Aortic Valve Stenosis
When you hear that your child may have aortic valve stenosis, the best first step you can take is making an appointment with our pediatric cardiologists. We understand how children’s hearts work. We know how your child is affected when something is not working quite right. Our specialists are prepared to make an accurate diagnosis and to treat your child with aortic valve stenosis. At Mount Sinai Children’s Heart Center, in partnership with Mount Sinai Fuster Heart Hospital, your child will get the kind of care we all want for our children—expert and compassionate.
About Aortic Valve Stenosis
Aortic valve stenosis is a congenital heart condition (present at birth) that makes the aortic valve too narrow. The aortic valve is located between the left lower pumping chamber of the heart (ventricle) and the aorta (the major blood vessel that takes blood to the body). The job of the aortic valve is open and close to control the flow of oxygen-rich blood that goes through the aorta to the body.
When the aortic valve is too narrow, it forces the heart muscle to work harder to pump blood. The stenosis (narrowing) can occur below the valve in the left ventricle, at the level of the valve, or above the valve in the aorta.
Aortic valve stenosis may be mild, moderate, or severe.
The most severe form of aortic stenosis is critical aortic stenosis. In this condition, the heart depends on a blood vessel (the patent ductus) to supply the body with blood because the heart is unable to get enough blood across the aortic valve. If your newborn has critical aortic stenosis, we will start treatment with an IV to give a continuous does of medicine called prostaglandin. This keeps open the patent ductus that all babies are born with to help your baby while our doctors prepare to treat the aortic stenosis with heart catheterization or surgery.
Symptoms
Milder forms of aortic stenosis tend not to cause symptoms.
With more significant stenosis, chest pain or fainting and dizziness with exercise may be signs that the heart is under strain. Symptoms that may indicate significant aortic stenosis include:
- Fatigue
- Heart murmur
- Chest pain
- Fainting
- Arrhythmias
Young infants with severe aortic stenosis may have symptoms such poor feeding and respiratory distress.
Diagnosis
Mild aortic stenosis may be noticed as a heart murmur that sounds like an extra noise during your child’s routine postnatal exam or checkup. To diagnose the source of the heart murmur accurately, we may need to perform some combination of the following tests, such as:
- Pulse oximetry—monitors the oxygen content of your child’s blood without drawing blood
- Chest X-ray—takes pictures of the your child’s heart, lungs, and blood vessels, and can show if the heart is enlarged
- Echocardiogram—a safe, noninvasive procedure that uses ultrasound waves that create an image of the size, shape, and movement of your child’s heart, valves, and chambers along with how blood flows through (also called an echo or cardiac ultrasound)
- Electrocardiogram (ECG)—a record of the electrical activity or rhythm of the heart which shows how your child’s heart is beating. It is non-invasive and obtained by placing stickers on your child’s chest.
- Cardiac MRI—uses safe, powerful magnets and radio waves to create pictures of your child’s heart
- Cardiac catheterization—minimally invasive procedure for diagnosis and sometimes treatment. Involves inserting a thin tube into the affected area to measure blood flow and pressure in the heart to determine severity of condition and if treatment is needed
Treatments We Offer
We base your child’s treatment on the symptoms as well as the location and extent of the stenosis. The specific treatment depends on your child's heart and the extent of the aortic stenosis, and may include:
- Cardiac catheterization—an interventional cardiologist inserts a thin tube (a catheter) into an artery in the leg, guiding the tube to the area of the heart that needs treatment. Once at the spot, a balloon is inflated briefly to open the narrow valve.
- Heart surgery—our pediatric cardiac surgeon will repair or replace the valve as needed and, if needed, enlarge the area above or below the valve.
If your child has been treated for aortic stenosis, lifelong follow-up care is needed. Our pediatric cardiologists will continue to monitor the function of your child’s valve and heart over time. And it is possible that your child will need additional procedures to treat the aortic valve.
Depending on the extent of the aortic stenosis, we will discuss with you any lifestyle changes your child may require, or if your child needs to have limitations in exercise.
Why Choose Children’s Heart Center?
Our interdisciplinary team of pediatric cardiac specialists offers continuous care for your child from before birth through adulthood. We test, diagnose, and treat congenital heart disease, including aortic valve stenosis. Parents tell us that the kind of personal and compassionate care we provide is unique, and serves to help them and the rest of their family as we treat their sick children as they are becoming well.
The pediatric cardiologists, surgeons, and staff of our Children’s Heart Center provide comprehensive and compassionate family-centered treatment of heart disease. Our specialists have extensive experience in diagnosing and treating congenital heart disease, with special expertise in complex and high-risk cases.