The aortic valve has 3 leaflets that function like a one-way door, allowing blood to flow forward into the aorta, but not
backward into the left ventricle. With aortic stenosis, the aortic valve is unable to open completely, so the blood flowing
from the left ventricle to the aorta is constricted, or squeezed.
If the constriction occurs at the valve, it’s called valvar aortic stenosis. If the constriction occurs above the valve, it’s
called supravalvular stenosis. If it is below the valve, it’s called subaortic stenosis. Aortic stenosis occurs in 3% to 6%
of patients with heart defects.
The constriction means that the left ventricle has to increase pressure to pump the blood through the opening. As a result,
the wall of the ventricle thickens.
| Aortic Stenosis |
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| The aortic valve is narrowed, making it unable to open completely. The aorta has trouble pumping the blood through the narrow
opening, so the body receives less oxygenated blood than it should.
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What are the symptoms of aortic stenosis?
In most cases, children don’t have symptoms. In severe cases, however, this condition can lead to a variety of symptoms, like
chest pain, dizziness or fainting, and heart failure, particularly in younger infants. A heart murmur is the most common sign of
this defect.
An electrocardiogram and echocardiogram are used to make a diagnosis. In mild cases, children with aortic stenosis don’t need
treatment, though they need to receive repeat medical checkups with echocardiograms because sometimes the narrowing gets worse
as the child grows older.
How is aortic stenosis treated?
Cardiac catheterization is often used to treat aortic stenosis. The narrowed valve is stretched open through a procedure called
balloon dilation valvuloplasty. This may relieve the narrowing but the valve leaflets may remain stiff and are unable to close
properly. This means there may be leakage of blood backwards through the valve, called regurgitation. Sometimes open heart
surgery to cut open the leaflets of the valve so they open better is needed. This is called a surgical valvotomy. Later, surgery
may be needed to replace the valve if it is very small or leaky. This is called aortic valve replacement.
What is the long-term outlook for children with aortic stenosis?
Children with aortic stenosis will need to be seen by a cardiologist for their whole lives, since the condition can worsen
over time, even after surgery.
