How can aortic stenosis be treated?

This heart valve disease can be life-threatening if left untreated, but don’t worry — you have options

After 80 years of good health, Nancy Ellis Robinson suffered what can only be called a life-altering headache. That’s because it led doctors to discover a more serious health issue occurring in her heart: aortic stenosis.

What does aortic stenosis do to the heart?

“Stenosis” means a compression or narrowing of a passage. With aortic stenosis, the aortic valve of your heart narrows — and that limits the flow of blood out to your brain and body.

During the mild or moderate stages of this disease, it might not be noticeable to you at all. But, over time, it puts extra strain on your heart. You might experience chest pain, fatigue, shortness of breath, dizziness or have difficulty walking short distances as a result.

If you progress to severe aortic stenosis, treatment is critical. At this stage, your heart could weaken to the point that your health, and life, are at risk. As serious as that sounds, the good news is that aortic stenosis is treatable, with proven options that can help you get back your quality of life.

What are the treatment options for aortic stenosis?

  • Monitoring: If your symptoms are mild, your doctor may recommend regular imaging and checkups to track how quickly the valve is narrowing.
  • Medications: Medicines can help manage symptoms such as fluid buildup or high blood pressure and reduce the burden on your heart. Note: Medications cannot cure aortic stenosis.3
  • Balloon aortic valvuloplasty: In this procedure, a small balloon catheter is threaded into the heart through an artery and then inflated to open the valve.1 However, the valve will eventually narrow again, requiring additional procedures.
  • SAVR: Surgical aortic valve replacement is an open-heart procedure where your surgeon removes the damaged valve and replaces it.
  • TAVI: Transcatheter aortic valve implantation is a minimally invasive procedure that is an option for people living with severe aortic stenosis who are not candidates for open-heart surgery. A new valve is implanted within your diseased aortic valve2 using a catheter threaded through an artery.  

 

What does TAVI involve?

Discuss all available treatment options with your doctor. It could be that TAVI, or any of the others listed above, might not be right for you based on a variety of factors.

If it is deemed to be the right option, you will be prepped for a minimally invasive procedure to implant an aortic valve replacement. Most people get a small incision near the femoral artery in their leg. The physician will then guide the valve replacement up to your heart using a special catheter and imaging equipment.

Once it is positioned correctly, the physician removes the catheter and the incision is closed. You’ll be advised to take it easy the first few weeks after the procedure, but many people are back to regular activity at one to two weeks.

How Nancy benefitted from a TAVI procedure

Robinson is proof that the signs and symptoms of aortic stenosis don’t always come in the form of the “usual suspects.” Thankfully, Robinson listened to her body and visited the emergency room to have her headache checked out. An MRI helped confirm that the real issue was in her heart.

For Robinson, open-heart surgery wasn’t an option. She instead had a TAVI procedure (also referred to as TAVR: transcatheter aortic valve replacement) and received Abbott’s Navitor valve.

It was implanted without opening her chest — which meant a smaller incision, a shorter hospital stay and a faster return to swimming, walks along the water and the other things she loves.

“I keep it moving,” Robinson says. Her life was altered, but, after treatment, she’s back to going with the flow. 

Nancy Robinson's account is genuine, typical, and documented. However, it does not provide any indication, guide, warranty, or guarantee as to the response other people may have to the treatment. Responses to the treatment discusses can and do vary and are specific to the individual patient.

References

1 Nishimura RA, Otto CM, Bonow RO, et al. 2014 AHA/ACC Guideline for the management of patients with valvular heart disease. Circulation. 2014;129(23):2240-2492. doi: 10.1161/CIR.0000000000000029

2 Satter Y, Rauf H, Bareeqa S, et al. Transcatheter aortic valve replacement versus surgical aortic valve replacement: A review of aortic stenosis management. Cureus. 2019;11(12):e6431. doi: 10.7759/cureus.6431

3 Carita P, Coppola G, Novo G, et al. Aortic stenosis: Insights on pathogenesis and clinical implications. J Geriatr Cardiol. 2016;13:489-498. doi:10.11909/j.issn.1671-5411.2016.06.001

Important Safety Information

Navitor TAVI System

Available by prescription only.

WHAT IS THE NAVITOR™ TAVI SYSTEM APPROVED FOR?

Transcatheter Aortic Valve Implantation (TAVI) with the Navitor™ TAVI System provides an alternative, minimally invasive treatment option for people living with severe aortic stenosis, a condition where the aortic valve does not fully open or close, who are not candidates for open-heart surgery due to age, frailty, or other conditions that make surgery too risky.

WHO SHOULD NOT RECEIVE TRANSCATHETER AORTIC VALVE IMPLANTATION WITH THE NAVITOR™ TAVI SYSTEM?

You should not receive the Navitor valve if you have any of the following conditions: any kind of infection, including an active infection in the heart; cannot tolerate medication that thins the blood or prevents blood clots from forming; have a reaction or allergy to nitinol, an alloy of nickel and titanium.

The Navitor™ TAVI System has not been studied in the following patient populations and therefore should not be used in patients who: have any evidence of a blood clot (thrombus), intracardiac mass or vegetation in, on or around the heart; have narrow veins or arteries with calcification that make insertion of the delivery sheath and access to the aortic valve impossible; have stenotic (narrowed) aortic valve without calcium deposits; have a heart valve defect from birth with either one or two leaflets vs. the normal three leaflets; are pregnant or breastfeeding; are age 21 or younger at the time of diagnosis or treatment; have an ejection fraction, or volume of blood fluid, less than 20%; have unstable heart function requiring mechanical assistance or drug therapy to support the normal function of the heart; are low or intermediate surgical risk; have had a previous heart valve or ring in any position in the heart; have mixed aortic valve disease (stenosis and regurgitation); have severe mitral valve disease (calcification, stenosis or inefficiency); have a medical condition that affects the cellular or plasma components of the blood; have significant coronary artery disease that requires treatment; have abnormally thick heart muscle (hypertrophic cardiomyopathy); are on dialysis, have kidney failure or inefficiency; have known allergy or sensitivity to aspirin, heparin, ticlopidine (Ticlid), or clopidogrel (Plavix), or sensitivity to contrast media/dye; have bulky calcium build up on the valve leaflets close to the coronary ostia which are the main arteries delivering blood from the heart to the rest of the body; have significant aortic disease, including abdominal aorta, thoracic aneurysm or any other folding, bending or narrowing which would make access to the aortic valve impossible.

WHAT ARE THE POSSIBLE COMPLICATIONS ASSOCIATED WITH TRANSCATHETER AORTIC VALVE IMPLANTATION WITH THE NAVITOR™ TAVI SYSTEM?

There are risks with any heart valve implantation procedure. The most serious risks are: death, stroke, serious damage to the arteries and serious bleeding. Additional risks include, but are not limited to: access site complications (e.g., pain, bleeding, infection, blood vessel damage); buildup of deposits (plaque) in and on the walls of coronary arteries; heart attack - blockage of blood flow to the heart muscle; allergic reaction to medication or products/devices used during the procedure (medication to prevent blood clotting, x-ray die, components of the valve delivery process); tear or burst of the aorta; irregular heart rate; disruption or injury of electrical system in your heart leading to the need for a permanent pacemaker implant; tear or separation of the layers of the wall of an artery; obstruction of an artery, typically by a clot of blood or an air bubble; inflammation of the lining of your heart; failure of your heart to pump enough blood to the body’s organs; unstable blood flow; rupture or destruction of blood cells; blood cell damage; low red blood cell count; bleeding, infection, clotting in or on the valve or tissue of the valve; loose clots in the bloodstream that may block an artery in your arms, legs, or brain; escape of blood from a ruptured blood vessel; blood pressure changes above or below the normal levels; infection; reduced blood flow to your heart, preventing the heart muscle from receiving enough oxygen; changes to the Mitral valve where it doesn’t close tightly; multi-organ failure - inflammation from a severe infection or injury causes dysfunction in two or more organ systems; wrong sizing or positioning of the implanted valve; collection of fluid or blood around your heart; perforation or tear of the heart muscle, ventricle or blood vessel; formation of scar tissue that may cover or block the valve from functioning normally; leakage of blood around the edge of the valve; valves in your heart don’t close tightly, allowing blood to flow backward in your heart; kidneys lose the ability to remove waste and balance fluids; blood doesn’t have enough oxygen or has too much carbon dioxide; sepsis; structural deterioration of the implanted valve (i.e., calcification, leaflet tear); having an abnormal particle (air or blood clots) floating in the bloodstream or attached to an object, including the valve; when extra fluid builds up in the space around the heart; when the transcatheter valve moves or is dislodged from the deployment position/location; permanent disability; the need for additional medical procedures to include blood transfusions, operation to remove the valve, use of a balloon to adjust the valve (valvuloplasty), and catheter insertion into coronary arteries to treat blockages.

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