Top 5 Aortic Stenosis Treatments: Surgical & Non-Surgical

Aortic stenosis treatment

Aortic stenosis refers to the narrowing of the aortic valve opening, which constricts blood passage from the left ventricle to the aorta and thence to the rest of the body. Treatment varies with the degree of disease and with symptom presence. This is a clear summary:

Treatment for Aortic Stenosis:

Monitoring (Watchful Waiting)

• For: Mild to moderate disease without symptoms

Includes:

• Periodic echocardiograms (every 6–12 months)
• Monitoring for symptoms such as chest pain, fatigue, shortness of breath
• Lifestyle changes (e.g., avoidance of strenuous activity)

Medications (Supportive Treatment)

• Purpose: To control symptoms, not to cure the disease

Frequently employed:

• Diuretics – to diminish fluid accumulation and alleviate heart workload
• Beta-blockers / ACE inhibitors – for elevated blood pressure
• Statins – decrease cholesterol (may retard valve calcification)
• Anti-arrhythmic medications – for patients with rhythm disturbances

Valve Replacement (Definitive Treatment)

A. Surgical Aortic Valve Replacement (SAVR)

• Traditional open-heart surgery
• Best for: Younger patients or those who can tolerate surgery

Involves:

• General anaesthesia

• Replacement with mechanical or bioprosthetic valve

B. Transcatheter Aortic Valve Implantation (TAVI/TAVR)

• Minimally invasive, catheter-based technique

Best for:

• Older adults
• Patients at intermediate or high surgical risk
• Approach: Through femoral artery or other sites
• Shorter recovery time than open surgery

Balloon Valvuloplasty

Temporary relief, primarily for:

• Infants and children with congenital aortic stenosis
• Adults who are not candidates for valve replacement
• Procedure: A balloon is introduced and inflated to enlarge the valve
• Usually followed by eventual valve replacement

Lifestyle Modifications (Supportive Measures)

• Sodium-restricted diet (when heart failure symptoms exist)
• Moderate activity as tolerated
• Avoid heavy physical exertion if symptomatic
• Routine vaccinations (flu, pneumococcal)
• Oral hygiene to avoid endocarditis

Best Treatment for Aortic Stenosis

Transcatheter Aortic Valve Replacement (TAVR)

• Optimal for: Elderly (>65), high/intermediate risk for surgery
• Minimally invasive, via catheter
• Shorter inpatient stay, faster recovery
• Increasingly becoming first-line for most patients

Surgical Aortic Valve Replacement (SAVR)

• Optimal for: Young, low-risk patient
• Longer recovery, but long-lasting particularly with mechanical valves
• Permits surgeon to treat additional heart conditions (e.g. coronary artery disease)

Surgical Treatment for Aortic Stenosis

The main surgical intervention for aortic stenosis is Surgical Aortic Valve Replacement (SAVR). This is the gold-standard intervention for suitable patients and provides excellent long-term results.

Surgical Aortic Valve Replacement (SAVR)

Indications

• Severe symptomatic aortic stenosis (e.g. chest pain, breathlessness, syncope)

Asymptomatic but with:

• Left ventricular dysfunction (EF < 50%)
• Abnormal stress test
• Very severe stenosis (aortic valve area < 0.6 cm²)
• Younger patients (<65) or those with other associated cardiac conditions requiring surgery (e.g. coronary bypass)

Procedure

• Open-heart surgery under general anaesthesia
• Sternotomy (opening of chest through breastbone)
• Cardiopulmonary bypass machine employed (heart-lung machine)
• Diseased valve is excised and replaced by prosthetic valve:
• Mechanical valve: Durable; needs lifelong anticoagulation (e.g., warfarin)
• Biological valve (tissue valve): No anticoagulation, but 10–20 years durable

Surgery Time

• 3 to 5 hours

Hospital Stay

• ICU: 1–2 days
• Total: 5–10 days

Recovery Time

• 6–12 weeks for complete recovery (age and comorbidities dependent)

Non-surgical Treatment for Aortic Stenosis

The non-surgical methods used in the treatment of aortic stenosis are interventions that are used when the condition involves minor cases, when a patient is not in a condition to undergo surgery and temporarily. It can be summarized in the following way:

Aortic stenosis treatment without surgery:

Medical (Conservative) Treatment

• Goal: Manage symptoms, and delay complications

Employed in:

• Middle or modular aortic stenosis
• Severe stenosis in the case that surgery or TAVR would be extreme risk or undesirable by the patient

Medications (Antisymptomatic Only)

• Diuretics (e.g., furosemide): reduce the excess fluid and ease shortness of breath
• Beta-blockers / ACE inhibitors: Cautious control of the blood pressure (use with caution)
• Statins: It may be bradial thermophilic valve calcification in the early stages
• Antiarrhythmics: Control unpredictable heartbeat patterns

Balloon Aortic Valvuloplasty (BAV)

• Dilation of valve by invasive catheter procedure

Key Points:

• A catheter (balloon-tipped) is introduced through the femoral (via artery) and is extended till it is in contact with the stenotic valve (inflated)

Used in:

• Young adults and children having congenital aortic stenosis
• Adults that cannot become a valve replacement candidate

Transition to TAVR/SAVR

TAVR Transcatheter Aortic Valve Replacement

• It is not technically surgery, but the preferred permanent non-open-heart care.

Best For:

• Marginal or high-risk patients of open surgery
• Old patients
• People, who need faster healing or less invasive surgeries
• Compared to BAV, TAVR involves irreversible replacement of the valve using catheter excluding sternotomy.

Lifestyle Adjustments

Illness-covering supportive care:

• Limit amount of sodium and fluid to avoid overload
• Avoid any strenuous activity when symptoms become worse when acting out
• Control secondary problems (high blood pressure, diabetes)
• Good oral hygiene (no infective endocarditis)

Aortic Valve Replacement Surgery

Critical aortic stenosis or aortic valve illness is treated by aortic valve replacement procedure. It is nothing but the removal of the diseased valve and its replacement by a mechanical or tissue (biological) valve.

Who needs the Aortic Valve Replacement?

• Severe aortic stenosis: The person has signs or the heart is functioning poorly
• Severe aortic regurgitation: enlarged left ventricle or symptomatic left ventricle
• Bicuspid aortic valve disease: The malfunction of valve and/or dilation of aorta
• Endocarditis: Damage of the valve due to infections

Aortic valve Replacement Types

A. Aortic Surgical Valve Replacement (SAVR)

• The traditional open-heart procedure
• Tough gastropexy (abrasion of chest bone)
• Cardiopulmonary bypass was used

B. Transcatheter Aortic Valve Replacement (TAVR)

• Minimally invasive (by means of groin artery)
• No open-heart surgery
• Saved on those who are older or at high risk surgical candidates

Recovery after Aortic Stenosis Surgery

Healing from surgical aortic valve replacement (SAVR) is time-consuming and varies with your age, overall health, and whether or not you had other procedures (such as bypass surgery). Below is an in-depth timeline and tips:

Recovery Timeline:

0–3 days (ICU & hospital stay)

• In ICU for 1–2 days, then moved to a regular room. Breathing tubes, drains, and wires are removed step by step. Pain and tiredness are normal.

4–10 days (hospital stay)

• Monitoring rhythm of the heart, controlling pain, getting up to walk and eat. All but a few go home by day 7–10.

Week 2–6

• Rest at home, walk each day, light exercise. Do not lift heavy objects. Gradual build-up of energy.

Week 6–12

• Most are returned to normal activity and light work. Driving can resume (after physician approval). Cardiac rehabilitation can start.

3+ months

• Mostly fully recovered. Back to work, travel, and normal levels of exercise.

Post-Surgery Care:

Incision Care

• Prevent the chest wound to become wet and dirty
• Care in monitoring infection: redness, swelling, drainage, fever

Medications

• Anticoagulants (warfarin) in case you have got a mechanical heart valve
• Pain killers
• Medications used to treat the heart (e.g. beta-blockers, diuretics)

Diet

• Healthy eating (low fat diet, low salt diet)
• Take sufficient fluids and also control the intake of fluids when told to do so

Physical Activity:

• Walk five to 10 minutes a day and increase it
• Not to lift an object weighing more than 5-7 kg with a period of 6-8 weeks
• No driving in 4 to 6 weeks or post release
• Do not have sex in 4-6 weeks or until energy level elevates

Emotional Well-being:

• It is expected to be somewhat depressed or anxious
• Counselling or support group
• Enquire about cardiac rehabilitation programs with your doctor

Follow-up Visits:

• First and Second follow-up: 710 days after discharge
• Echo or ECG as ordered (In the range of 6-12 weeks)
• Follow up of INR (warfarin patients)

New Treatments for Aortic Stenosis

Therapy of aortic stenosis (AS) is evolving more than the ordinary surgery (SAVR) and TAVR. Different new less invasive and more permanent treatment is in testing or being introduced. Here is the summary table on past, present and future treatment:

Next-Generation TAVR devices

Key Innovations:

• Smaller delivery systems: Allow use of smaller or small anatomies
• Positionable valves: Valves that can be retrieved and moved: Reduce placement mistake
• Better sealing skirts: decrease leakage (paravalvular leak)
• Longer life span models: Suitable to younger patients

Note-worthy devices:

• Evolut FX (Medtronic)
• Sapien X4 (Edwards Lifesciences)
• Navitor (Abbott) - adaptive sealing self-expanding valve

Valve-in-Valve (ViV-TAVR)

• In failed bioprosthetic valves (of prior surgery)
• Minimally invasive, no need of second open-heart surgery
• Most appropriate in aging or high-risk individuals that need to be reintervened

TAVR in Lower-Risk and Younger Patients

TAVR finds its more widespread application in:

• Patients with low surgery risk (FDA/Ce approved)
• Patients at younger ages (50 60 years) - so longer-term follow-up shows promising durability
• Bicuspid aorta valve patients- previously consider it inappropriate, but today it is explored with better devices

Transapical, and Transcarotid TAVR

• In case of patients with plugged arteries in the femur
• Uses other points of entry (carotid artery or apex of th heart)
• Applies TAVR to more complex cases

Investigational Percutaneous Aortic Valve Repair

• Research being conducted to come up with repair gadgets, which soften or remodel hardened valves
• Objective: To put off or avert full valve replacement in mild diseases
• At the preclinical development or early human stage

Stem Cell & Regenerative Therapy (Research Phase)

• They are made in order to reverse calcification or recreate tissue in the valves

Examining:

• Anti-calcification drugs
• Gene therapy Targeted
• Stem-cell valve bioengineering
• Not currently availed clinically, though it has a prospect in future without replacement therapy

Artificial Intelligence (AI)-Driven Risk Stratification

AI applied to:

• Predict progression of disease
• Determine best timing for intervention
• Customize treatment for personal anatomy and risks

3D Printing & Custom Valve Implants

• Utilized for patient-specific valve sizing and modeling
• Decreases risk of complications
• Particularly useful in redo cases or difficult anatomies

Best Hospitals for Aortic Stenosis Treatment

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Risks of Aortic Valve Replacement Surgery

Aortic valve replacement (particularly surgical, or SAVR) is a lifesaving operation for critical aortic stenosis—but like any major operation, it has some risks and complications. Overall success is high, particularly in high-volume centers, but knowledge of possible risks facilitates informed choice.

Common Complications

• Bleeding: From blood thinners or from incision; can require transfusion
• Infection: Wound infection, pneumonia, or occasional endocarditis (infection of the valve)
• Arrhythmias: Abnormal heartbeat; some patients require a permanent pacemaker
• Stroke: Due to clots or debris dislodged during surgery
• Kidney dysfunction: Temporary or permanent, particularly in elderly or diabetic patients
• Respiratory complications: Difficulty weaning from ventilator, lung collapse, or pneumonia
• Blood clots: Can cause stroke, DVT, or pulmonary embolism
• Valve complications: Leakage, valve misplacement, or degeneration (particularly with tissue valves)

Rare but Serious Risks

• Death in or after operation: <2–5% in low-risk; more in elderly or critically ill
• Myocardial infarction
• Severe stroke or paralysis
• Complications from anaesthesia

Long-Term Complications

• Degeneration or dysfunction of valve (more frequent with tissue valves)
• Reoperation (if valve fails or leaks)
• Prosthetic valve endocarditis (risk of infection with time)
• Embolic events (clots breaking off from valve)

Lifestyle Changes for Aortic Stenosis

Dietary Changes

• Heart-Healthy Diet (DASH or Mediterranean type)
• Fresh fruit, vegetables, whole grains: Saturated fats (red meat, butter, cheese)
• Plant proteins (beans, lentils): Trans fats (fried/processed foods)
• Omega-3 foods (flaxseed, walnuts): High-sodium foods (pickles, chips, canned soups)
• Low-fat dairy (or plant-based if required): Sugary beverages and added sugar

Exercise and Activity

Mild to Moderate Aortic Stenosis:

• Daily light exercise (e.g. walking, yoga, cycling)
• 30 minutes/day, 5 days/week
• Stop if you experience dizziness, chest pain, or shortness of breath

Weight Management

• Maintain BMI between 18.5–24.9
• Obesity aggravates heart strain and surgery
• Emphasize slow, long-term weight loss

Manage Other Conditions

• Hypertension: Control <130/80 mmHg
• Diabetes: Control HbA1c <7%
• High cholesterol: LDL <100 mg/dL (or <70 mg/dL if high risk)
• Take medications as directed and follow up regularly.

Quit Smoking & Alcohol Control

• Smoking hastens valve calcification and elevates surgical risk
• Alcohol should be restricted (or avoided if instructed by your cardiologist)

Oral Hygiene

• Practice perfect oral hygiene to avoid endocarditis
• Dental examination every 6 months
• Antibiotic prophylaxis prior to dental procedures if valve replacement has occurred

Sleep & Stress

• Get 7–8 hours of sleep
• Deal with stress using meditation, deep breathing, prayer, or hobbies
• Avoid stimulants (caffeine, energy drinks) if one is sensitive

Monitoring & Medical Follow-up

• Echocardiogram: Every 6–12 months depending on severity

Follow for new or increased symptoms:

• Shortness of breath
• Chest pain
• Passing out
• Adhere strictly to medication schedule

Why Choose GetWellGo for Aortic Stenosis Treatment?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for Aortic Stenosis treatment.
• Expert doctor with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food