Aortic Valve Disease

Receiving a diagnosis of aortic valve disease means you need experienced heart doctors to help you feel better. At Henry Ford Health, we use minimally invasive procedures to restore your heart, helping you return to the life you love.

One example of these approaches is transcatheter aortic valve replacement (TAVR). Our TAVR experience means we can handle difficult cases and treat people other programs can’t. In fact, 60 percent of our cases come from doctors outside Henry Ford.

Aortic heart valve disease: Why choose Henry Ford?

The doctors at our Center for Structural Heart Disease can treat even the most complex cases of aortic valve disease. We customize your treatment and offer you:

• Minimally invasive options: Our team performs the latest minimally invasive treatments for aortic valve disease. For many people, these treatments can avoid open-heart surgery, for fewer complications and faster recovery.
• Experienced team: We helped expand the use of TAVR to a wide range of people. It’s now the go-to treatment for aortic valves, with our team completing more than 1,600 procedures. Our specialists are led by William W. O’Neill, M.D., who performed the first TAVR in the U.S. and is a world-renowned structural heart expert.
• Coordinated care: Despite the growing use of TAVR, some people are best treated with an open-heart surgery. We have a highly experienced surgical team that performs safe and effective treatment for these cases. Learn more about Henry Ford heart surgery.
• Expanded access: In addition to our main Detroit campus, we now offer TAVR in additional locations across southeastern and south-central Michigan.

How your aortic heart valve should work

Your heart has four valves that help control the flow of blood. The aortic valve sits between the left ventricle (the lower chamber) and the aorta (the large artery that carries blood to the rest of the body).

Most aortic valves have three flaps. The flaps open to send blood from the left ventricle to the aorta. The flaps then close to prevent blood from flowing back into the heart.

What is aortic valve disease?

Aortic valve disease means your valve doesn’t work properly. The two types of disease are:

• Aortic stenosis (narrowing): When the valve’s flaps get stiff and thick, they can’t fully open. The narrowed valve restricts blood flow out of the heart. This barrier causes blood to back up into the heart and lungs.
• Aortic regurgitation: This condition develops when the valve flaps don’t close tightly. The aorta still receives some of the blood your body needs. However, blood also flows backward into the left ventricle.

The heart must work harder to pump blood with both types of aortic valve disease. The extra strain causes the muscles in the left ventricle wall to thicken, which can lead to dangerous complications.

Causes of aortic valve disease

Aortic valve disease has two main causes:

• Congenital aortic valve disease: This condition is present at birth. Some people are born with a narrowed aortic valve, have too few flaps or have fused flaps.
• Acquired aortic valve disease: Disease develops later, typically from wear and tear as we age or from the natural buildup of calcium from the blood. Heart valve infections (endocarditis) and rheumatic fever can also cause damage that leads to valve disease.

Symptoms of aortic valve disease

Both aortic stenosis and regurgitation can develop and worsen over time. You may experience no symptoms in the early stages. As your heart works harder, you may have symptoms that often worsen during physical activity, including:

• Fatigue and shortness of breath (most common symptoms)
• Chest pain
• Cough
• Fainting and dizziness
• Heart murmur (an unusual sound during a heartbeat)
• Pounding, racing or fluttering heartbeat
• Swollen ankles or feet

Diagnosing aortic valve disease

We begin diagnosis with a thorough evaluation by members of our heart team, including an interventional cardiologist, surgeon, imaging specialist and nurse coordinator. You meet with various team members in a series of appointments, typically scheduled for the same day. You can schedule this evaluation at our main campus, Henry Ford Hospital, Jackson (Henry Ford Allegiance) or Clinton Township (Henry Ford Macomb).

During your first visit, we meet with you to:

• Perform a complete physical exam
• Review your medical history
• Discuss your symptoms and lifestyle
• Review any previous tests or imaging studies
• Recommend additional diagnostic tests

Advanced treatment for aortic valve disease

After your evaluation, our heart team comes together to review your case. Depending on your symptoms and health, we may recommend one of the following treatment options:

• Minimally invasive aortic valve replacement: Our doctors use the latest techniques to replace heart valves without open-heart surgery. During TAVR, we use a thin tube (catheter) to replace your valve through a blood vessel. Learn more about TAVR.
• Minimally invasive aortic valve repair: Sometimes our team repairs, rather than replaces, your aortic valve, to prepare you for another heart procedure. Our doctors can open the narrowed valve and relieve your symptoms. Using a small catheter, we access the aortic valve by going through an artery in the neck, arm or groin.
• Open-heart surgery: Sometimes the best option comes from an operation that accesses your heart through your chest.
• Medications and lifestyle: You may not need a procedure if you are in the early stage of aortic valve disease, meaning you have mild symptoms or none at all. At that point, we may prescribe certain medications to help. These medications don’t treat aortic valve disease, but they can relieve symptoms you do experience. We can also help you make heart-healthy lifestyle changes to control symptoms and prevent complications.

Working together, our heart team helps determine what treatment works best for your particular needs.