Insights in Biomedicine Open Access

Introduction

Degenerative aortic stenosis heart valvular disease [1] accounts for numerous surgical procedures as it is quite prevalent in USA with numerous patients suffering from degenerative valve disorders. In terms of therapeutic interventions and early detection of valvular heart disease [2], it is crucial for us to find an imperative provision for such form of cardiovascular disease caused due to degenerative calcification of a tri-leaflet valve or advancing stenosis of congenital bicuspid valve. Aortic stenosis valvular heart disease [3] is related to congested heart failure along with other complications. Early detection of Aortic stenosis valvular heart disease [4] can play a crucial role in terms of reducing the severity of the valve diseases through comprehensive echocardiographic [5] evaluation of all valves along with aorta. It should examine the indices of left ventricular enlargement [6] along with pulmonary pressures and ventricular function of right ventricle. Cardiac Magnetic Resonance is also useful in terms of accessing ventricular volumes, valvular lesions [7] and systolic functions in order to assess any associated valve diseases.

Early detection of aortic stenosis heart valvular disease [8] can reduce the risk of congestive heart failure, congenital heart septal defects along with tricuspid regurgitation. It can effectively improve the long-term survival of patients through valve repair or valve replacement of severe symptomatic aortic stenosis [9] patients. Less invasive treatment options like trans-catheter aortic valve replacement can reduce the potential risk for patients aged over 65 years such as left ventricular dysfunction [10] and other chronic diseases associated with age. The onset of the symptoms can be sudden and the severity of the aortic stenosis heart valve disease doesn’t correlate with the manifestation of the symptoms. Patients suffering from aortic stenosis [11] due to congenital defect specially infants and children can exhibit symptoms like breathlessness, fatigue upon exertion and decreased normal activities. Though, patients suffering congenital aortic stenosis does not always exhibit noticeable symptoms as the amount of blood flow from the left ventricle through the valve is restricted which eventually effects the pressure of the left atrium.

Conclusion

Though, there are various surgical options associated with aortic valve replacement such as TAVI (Trans-catheter Aortic Valve Replacement) and TAVR (Trans-catheter Aortic Valve Implantation) [12] procedures along with Ross procedure are the ones which effectively treat damaged aortic valve and ensures long term wellness. The procedure involves swapping aortic valve with healthy pulmonary valve while the missing pulmonary valve is replaced with a donor valve. Non-invasive imaging techniques [13] like Doppler Echocardiography and Cardiac Magnetic Resonance (CMR) along with mainstay echocardiography can play a crucial role in terms of accessing pathophysiology and early detection of major valvular heart diseases like aortic stenosis. Furthermore, early detection can reduce the risk of implications by laying the concept of risk stratification and optimizes the timing for surgery associated with degenerative aortic stenosis heart valvular disease.

References

1. Maganti K, Rigolin VH, Sarano ME, Bonow RO (2010) Valvular heart disease: Diagnosis and management. Mayo Clinic Proceedings 85(5): 483-500.
2. Arora S, Misenheimer JA, Ramaraj R (2017) Transcatheter aortic valve replacement: Comprehensive review and present status. Tex Heart Inst J 44(1): 29-38.
3. Bax JJ, Delgado V (2017) Advanced imaging in valvular heart disease. Nat Rev Cardiol.
4. Nishimura RA, Rick A (2014) AHA/ACC guideline for the management of patients with valvular heart disease. Circulation.
5. Zilberszac R, Lancellotti P, Gilon D, Gabriel H, Schemper M, et al. (2017) Role of a heart valve clinic programme in the management of patients with aortic stenosis. Eur Heart J Cardiovasc Imaging 18(2): 138-144.
6. Alec V (2012) Guidelines on the management of valvular heart disease. J Euro heart 33: 2451-2496.
7. Lung B, Baron G, Butchart EG, Delahaye F, Gohlke-Bärwolf C, et al. (2003) A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. European Heart Journal 24: 1231-1243.
8. Bonow RO, Carabello BA, Chatterjee K, De Leon AC, Faxon DP, et al. (2008) Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease) endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 52: e1-e142.
9. Raffi B, Grayburn PA (2002) Valvular heart disease. Circulation 112: 125-134.
10. Cribier A, Eltchaninoff H, Bash A, Borenstein N, Tron C, et al. (2002): Percutaneous trans-catheter implantation of an aortic valve prosthesis for calcific aortic stenosis. Circulation 106: 3006-3008.
11. Otto CM, Kuusisto J, Reichenbach DD, Gown AM, O'Brien KD, et al. (1994) Characterization of the early lesion of degenerative valvular aortic stenosis. Histological and immuno-histochemical studies. Circulation 90: 844-853.
12. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, et al. (2010) Trans-catheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 363: 1597-1607.
13. Terje S, Hegrenaes L, Hatle L (1985) Non-invasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two-dimensional echocardiography. Circulation 72: 810-818.