Aortic Stenosis (AS)

Aortic valve is a heart valve that controls the blood flow between left ventricle and aorta. Aortic stenosis occurs when valve leaflets become deformed, thus obstructing blood flow to other organs including the heart itself. Rheumatic heart disease is the most common cause of aortic stenosis (AS) in developing countries. In developed countries, an old aortic valve with built-up calcification is the most common cause of AS.

Aortic stenosis is severe when the calculated area of the valve is less than 1cm2. The measurment of the valve area is performed indirectly by measuring the blood flow and pressure gradient across the valve. Doctors usually recommend either echocardiography or cardiac catheterization to measure the area of valve, depending on whether the pumping power of left ventricle is normal or weak.

Patients with severe AS are considered candidates for valve replacement operation if they develop chest pain, pass-out, or heart failure. However, the 2006 American Heart Association (AHA) guidelines concluded that valve replacement should not be performed routinely in patients without aforementioned symptoms. There are exceptions when surgery is still recommended in patients without symptoms.

The 2007 AHA guidelines no longer recommended routine antibiotic prophylaxis before dental or invasive procedures for patients with AS.

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Diet and Your Heart

The following food and supplements are proven effective in preserving health of your heart.

1. Fruits and vegetables: green leafy vegetables, citrus fruits




2. High-fiber food




3. Unsaturated fat: olive and canola oil




4. Folate: 400 micrograms a day

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Aortic Regurgitation (AR)

Aortic regurgitation (AR) occurs when aortic valve leaflets do not close adequately. As a result, blood flow leaks back to left ventricle (LV) which is one of the four heart chambers (see picture).

In developed countries, the most common causes of AR are aortic root dilation and congenital bicuspid aortic valve. In developing countries, the most common cause is rheumatic heart disease.

Since the size and function of left ventricle (LV) is critical in determining the timing and need for surgery, doctors may recommend serial echocardiography ranging from every 6 months to every 3 years.

The American Heart Association recommended aortic valve replacement or repair in asymptomatic patients with left ventricle pumping power (LVEF) <50>

With regard to medications, ACE inhibitor shows greatest benefit in patients with shortness of breath and significant dilation of left ventricle.

Women have a poorer outcome following aortic valve replacement when compared to men; post-operative 10-year survival rate for women and men was 39 and 72 percent respectively [Circulation 1996 Nov 15;94(10):2472-8].

The 2007 American Heart Association guidelines did not recommend antibiotic prophylaxis for patients with (AR) when they had dental or surgical procedures.