Aortic stenosis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Claudia P. Hochberg, M.D. [2], Abdul-Rahman Arabi, M.D. [3], Keri Shafer, M.D. [4], Mohammed A. Sbeih, M.D. [5]

Overview

Aortic valve stenosis can lead to serious complications if left untreated because it can weaken the heart. If the aortic valve is narrowed, the left ventricle strains to pump the required amount of blood into the aorta and to the rest of the body, the left ventricle becomes hypertrophied to compensate the narrowing of the valve. Eventually these changes weaken the left ventricle and the whole heart.

Aortic valve stenosis can lead to life-threatening heart problems if it has not been managed appropriately.

As with any surgical intervention, surgical therapies for aortic stenosis carry risks and potential for complication. These complications commonly include vascular issues such as vascular complications and mitral valve injury.

Natural History

Aortic stenosis disease has prolonged latent period during which morbidity and mortality are very low and there may be no obvious symptoms. The average rate of progression in Aortic stenosis -once moderate stenosis is present- is a decrease in valve area of 0.1 cm2 per year.

Complications

Possible complications for untreated aortic stenosis include:

• Arrhythmias.
• Endocarditis.
• Left-sided heart failure.
• Left ventricular hypertrophy (enlargement) caused by the extra work of pushing blood through the narrowed valve.
• Atrial fibrillation.
• Myocardial infarction.
• Angina.
• Fainting (syncope).

Prognosis

30% reduction in gradient is expected as the immediate result of surgical intervention. Patient survival after repeat BAV is higher than that of untreated patients.