Aortic valve insufficiency
If the aortic valve no longer closes completely, this is referred to as aortic valve insufficiency or aortic insufficiency for short. During the relaxation phase between heartbeats (diastole), blood flows from the aorta back into the left ventricle and places a strain on it. This strain increases over time and leads to an enlargement of the ventricle with a corresponding functional impairment.
There is a chronic and an acute form of aortic valve insufficiency. Chronic aortic valve insufficiency is often not recognised immediately: Initially, the heart compensates for the refluxed blood by increasing the stroke volume. In the long term, however, the additional load on the left side of the heart leads to problems.
Acute aortic valve insufficiency is characterised by a rapid increase in the ventricular volume (blood volume) of the left ventricle. The heart can no longer compensate for this increase and immediate treatment is necessary.
Causes
Possible causes of aortic valve insufficiency are
- Congenital bicuspid aortic valve
- Secondary causes such as an enlargement of the aorta
- Inflammation of the heart valve (endocarditis)
- Genetic diseases, such as Marfan syndrome (disease of the connective tissue)
However, around one per cent of all people are born with a so-called bicuspid aortic valve. In those affected, two of the three valve pockets are fused together. This altered structure leads to increased strain on the aortic valve with an increased risk of aortic valve insufficiency.
Diagnosis
If aortic valve insufficiency is suspected, the doctor will usually first perform an ultrasound of the heart (echocardiography). This examination makes it possible to recognise altered structures and functional limitations of the heart valves.
The following methods are also available for diagnosis:
- ECG (electrocardiogram) to measure the electrical activity of the heart
- Chest X-ray
- Cardiac catheterisation: a thin tube (catheter) is used to visualise the coronary vessels and the heart chambers on an X-ray screen.
You can find out more about the individual methods on our diagnostics page.
The doctors at the DHZC can reconstruct or replace a defective aortic valve as required. Such an operation is only necessary if the aortic valve shows severe structural and functional changes.
(Image: DHZC/Külker)
The doctors at the DHZC can reconstruct or replace a defective aortic valve as required. Such an operation is only necessary if the aortic valve shows severe structural and functional changes.
(Image: DHZC/Külker)
Therapy of aortic valve insufficiency
Patients suffering from a mild form of aortic insufficiency generally do not require any treatment. Regular medical check-ups are sufficient in this case. If there is increased blood pressure in the large arteries of the circulatory system (arterial hypertension), patients may need to take antihypertensive drugs such as calcium antagonists or ACE inhibitors. If symptoms of heart failure occur, the use of diuretics may be necessary.
Surgery, in which doctors replace the valve, is only necessary if the aortic valve shows severe structural and functional changes. The valve can either be reconstructed or replaced. At the DHZC, we perform both reconstructions and operations to replace the aortic valve.
During repair, the normal shape of the aortic valve can be restored using various methods (e.g. by tightening) so that the aortic valve closes completely again. If the aortic valve cannot be reconstructed, it must be replaced in an operation.
