Aortic Valve Insufficiency
Heart valves are door-like structures that allow blood to pass in only one direction. They open with the driving force of the blood flow; and they close when the heart’s pumping action ends and the driving force of the blood decreases. In this way, they ensure that blood does not leak back to where it came from. The aortic valve, which is one of these valves, is the valve through which blood passes while being pumped to the body. When there is insufficiency (regurgitation; leakage) in this valve, the amount of blood that can be sent to the body decreases.
Common causes of aortic valve insufficiency include: Bicuspid valve; that is, a congenital abnormality of the aortic valve (consisting of two leaflets instead of three), age-related calcification, valve infection, rheumatic involvement, systemic diseases, and the presence of an aneurysm in the initial part of the aorta. When the leakage is mild or moderate, the patient has no complaints. However, if the leakage increases over time and reaches a severe (advanced) level, the blood that can be sent to the tissues becomes insufficient, and symptoms begin in the patient. These are most commonly: getting tired easily, weakness, shortness of breath, chest pain, and palpitations. Diagnosis is made with ECHO, that is, heart ultrasound. ECHO easily detects the movement of heart valves and the backflow of blood. It clearly shows the amount of blood leaking back, in other words, the severity of the leakage. If the leakage is mild or moderate, it is sufficient for the patient to remain under follow-up. However, if it is severe, the generally preferred treatment method is surgery. In surgery, the aortic valve is replaced with an artificial valve or repaired. If the cause of the leakage is age-related calcification, partial stenosis (narrowing) also accompanies the leakage; in this case, replacing the aortic valve with a non-surgical method, namely TAVI, can also be considered in the treatment.
References
- Otto CM, Nishimura RA, Bonow RO, et al. ACC/AHA Guideline for the management of patients with valvular heart disease. J Am Coll Cardiol. 2021 Feb 2;77(4):e25-e197.
- Vahanian A, Beyersdorf F, Praz F, et al. ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2022;43(7):561-632.
- Mazzolai L, Teixido-Tura G, Lanzi S, et al. ESC Guidelines for the management of peripheral arterial and aortic diseases. Eur Heart J. 2024 Sep 29;45(36):3538-3700.