Why Is Surgery Necessary?
The aortic valve is the outflow valve of the left side of the heart, meaning that it opens during systole (when the ventricle contracts or squeezes blood out into the aorta and the rest of the body). When the aortic valve is too narrow or stenotic, the ventricle has to work harder to pump the blood out to the body. This extra work consumes significant energy and ultimately requires extra blood flow to the heart itself. If there is not enough blood flow, the heart becomes ischemic causing anginal chest pain. Aortic stenosis is often progressive, growing worse with time. As the valve gets tighter, the heart has to continue to work harder and harder to keep pumping blood out of the heart. At some point the heart can no longer compensate, resulting in episodes of low blood pressure or hypotension or even syncope. As the heart fails to compensate, fluid will build up in the lungs creating congestion.
When the aortic valve leaks, the heart has to work harder and similar problem occur. The ventricle must pump more blood with each contraction to produce the same forward output, creating a condition called volume overload. The heart can compensate for this volume overload for many months or years provided the leakage develops slowly. Eventually, the heart begins to fail producing shortness of breath and fatigue. </s>