Aortic stenosis (AS) is narrowing of the aortic valve opening that impedes blood flow from the left ventricle to the aorta. This progressive condition can remain silent for years but eventually causes left ventricular dysfunction and heart failure. Livasa Hospital provides comprehensive AS management from diagnosis through medical optimization and definitive valve intervention when appropriate.

Understanding Aortic Stenosis

The aortic valve has three leaflets (tricuspid) normally, though bicuspid valves are common congenital variants. Stenosis develops from:

• Degenerative calcification – Most common in adults >60 years

• Rheumatic disease – From prior rheumatic fever

• Bicuspid aortic valve – Congenital variant prone to stenosis

• Post-radiation – From prior chest radiation therapy

Pathophysiology

Progressive narrowing creates:

• Increased resistance to left ventricular ejection

• Left ventricular hypertrophy

• Increased myocardial oxygen demand

• Eventual systolic and diastolic dysfunction

• Atrial fibrillation

• Risk of sudden cardiac death

Severity Classification

Clinical Presentation

Many patients are asymptomatic for years. When symptoms develop:

• Angina – Chest pain with exertion

• Dyspnoea – Breathing difficulty with activity

• Syncope – Fainting with exertion

• Heart failure – Dyspnoea at rest, orthopnoea

Once symptoms develop, prognosis is poor without intervention.

Diagnostic Evaluation

Echocardiography:

• Gold-standard for AS diagnosis and severity assessment

• Measures valve area, gradients and velocities

• Assesses left ventricular function

• Evaluates for associated valve disease

ECG:

• Left ventricular hypertrophy

• May show atrial fibrillation

Chest X-ray:

• Aortic valve calcification

• Signs of heart failure if present

Cardiac catheterization:

• Invasive pressure measurements (when echo non-diagnostic)

• Coronary angiography to rule out CAD

Treatment Strategy

Asymptomatic severe AS:

• Regular echocardiographic surveillance

• Exercise testing to unmask symptoms

• Monitoring for left ventricular dysfunction

• Valve intervention if EF declines or symptoms develop

Symptomatic AS:

• Valve replacement or TAVR indicated

• Excellent outcomes with intervention

• Early intervention prevents irreversible LV dysfunction

Aortic Valve Replacement

Surgical replacement:

• Traditional approach for most AS patients

• Median sternotomy and cardiopulmonary bypass

• Prosthesis choice (mechanical vs bioprosthetic)

• Excellent long-term outcomes

TAVR (Transcatheter aortic valve replacement):

• Catheter-based valve implantation

• Increasingly used in elderly or high-risk patients

• Minimally invasive with rapid recovery

• Expanding indications

Post-Intervention Management

• Regular echocardiographic follow-up

• Anticoagulation if mechanical valve

• Endocarditis prophylaxis guidance

• Activity recommendations

Why Choose Livasa Hospital?

• Experienced cardiac surgeons for aortic valve replacement

• TAVR expertise and technology

• Comprehensive valve assessment

• Long-term follow-up programs

NAP – Contact Details

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

Call +91-80788 80788 to schedule aortic stenosis evaluation at Livasa Hospital.