserts a catheter with a balloon at its tip into a blood vessel, then maneuvers it to the heart and aortic valve. […] Transcatheter aortic valve replacement (TAVR). In this minimally invasive procedure, a doctor performs a balloon valvuloplasty to stretch out the old valve. […] Aortic valve surgery is safe and has proven long-term benefits. It can help alleviate patients’ symptoms and prolong their lives.

• #3 Aortic Valve Disease | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/aortic-valve-disease

  Aortic valve diseases can threaten your health and impact your quality of life. Our heart and vascular specialists at the University of Michigan Health Frankel Cardiovascular Center are skilled in diagnosing and treating diseases of the aortic valve. […] We use innovative techniques and a unique team-based approach to help you feel better as quickly as possible. […] Our surgeons are among the top in the nation. They are continually developing new treatments and refining existing ones to improve patient outcomes. […] As one of the nations largest aortic valve programs, we participate in clinical trials for medical device companies. This gives you access to treatments and devices that may not be available elsewhere. […] Our team meets weekly to review your case, evaluate your symptoms and identify treatment options. We then work with you to develop a treatment plan that is best for your condition and personal needs.

• #4 Aortic Valve Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK542205/

  Aortic valve replacement is the most essential treatment modality. It is generally indicated in patients with symptomatic aortic valve disease or severe disease, as the American Heart Association guidelines indicate. […] Valve replacement for aortic stenosis is recommended for asymptomatic patients (evidenced by history or stress testing) with a high-gradient disease or asymptomatic patients with severe aortic stenosis (C2) and a left ventricular ejection fraction less than 50%. […] Valve replacement for the treatment of aortic regurgitation is indicated for symptomatic patients with severe AR regardless of LV systolic function (D), asymptomatic patients with chronic severe AR and evidence of LV systolic dysfunction (EF less than 50%; ie, C2), and patients with severe AR (C or D) while undergoing cardiac surgery for any other indication.

• #5 Aortic valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-stenosis/diagnosis-treatment/drc-20353145

  Treatment for aortic valve stenosis depends on the symptoms and how severe the condition is. Aortic valve stenosis ranges from mild to severe. […] If you have no symptoms or just mild ones, you may only need regular health checkups. Some people need medicines to treat valve disease symptoms or reduce the risk of complications. […] Other treatments for aortic valve disease may include: Heart-healthy lifestyle changes. Eat healthy, get regular exercise and stay active, and do not smoke. Medicines to treat symptoms or reduce the risk of complications. Surgery to fix or replace the valve. […] Some people with aortic valve stenosis may need medicines to treat symptoms or reduce the risk of complications. For example, medicines may be used to: Lower blood pressure. Prevent irregular heartbeats. Remove excess fluid from the body to reduce the strain on the heart.

• #6 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p371.html

  Watchful waiting is recommended for most asymptomatic patients with aortic stenosis, including those with severe disease. […] Transcatheter aortic valve replacement is recommended for patients who have an indication for valve replacement but are at prohibitive surgical risk. […] Surgical aortic valve replacement is the standard of care in patients with low or intermediate surgical risk.

• #7 Heart Valve Disease Treatment Without Surgery: The Options

  https://www.healthline.com/health/heart-valve-disease-treatment-without-surgery

  Heart valve disease doesnt always require surgery. Nonsurgical treatments like medications, lifestyle changes, or minimally invasive procedures are sufficient for some people. […] A doctor may recommend nonsurgical options if your heart valve disease is mild or to help minimize your risk of complications while you wait for surgery. […] Medications can help reduce your symptoms, prevent complications, and take the stress off your heart. […] Lifestyle changes alone might be enough to treat minor heart valve disease or help maximize your heart health until you can receive surgical treatment. […] Surgeons can use nonsurgical procedures to treat heart valve disease by repairing your valve from within your bloodstream. These are called percutaneous valve procedures. […] Your life expectancy depends on the type and extent of your heart valve disease. Minor problems might never cause complications or shorten your life span, even without surgery. But severe disease might lead to fatal complications without treatment.

• #8 Heart Valve Diseases – Treatment | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/heart-valve-diseases/treatment

  Your healthcare provider may recommend healthy lifestyle changes or medicine first to treat symptoms, which may delay problems. […] Eventually, you may need to have your faulty heart valve repaired or replaced. After repair or replacement, you’ll still need certain medicines and regular checkups with your doctor. […] Your doctor may prescribe medicines to relieve the symptoms of your heart valve disease, prevent it from getting worse, or treat other heart problems that can affect your heart valves. […] Your doctor may recommend heart valve repair if you have new symptoms of heart valve disease or your current symptoms get worse. […] Heart valve repair can improve symptoms, but sometimes problems return. […] Sometimes faulty or diseased heart valves cannot be repaired and must be replaced.

• #9 Heart Valve Disease: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17639-what-you-need-to-know-heart-valve-disease

  Although medicines cant cure heart valve disease, they and a healthy lifestyle can help with symptoms and decrease your chance of having a stroke or cardiac arrest. You may be able to stop taking some medications after valve surgery, but you may need to take other medicines for the rest of your life. […] Heart valve disease is a problem with the opening or closing of your leaflets, and you may need surgery to repair or replace your valve. Some infants who have congenital (present at birth) valve issues need surgery during childhood. […] Heart valve repair allows your surgeon to fix your faulty valve, often without the use of artificial parts. In some cases, like a narrow mitral valve, your provider may use a balloon on a catheter (valvuloplasty) to widen your valve. They may perform an annuloplasty to fix or reinforce the ring around your valve so it closes better.

• #10 Aortic Valve Disease | Duke Health

  https://www.dukehealth.org/treatments/heart/aortic-valve-disease

  Aortic valve diseases, including aortic valve stenosis (a narrowed valve opening) and aortic valve regurgitation (a leaking valve), require evaluation and management by a cardiologist or cardiac surgeon. More serious conditions may require surgery to repair or replace the aortic valve. […] Our cardiologists and heart surgeons use a full range of therapies to treat aortic valve disease. When surgery is needed, our skilled heart surgeons repair or replace diseased aortic valves, often with minimally invasive techniques. […] Medications may be prescribed to reduce and prevent aortic valve disease symptoms and complications. These may include ACE inhibitors or beta-blockers to lower blood pressure, antiarrhythmics to help maintain a regular heart rhythm, anticoagulants to prevent blood clots, and diuretics that can help reduce fluid retention.

• #11 Medical management of symptomatic aortic stenosis – UpToDate

  https://www.uptodate.com/contents/medical-management-of-symptomatic-aortic-stenosis

  Aortic valve replacement (AVR, including surgical aortic valve replacement and transcatheter aortic valve implantation [TAVI]) is the mainstay of treatment of symptomatic aortic stenosis (AS). AVR offers substantial improvements in symptoms and life expectancy. Medical therapy may not prolong life in patients with AS and has limited utility in treating symptoms. […] In patients who are awaiting AVR, medical therapy to optimize hemodynamics in the preoperative setting may be needed. When severe symptoms are present, it may be prudent to admit the patient to the hospital and perform AVR urgently, as there is a high risk of cardiac death once severe symptoms are present. […] Longer-term palliative medical management of symptomatic AS is appropriate for patients who are not candidates for aortic valve intervention due to coexisting medical conditions and in patients who decline aortic valve intervention. TAVI enables AVR in many patients with prohibitive or high operative risk for surgical AVR. However, TAVI may not be feasible in some patients due to anatomic factors or may not be appropriate in patients with a limited life expectancy due to other comorbidities or extreme frailty.

• #12 Aortic valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-disease/diagnosis-treatment/drc-20355122

  During aortic valve repair, the surgeon may do one or all of the following: Separate valve flaps that have fused. Add support to the base of the valve. Reshape or remove excess valve tissue so that the cusps can close tightly. Patch holes or tears in a valve. […] In a mechanical valve replacement, an artificial heart valve made of strong material replaces the damaged valve. […] In a biological valve replacement, a valve made from cow, pig or human heart tissue replaces the damaged heart valve. […] Transcatheter aortic valve replacement (TAVR) is a type of heart valve surgery. It’s done to replace a narrowed aortic valve, a condition called aortic valve stenosis. A doctor inserts a flexible tube called a catheter into a blood vessel and guides it into the heart. A replacement valve made of cow or pig tissue goes through the tube to the specific area in the heart. A balloon on the catheter tip inflates to press the new valve into place. Some valves are self-expanding.

• #13 Aortic Valve Disease, Osseo – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/locations/osseo/services-and-treatments/cardiology/diseases/aortic

  Aortic valve disease is a condition where the valve between the main pumping chamber of your heart and the main artery to your body, the aorta, doesn’t work properly. Aortic valve disease may be a congenital condition or it can result from other causes. […] Your treatment depends on the type and severity of your aortic valve disease. In some cases, you may need surgery to repair or replace the aortic valve. […] To repair an aortic valve, surgeons may conduct several types of repair, including separating valve flaps that have fused, removing excess valve tissue so that the valve flaps can close tightly or patching holes in a valve. […] Doctors may conduct a procedure using a long, thin tube, or catheter, to open up a valve with a narrowed opening. This is called aortic valve stenosis. In this procedure, which is called balloon valvuloplasty, a doctor inserts a catheter with a balloon on the tip into an artery in your groin and guides it to the aortic valve. A doctor then inflates the balloon, which expands the opening of the valve. The balloon is then deflated, and the catheter and balloon are removed.

• #14 Aortic Disease Treatments and Procedures | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/aortic-disease-treatments-and-procedures

  Open aortic valve procedures require direct access to the heart. Procedures available to patients at the Frankel Cardiovascular Center include: […] Aortic valve repair or replacement: If you have a leaking valve, repair allows you to keep your valve, which may improve long-term outcomes. If repair is not possible, the valve can be replaced with a mechanical or tissue valve. […] The Ross procedure is most often performed on younger patients. […] This procedure developed at the Frankel Cardiovascular Center offers excellent outcomes for people who need a new aortic valve. The cardiac surgeon enlarges the aortic root and inserts a prosthetic valve that is three to four valve sizes larger. The large valve results in improved blood flow, quality of life and long-term survival.

• #15 Aortic valve stenosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-stenosis/diagnosis-treatment/drc-20353145

  You may eventually need a surgery to repair or replace the narrowed aortic valve, even if you don’t have symptoms. Aortic valve surgery may be done at the same time as other types of heart surgery. […] Surgery to repair or replace an aortic valve is usually done through a cut in the chest. Less invasive approaches may be available. Ask your healthcare professional which type of aortic valve treatment is best for you. […] Surgery and procedures for aortic valve stenosis include: Balloon valvuloplasty. This treatment helps open a narrowed valve. It may be done in infants and children with aortic valve stenosis. In adults, the aortic valve tends to narrow again after the treatment. So it’s usually done only if an adult is too sick for surgery or if an adult is waiting for a valve replacement.

• #16 Aortic Valve Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK542205/

  Patients whose life expectancy after the replacement is less than 1 year or whose quality of life is not expected to improve would not be candidates for valve replacement. However, if life expectancy is greater than 1 year, and predictions include improvement in the quality of life, there are 2 methods for aortic valve replacement: surgical or transcatheter. […] Transcatheter aortic valve replacement is only indicated for aortic stenosis, not aortic regurgitation. Electing 1 method over the other is determined by evaluating the morbidity and mortality risk of surgical valve replacement, often utilizing the Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM). If the risk of serious complications or death is greater than 50%, transcatheter aortic valve replacement (TAVR) is the preferred option. If the surgical risk is less than 50%, the consensus has been that SAVR is the preferred method. However, several studies now show no difference in morbidity and mortality 1-year post-op between SAVR and TAVR and that TAVR is safe to use in any patient regardless of the risk level. […] This procedure involves balloon inflation in the valve orifice to widen the valve, used only as a temporary bridge to valve replacement for hemodynamically unstable patients or for palliative/symptomatic relief in patients who are not surgical candidates.

• #17 Heart Valve Disease: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17639-what-you-need-to-know-heart-valve-disease

  Replacing your heart valve involves removing your old valve and sewing a new valve to the ring-shaped part of your old one. The new valve could be mechanical or biological (made with tissue from a human, cow or pig). These replacement valves can provide function when repair cant. But depending on the type of valve you get, you may have to take certain medications to prevent blood clots or get a new valve again in 10 or 15 years. […] Depending on the type of valve problem and your other medical conditions, you may be able to have minimally invasive valve repair or replacement. […] Older people and those whose health isnt good to begin with have a higher risk of complications from valve replacement surgery. […] You may be in the hospital for about five to seven days after heart valve surgery. After that, it can take about four to eight weeks to recover. Your provider may recommend cardiac rehab, a carefully monitored program to assist with your recovery.

• #18 Heart Valve Diseases – Treatment | NHLBI, NIH

  https://www.nhlbi.nih.gov/health/heart-valve-diseases/treatment

  Your surgeon will replace the faulty or diseased valve with either a mechanical or a biological heart valve. […] Valves can be replaced during open-heart surgery or with a minimally invasive procedure using a catheter a thin tube threaded through a blood vessel to the heart. […] Your doctor will discuss which heart treatment is best for your circumstances. […] The risks of heart valve replacement include stroke, blood clots, damage and bleeding where the catheters were inserted, and injury to the kidneys or the heart. Sometimes the new valve leaks because it does not fit well. […] NHLBI-funded scientists have developed new ways to make transcatheter aortic valve replacement (TAVR) surgery safer for high-risk patients.

• #19 Options for Heart Valve Replacement | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options/options-for-heart-valve-replacement

  The aortic valve is the most commonly replaced valve. […] The most common surgical procedure for aortic stenosis, or narrowing of the aortic valve, is aortic valve replacement. […] Aortic regurgitation, sometimes referred to as aortic insufficiency, is another common valve problem that may require valve replacement. […] Surgical options for valve replacement include: Mechanical valve — a long-lasting valve made of durable materials, Tissue valve — may include human or animal donor tissue, Ross Procedure — “Borrowing” your healthy valve and moving it into the position of the damaged valve aortic valve and replacing the “borrowed” valve with a new valve, TAVI/TAVR procedure — Transcatheter aortic valve implantation/transcatheter aortic valve replacement, Less invasive surgery options. […] The procedure chosen will depend on the valve that needs replacement, the severity of symptoms and the risk of surgery. Some procedures may require long-term medication to guard against blood clots. […] Age is not the only factor in making a decision on treatment. It is critical to talk to your care team to weigh the risks and benefits of each approach and take into account your values and preferences.

• #20 Aortic valve disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/aortic-valve-disease/diagnosis-treatment/drc-20355122

  Aortic valve replacement typically requires open-heart surgery. Sometimes, surgeons can use a minimally invasive procedure called transcatheter aortic valve replacement (TAVR) to replace a narrowed aortic valve with a biological tissue valve. TAVR uses smaller incisions than those used in open-heart surgery. TAVR may be an option for people at increased risk of heart valve surgery complications.

• #21 Aortic Valve Disease | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/heart-and-vascular/conditions-and-treatments/aortic-valve-disease-old/treatments

  Northwestern Medicine offers many approaches to aortic valve surgery. The choice of incision depends on: How much work is needed to repair or replace the valve, Whether any other procedures are needed to fix other heart problems, Whether you have had any other chest surgery, Other factors. […] Our priority is to give you the safest possible operation, with the best possible recovery.

• #22 Aortic Valve Disease | UNC Heart Valve Clinic

  https://www.med.unc.edu/medicine/cardiology/uncheartvalve/diseases-and-treatments/aortic-valve-disease/

  Aortic valve stenosis occurs when the opening of the aortic valve becomes narrowed and the valve no longer opens fully with each heartbeat. […] Unfortunately, at least 1/3 of patients with aortic valve stenosis today are not receiving valve replacement, which is the only treatment that is effective for this condition. […] Transcatheter aortic valve replacement (TAVR) is an alternate treatment option to conventional open heart surgery, and TAVR has shown to have equal, and sometimes better outcomes than traditional surgery. […] With TAVR, physicians now have the ability to provide aortic valve replacement via minimally-invasive approaches, including percutaneous procedures (intervention without an incision), which provide outcomes that are as good, or sometimes better than, surgical valve replacement.

• #23 Aortic Valve Disease, Osseo – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/locations/osseo/services-and-treatments/cardiology/diseases/aortic

  Aortic valve replacement is often needed to treat aortic valve disease. In aortic valve replacement, your surgeon removes the damaged valve and replaces it with a mechanical valve, or a valve made from cow, pig or human heart tissue. The latter is called a biological or tissue valve. Another type of biological tissue valve replacement that uses your own pulmonary valve is sometimes possible. […] Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace a narrowed aortic valve that fails to open properly. This is called aortic valve stenosis. Transcatheter aortic valve replacement is sometimes called transcatheter aortic valve implantation (TAVI). […] TAVR is usually reserved for people who can’t undergo open-heart surgery or surgery presents too many risks. TAVR can relieve the signs and symptoms of aortic valve stenosis, and may improve survival in people who can’t undergo surgery or have a high risk of surgical complications.

• #24 Aortic Disease Treatments and Procedures | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/aortic-disease-treatments-and-procedures

  Our Comprehensive Aortic Program at the Frankel Cardiovascular Center offers a wide range of treatment options for aortic disease. […] Aortic valves can be replaced or repaired. In patients who have aortic valve stenosis, replacement is usually the only option. If the valve is leaking, it can be repaired or replaced. […] In general, surgeons prefer aortic valve repair over replacement, especially in younger patients. Your surgeon will discuss your options and recommend the optimal procedure and valve type for you. […] At the Frankel Cardiovascular Center, our surgeons perform all types of aortic valve repair and replacement, including: […] TAVR is a minimally invasive procedure for patients with aortic stenosis. Our surgeons insert a tissue valve inside the diseased valve. The replacement valve expands in place, where it immediately takes over valve function.

• #25 Aortic Valve Treatment – Heart | NewYork-Presbyterian

  https://www.nyp.org/heart/heart-valves/aortic-valve-treatment

  Aortic stenosis is a narrowing of the aortic valve, which lies between the left ventricle and the aorta. NewYork-Presbyterian has more experience with transcatheter aortic valve replacement (TAVR) than any other center in the country. During this procedure, an interventional cardiologist implants a device through a catheter (long, flexible tube) threaded through a blood vessel in your leg and guided to your heart. Clinical trials, including those co-led by our physician-scientists, have shown TAVR to be a safe and effective minimally invasive option which results in shorter hospital stays and a lower risk of complications for patients of all ages and risk levels. This treatment was once primarily indicated for patients considered high-risk for traditional surgery, but it is now also used in patients at low risk who are experiencing symptoms.

• #26 Aortic Valve Treatments | Division of Cardiology

  https://www.columbiacardiology.org/patient-care/columbia-structural-heart-and-valve-center/conditions-and-treatments/aortic-valve-treatments

  This life-saving device originally provided a treatment option for patients who were too sick or too old to undergo a surgical replacement. It is now FDA approved for all patients independent of surgical risk. […] TAVR is now an option for the majority of patients with aortic stenosis, offering a much shorter recovery time and lower procedural risk than open heart surgery. […] During open heart surgery using general anesthesia, a mechanical or biological tissue valve is implanted to replace the damaged aortic valve. This type of treatment is highly effective, but is associated with a longer recovery time. […] Some aortic valve conditions can be repaired as an alternative to replacement or as a bridge to replacement. […] In general, transcatheter procedures require less recovery time than surgical treatments. The majority of patients go home the next day after the procedure in good health, with no restrictions after one week. […] Patients may also take medications after treatment to control blood pressure or reduce the risk of blood clots.

• #27 Severe Aortic Stenosis Treatment Options | Heart Valve Failure Patient

  https://treatheartvalvefailure.com/about-treatment/treatment-options

  Heart valve failure may sound scary, but it’s treatable, and you should know your options. TAVR (transcatheter aortic valve replacement) and SAVR (surgical aortic valve replacement), also called open heart surgery, are both ways to replace your heart valve. They reduce your risk of death from heart valve failure and provide relief from your symptoms. They each have their own key differences. […] TAVR does not involve opening the chest. The average TAVR procedure takes about 1 hour. Open heart surgery, by comparison, lasts about 4 hours. Most TAVR patients return home the next day and have a short recovery time, getting them back to everyday activities quickly. TAVR may also be used for patients at high risk for surgery. […] The PARTNER 3 Trial, SAPIEN 3 TAVR proven superior to surgery on the primary endpoint of all-cause death, all stroke, and re-hospitalization (valve-related or procedure-related and including heart failure) at one year, and multiple pre-specified secondary endpoints in low risk patients.

• #28 Aortic Valve Treatments | Division of Cardiology

  https://www.columbiacardiology.org/patient-care/columbia-structural-heart-and-valve-center/patient-care/conditions-and-treatments/aortic-valve-treatments

  This life-saving device originally provided a treatment option for patients who were too sick or too old to undergo a surgical replacement. It is now FDA approved for all patients independent of surgical risk. […] TAVR is now an option for the majority of patients with aortic stenosis, offering a much shorter recovery time and lower procedural risk than open heart surgery. […] During open heart surgery using general anesthesia, a mechanical or biological tissue valve is implanted to replace the damaged aortic valve. This type of treatment is highly effective, but is associated with a longer recovery time. […] Some aortic valve conditions can be repaired as an alternative to replacement or as a bridge to replacement. […] Recovery from aortic valve treatment will vary based on several factors, including the type of treatment, the severity of disease, additional heart conditions, previous surgeries, age, and overall health.

• #29 Aortic Valve Disease | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/aortic-valve-disease

  During open surgery, the aortic valve can be replaced or repaired. […] Patients with stenosis typically require valve replacement. […] Leaky valves can often be repaired or replaced. […] Because replacement valves have a limited lifespan, surgeons prefer to repair a diseased aortic valve if possible, especially in younger patients. […] Our surgeons have developed a reputation as leaders in aortic valve open surgery. […] This procedure is used when an aortic aneurysm or dissection occurs near the aortic root, but the valve is healthy. […] The surgeon replaces the diseased aortic valve with the pulmonary valve. […] The Ross procedure is often preferred for younger patients because the relocated aortic valve can grow with the child. […] This procedure was developed at the Frankel Cardiovascular Center and is recognized globally as game-changing for patients who need a new aortic valve but have a small aortic root.

• #30 Evolving treatment options for valve and aortic disease with bicuspid aortic valve

  https://atm.amegroups.org/article/view/14868/html

  Treatment decisions for patients with bicuspid aortic valves (BAVs) are unique for two principal reasons: (I) aortopathy with dilation of the proximal aorta is seen about 50% of cases, and frequently requires a combined repair; (II) patients are significantly younger than those undergoing treatment for acquired aortic valve disease, making the durability and lifestyle implications of treatment choices increasingly important. The traditional treatment for valve and aortic disease with BAV is composite or separate replacement of the valve and ascending aorta. While mechanical aortic valves are more durable, they require life-long anticoagulation. Bioprosthetic valves may be an even less attractive option for younger patients as primary valve failure has been reported in 26% of cases at 15 years. In this context, an alternative treatment approach with repair rather than replacement of the valve and aortic root, as proposed by Cosgrove et al. and later refined by Schfers et al., is very appealing.

• #31 Surgical treatment of aortic valve disease | Nature Reviews Cardiology

  https://www.nature.com/articles/nrcardio.2013.72

  Young adults with aortic stenosis, particularly women during childbearing years, can be treated with the Ross procedure. […] Finally, poor candidates for surgery who have aortic stenosis can now be treated with catheter-based aortic valve implantation but, in this article, the current status of aortic valve surgery is reviewed.

• #32 Aortic Valve Regurgitation: Treatment & Diagnosis | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/heart/conditions/aortic-valve-regurgitation/treatment

  TAVR is a minimally invasive surgery used to replace the aortic valve. A prosthetic valve is inserted through a catheter, typically placed via an artery in the groin. While TAVR is currently used primarily for patients with severe aortic stenosis, research is ongoing to explore its potential use for patients with aortic regurgitation in the future. […] This surgery replaces the aortic root while keeping the valve intact. Retaining the aortic valve eliminates the need for lifelong blood-thinning medications often required with valve replacement surgeries.

• #33 Aortic Valve Conditions and Treatment

  https://www.froedtert.com/heart-valve-disease/aortic-valve

  Aortic valve stenosis can, in some cases, be treated with the minimally invasive transcatheter aortic valve replacement (TAVR) procedure. […] We provide the widest range of options for aortic valve treatment. Whether your heart valve is repaired or replaced depends on many factors and both approaches can be highly successful. […] TAVR offers patients with aortic valve disease a minimally invasive alternative to open heart surgery. […] This transcatheter procedure uses a balloon to open or widen the problem valve to restore normal blood flow in patients. […] Underlying medical conditions, multiple heart problems and other factors may mean you will do better with a traditional, open procedure for aortic valve repair or replacement. […] Valve-sparing aortic root replacement aims to repair an aortic aneurysm or dissection preserving the patients own aortic valve instead of implanting an artificial valve.

• #34 Understanding Your Heart Valve Treatment Options | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options

  Most valve conditions can’t be treated with medication alone. However, sometimes the problem isn’t severe enough to require repair or valve replacement, but it’s bothersome enough to cause symptoms or risks. In these cases, a condition might be effectively managed for a while with medication. […] Heart valve disease is usually progressive. The outlook for those who receive no treatment can be poor. But many who do receive treatment go on to live very full and healthy lives, especially when their cardiovascular risks are otherwise low. […] Evidence is also clear that, with proper treatment, most people enjoy an improvement in health and quality of life. […] As with all surgeries, there are risks. Because every patient is different, your doctor and your health care team will discuss your treatment options and recommend the best option for you. […] People who have damaged, repaired or replaced heart valves are at increased risk for developing an infection of the valve, known as infective endocarditis.

• #35 Aortic Valve Disease | UNC Heart Valve Clinic

  https://www.med.unc.edu/medicine/cardiology/uncheartvalve/diseases-and-treatments/aortic-valve-disease/

  Patients benefit greatly when they can be evaluated by a multidisciplinary team, who then together decide on the best treatment option and provide the highest level of care. […] When traditional open heart surgery is needed for your aortic valve, you want a team of surgeons who offer the highest level of care and the most treatment options.

• #36 Aortic stenosis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/325

  Aortic stenosis (AS) is obstruction of blood flow across the aortic valve due to aortic valve fibrosis and calcification. […] Treatment of severe aortic stenosis with either a transcatheter or surgical valve prosthesis should be based primarily on symptoms or reduced ventricular systolic function. Earlier intervention may be considered if indicated by results of exercise testing, biomarkers, rapid progression, or the presence of very severe stenosis. […] Choice of intervention should be a shared decision-making process, taking account of lifetime risks and benefits associated with the type of approach (transcatheter versus surgical) and type of valve (mechanical vs. bioprosthetic). […] Following valve replacement, patients are subject to the complications of prosthetic valves.

• #37 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0301/p371.html

  Aortic valve replacement is recommended for most symptomatic patients with evidence of significant aortic stenosis on echocardiography. […] Surgical valve replacement is the standard of care for patients at low to moderate surgical risk. […] Transcatheter aortic valve replacement may be considered in patients at high or prohibitive surgical risk. […] Aortic valve replacement is the only effective treatment for symptomatic, hemodynamically severe aortic stenosis. […] Aortic valve replacement is also recommended for asymptomatic patients with severe stenosis accompanied by LV systolic dysfunction (EF less than 50%). […] Aortic valve replacement is also indicated in asymptomatic patients with severe or even moderate stenosis who are undergoing cardiac surgery for other indications; this avoids the need for repeat surgery once the valve disease inevitably progresses.

• #38 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0915/p717.html

  Aortic valve replacement is the only effective treatment for hemodynamically significant aortic stenosis. […] Aortic valve replacement is also recommended for asymptomatic patients with severe aortic stenosis accompanied by LV systolic dysfunction (i.e., ejection fraction of less than 50 percent). […] Watchful waiting is recommended in most asymptomatic patients with aortic stenosis, including those with severe disease. […] The average overall survival rate is two to three years in symptomatic patients without surgical treatment. […] Although there are no prospective randomized trials comparing aortic valve replacement with medical management, retrospective observational studies have shown that surgical repair leads to significant improvement in survival, usually accompanied by symptom improvement.

• #39 Antithrombotic Therapy in Patients With Valvular Heart Disease

  https://www.uspharmacist.com/article/antithrombotic-therapy-in-patients-with-valvular-heart-disease

  Most patients with VHD require surgery to repair or replace the valve and subsequent antithrombotic therapy to prevent clotting. […] After a prosthetic valve replacement, optimal antithrombotic therapy is recommended to prevent thromboembolism while minimizing the risk of bleeding. […] The therapeutic goals for treating VHD include reducing symptoms, repairing or replacing valves, and preventing blood clots. […] After the procedure, it is recommended that patients be started on antithrombotic therapy, such as warfarin or aspirin, to prevent thromboembolism. […] The choice of an antithrombotic agent is dependent upon the location of the replaced valve and the type of valve replacement(s). […] After valve replacement(s), antithrombotic therapy with an antiplatelet and vitamin K antagonist (VKA) is recommended with the dosing, duration, and international normalized ratio (INR) goal varying among bioprosthetic and mechanical replacements and TAVR.

• #40 Antithrombotic Therapy in Patients With Valvular Heart Disease

  https://www.uspharmacist.com/article/antithrombotic-therapy-in-patients-with-valvular-heart-disease

  It is recommended that patients with mechanical valves be on daily low-dose aspirin indefinitely and a VKA, but the INR goal depends on the type of mechanical valve and the presence of venous thromboembolism (VTE) risk factors. […] For patients post-TAVR, daily low-dose aspirin indefinitely and clopidogrel 75 mg daily for the first 3-6 months may be reasonable. […] Antiplatelet therapy is preferred over DOACs in these patients, as rivaroxaban 10 mg daily has been shown to put patients who are not indicated for anticoagulation for another reason at a higher risk of death or thromboembolic complications compared with antiplatelet therapy.

• #41 Aortic Valve Treatments | Division of Cardiology

  https://www.columbiacardiology.org/patient-care/columbia-structural-heart-and-valve-center/patient-care/conditions-and-treatments/aortic-valve-treatments

  In general, transcatheter procedures require less recovery time than surgical treatments. The majority of patients go home the next day after the procedure in good health, with no restrictions after one week. […] Patients may also take medications after treatment to control blood pressure or reduce the risk of blood clots.

• #42 Aortic Valve Disease | Duke Health

  https://www.dukehealth.org/treatments/heart/aortic-valve-disease

  Our heart surgeons offer minimally invasive techniques in which they reach and repair the aortic valve through small incisions — which may reduce blood loss, scarring, and the risk of infection while speeding your recovery. […] If you need a heart valve replacement, we offer mechanical valves made of carbon, as well as valves made from animal tissue. We screen and educate you on the best option for your needs and lifestyle. […] Our cardiac prevention and cardiac rehabilitation programs give you a personalized plan for recovery after surgery and help with long-term management of your heart health. Programs include exercise instruction, nutritional counseling, and lifestyle modification to optimize your health.

• #43 Aortic Stenosis: Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/23046-aortic-valve-stenosis

  Valve replacement offers several options for people who cant have a valve repair. Aortic valve surgery replaces the valve with a donor valve (usually from a cow or pig), a mechanical valve or a bioprosthetic valve. […] Transcatheter methods like balloon valvuloplasty and TAVR have shorter recovery times. […] Treating bacterial infections promptly is the only way to prevent aortic stenosis. […] Your outlook with aortic stenosis depends on how quickly you get treatment. […] With timely or early treatment, the prognosis for aortic stenosis is good or excellent. […] If you have mild aortic stenosis or no symptoms, you may only need routine echocardiograms and regular follow-up appointments. […] If you have moderate aortic valve stenosis, you may need to monitor symptoms, get routine echocardiograms and limit your activity. […] With severe aortic valve stenosis, youll likely need follow-up visits after a valve repair or replacement.

• #44 Valvular Heart Disease | Heart Valve Disease | MedlinePlus

  https://medlineplus.gov/heartvalvediseases.html

  In some cases, valve replacement is necessary. There are 2 types of replacement valves: […] Biologic valves made from pig, cow, or human tissue. These valves tend to wear out after 10 to 15 years, but some may last longer. […] Mechanical (human-made) valves usually don’t wear out. But with a mechanical valve, you usually have to take blood thinners for the rest of your life to prevent blood clots. And your risk of endocarditis (a heart infection) is higher than with a biologic valve.

• #45 Understanding Your Heart Valve Treatment Options | American Heart Association

  https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options

  Recovery statistics are very good for people who receive proper treatment. […] Treatment for valve disease will include a plan to: Protect your heart from further damage. Assess your need for medication to help manage symptoms. Repair the valve problem if needed. Communicate steps for management, self-care and the importance of follow-up care. […] Generally, once it’s determined that a diseased heart valve needs treatment, the available choices are valve repair or replacement: Valve repair — preserves the patient’s valve and leaflets. Sometimes repairs require a minor surgical procedure and other times repairs need a more extensive surgery. Repair is most often possible mitral valve regurgitation and tricuspid valve regurgitation. Valve replacement — may include open heart surgery or a minimally invasive procedure such as TAVR (or TAVI).

• #46 Aortic Stenosis: Symptoms, Causes, and Treatment

  https://patient.info/heart-health/heart-valves-and-valve-disease/aortic-stenosis

  Open heart surgery to replace the valve. The replacement may be with a mechanical or a tissue valve. […] Transcatheter aortic valve implantation (TAVI) Plastic tubes (catheters) are inserted into the heart through various arteries. Using these tubes, an artificial valve is sited within the existing aortic valve. This procedure does not require open heart surgery. […] Stretching the stenosed valve (balloon valvuloplasty) This is an option that is occasionally considered. This also does not require open heart surgery. […] Balloon valvuloplasty has historically been used only in those who were unsuitable for valve replacement surgery because the improvement in the flow across the valve (following balloon valvuloplasty) often only lasts for a year or so. […] Surgery is usually advised for anyone with symptoms but referral for consideration of surgery is now advised for anyone with moderate or severe aortic stenosis, even if they have no symptoms. Surgical treatment has greatly improved the outlook (prognosis) in most people. Surgery has a very good success rate.

• #47 Aortic Stenosis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2008/0915/p717.html

  Aortic valve replacement should be performed promptly in symptomatic patients. […] Patients with very severe aortic stenosis (aortic valve area of 0.6 cm2 or less or an aortic jet velocity of 5 m per second or more), a more rapid increase in aortic jet velocity over time (0.3 m per second or more per year), or severe valve calcification have a high risk of developing symptoms and of needing aortic valve replacement within the next one to two years. […] Aortic valve replacement should be considered if symptoms occur when the patient is at less than 80 percent of the predicted maximum heart rate or if the patient has an abnormal blood pressure response.

• #48 Heart Valve Disease Treatment Without Surgery: The Options

  https://www.healthline.com/health/heart-valve-disease-treatment-without-surgery

  Your doctor may recommend heart valve surgery if your condition is causing symptoms or if they think that it could lead to heart damage in the future. […] Mild heart valve disease might be manageable without surgery. Your doctor might recommend lifestyle changes, medications, or nonsurgical procedures.

• #49 Aortic Valve Stenosis Symptoms & Causes, Treatment for Aortic Stenosis

  https://www.thekeyholeheartclinic.com/services/valve-disorders/aortic-valve/aortic-stenosis/

  Aortic stenosis treatment is always the best answer. […] Therefore, the best aortic stenosis treatment available is surgery, and your doctor will be able to explain and recommend different kinds of aortic stenosis treatment London with you. […] The best treatment, by far, is replacement of your aortic valve by surgery. This treatment is effective, and will make you feel better, and live a longer, healthier life. […] Aortic stenosis treatment, such as aortic valve replacement, can be performed through keyhole incisions that either divide only a very small portion of the breastbone, or, in some cases, can avoid breastbone division altogether. […] The best treatment is still surgical replacement.

• #50 Bicuspid Aortic Valve Treatment | UVA Health

  https://uvahealth.com/services/heart-valve-disease/bicuspid-aortic-valve-treatment

  Medicines can’t repair your bicuspid aortic valve. But they can help with symptoms. […] When medicines arent working, you may need a procedure or surgery to fix your aortic valve. The best way to fix your aortic valve depends on lots of factors. We’ll go over with you the best choice for your condition. Options include: A procedure called transcatheter aortic valve replacement (TAVR), Open valve surgery. […] TAVR isn’t the right choice for everyone. If we can’t use TAVR, we can still repair or replace your bicuspid valve with a traditional open surgery. […] If you’re having bicuspid valve symptoms, it’s important to see an aortic valve expert. A bicuspid valve can make it harder for your heart to pump blood around your body. […] Without treatment, your body doesnt get the right amount of oxygen, and you may develop heart failure.

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