Aortic valve stenosis occurs when the aortic valve is blocked or narrow and does not work correctly. This one-way valve controls blood flow from the left ventricle inside the heart to the aorta, the main blood vessel that brings blood to the body. When the aortic valve does not work properly, the heart must work harder to pump blood out to the body. Over time, this can weaken the heart.
Aortic valve stenosis can range from mild to severe. As the child gets older, the condition can get worse as the heart has to work harder to pump blood.
Aortic stenosis results in a muscle enlargement, or compensatory ventricular hypertrophy, of the left ventricle. The degree of hypertrophy is generally related to the severity of the stenosis.
Many children with mild to moderate aortic valve stenosis don’t have any symptoms at first. The only symptom they may have is a heart murmur. This is an extra heart sound your child’s doctor can hear using a stethoscope.
Over time, the aortic valve stenosis may progress and cause symptoms including:
Aortic valve stenosis can also be caused by rheumatic fever. This can happen if scar tissue forms on the aortic valve.
Your child’s treatment will depend on their age and how severe their condition is. Some children with mild aortic valve stenosis may not need any treatment. Instead, your child’s doctor may track their condition over time. Your care team at Arkansas Children’s is experienced in treating aortic valve stenosis and will work with you to come up with the best treatment option for your child. Treatments may include:
After an aortic stenosis repair, monitoring in the postoperative period will include invasive lines, such as an arterial line and central venous line, to monitor blood pressure and deliver medications. Medications may be needed to control hemodynamics (nitroprusside or nicardipine), provide sedation and maintain hydration during recovery. Perfusion is monitored by pulse oximetry and NIRS (near-infrared spectroscopy) probes. Depending on various factors specific to each individual, the breathing tube (endotracheal tube) may or may not still be present after surgery. Pacing wires, which can assist with any rhythm issues that may arise in the postoperative period, will be placed in the operating room. Pacing wires are typically removed 1-2 days after surgery if not needed. Chest tubes will be present to remove air, blood or fluid from around the heart or lungs. These tubes will be removed in the ICU as soon as possible, typically the next day.
Length of stay can vary but typically ranges from 1-3 weeks, depending on the degree of stenosis and associated surgical repair required.