Understanding your aortic stenosis treatment options
By ShareMD Connect
Aortic stenosis is a serious disease that will not go away on its own. It is usually progressive, meaning that it worsens over time, and severe cases always require medical intervention to be managed and treated.
If you or a loved one have been recently diagnosed with aortic stenosis - or your aortic stenosis is worsening - you may enjoy a fuller and longer life by choosing to treat your condition.
While those with severe aortic stenosis may not have many choices beyond surgical valve replacement, those with mild to moderate disease have treatment options. It’s important that you understand them all so that you can make the most informed decision.
These are the three most common treatments prescribed.
Watch and wait
If your aortic stenosis is mild, or you aren’t yet experiencing any symptoms, your doctor will probably suggest a “watch and wait” approach.
This approach is common and assumes that your disease doesn’t require surgical intervention until severe symptoms start.
However, having moderate aortic stenosis does not necessarily exclude you from being a candidate for surgery. Research has shown that many patients who could likely benefit from aortic valve replacement do not undergo evaluation for the condition; thus, proper management of the disease is lacking.
The disease is usually progressive, and unfortunately, too many people wait until it has progressed significantly to assess their treatment options.
Even if you’re not yet ready for surgery, it’s a good idea to explore your treatment options and understand the benefits and risks of each choice.
Using medication to manage symptoms
Medications can be part of an effective aortic stenosis treatment plan. They’re used to decrease overall cardiovascular risk by lowering blood pressure, managing cholesterol, thinning the blood, and more, which can help you live longer. But medication alone cannot cure aortic stenosis when it becomes severe.
Medication management can be a good treatment choice for someone suffering from other health problems or someone who is considered too high risk for surgery. It can also be the right choice for someone who doesn’t want to undergo surgery.
In cases of mild aortic stenosis, medication will relieve immediate symptoms, but it won’t cure your condition, so it’s important that you have routine check-ups with your cardiology specialist to monitor ongoing disease progression.
In cases of severe aortic stenosis where medication management is the chosen treatment, it’s a good idea to ask your doctor about other palliative care options to help you achieve the best quality of life possible.
Surgical valve replacement
Surgical valve replacement is the only proven treatment for aortic stenosis and is often the treatment of choice for those with severe disease.
There are two types of aortic valve replacement procedures: Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Replacement (TAVR). You may also see the option of Transcatheter Aortic Valve Implantation (TAVI), which is the same thing as TAVR, just named differently.
SAVR is open heart surgery, while TAVR is a newer, less invasive procedure. Research has shown that either procedure prolongs your life expectancy. Left untreated, those with symptomatic, severe aortic stenosis have a 50% mortality rate after one year. But with SAVR, the mortality rate at one year is about 11.5% and for TAVR the mortality rate is even lower at 7.9%.
Each procedure has pros and cons, the biggest difference being recovery time, surgical risk, and long-term outlook. And while you may be a candidate for only one of the two procedures, you should discuss both options with your physician.
Choosing how to manage your aortic stenosis is a very personal decision. However, it's important to note that while treating your aortic stenosis is essential to your heart health, surgical treatment may not improve your quality of life if your symptoms are caused by other conditions such as obesity, diabetes, other heart diseases, or depression and anxiety.
Be sure to discuss your treatment goals and expectations with your doctor. Tell them about any concerns you have and be clear about what you hope to gain from treatment (getting rid of the disease, quality of life improvement, living longer, etc.).
There’s a lot to consider when choosing your treatment option. Be sure to keep track of any questions you have and frequently communicate with your doctor throughout this process.
And if you need help sorting through the information, or if you want to talk about your options with a trusted advisor, ShareMD nurses are here to help. Our nurses have decades of cardiology experience and can help you understand your condition, weigh the pros and cons of treatment options and even connect you with quality care in your area.