Aortic Stenosis

In cases of aortic stenosis, the aortic valve (the valve between the left ventricle and the aorta) is too small, narrow or stiff to open all the way.

The aortic valve and pulmonary valves control blood flow as blood leaves the heart and keeps it flowing forward. The valves open to let blood move ahead, then quickly close to keep it from flowing backward.

With aortic stenosis, the heart has to work harder to force blood through the aortic valve. Over time, this added stress can weaken the heart.

The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, are the leading providers of pediatric heart care in Louisville and Southern Indiana. The Norton Children’s Heart Institute team has the skill and experience to provide a precise diagnosis for aortic stenosis and develop a customized treatment plan for you and your child.

Norton Children’s has a network of outreach diagnostic and treatment services throughout Kentucky and Southern Indiana.

Aortic Stenosis Symptoms in a Child

Symptoms of aortic stenosis depend on the size of the narrowed valve. Many children have no symptoms at all, and others have only mild symptoms that usually do not become bothersome.

Infants and children with more severe aortic stenosis may show signs of heart failure, such as:

Children with severe aortic stenosis may:

These symptoms may be worse during activities or exercise.

Aortic stenosis tends to be more common in baby boys than girls. Aortic stenosis may be caused by an abnormal valve such as a bicuspid aortic valve, from the effects of rheumatic fever, or even related to a genetic syndrome.

Diagnosing Aortic Stenosis

The specialists at Norton Children’s Heart Institute can identify aortic stenosis before birth. This allows babies to get the treatment they need as soon as possible after birth.

Diagnostic tools include a fetal echocardiogram (fetal echo). The fetal echo, available at Norton Children’s Heart Institute diagnostic centers, uses ultrasound. This safe and painless test provides an image of the baby’s heart before birth.

If the heart issue was not found before birth, infants and older kids who have a suspected heart condition may get an echocardiogram to identify aortic stenosis. This is similar to a fetal echo but is performed after birth.

Norton Children’s Heart Institute has 28 tele-echo locations in Kentucky and Southern Indiana.

Aortic Stenosis Treatment

Mild cases of aortic stenosis may not need treatment. However, moderate to severe cases of aortic stenosis may require a procedure or a surgery to repair the valve.

Several types of procedures can repair or replace the aortic valve. Treatments include:

  • Balloon valvuloplasty: During this procedure, a doctor threads an unopened balloon via a catheter to the heart. Once the catheter reaches the aortic valve, the doctor inflates the balloon which can help the stenotic valve open more easily.
  • Valve replacement: An artificial valve or a valve from a donor replaces the patient’s abnormal aortic valve. This is either done by cardiac catheterization or by open heart surgery.

To decide what type of treatment to use, doctors consider:

  • Patient’s age and size
  • Location and size of the narrowing
  • How well the other valves in the heart are working
  • Other conditions the patient may have
  • Previous heart surgeries the patient has had

Aortic Stenosis Complications and After Care

The biggest challenge for patients with aortic stenosis is that it can come back after treatment. This can happen for different reasons, including scar tissue that forms after a procedure or a valve replacement that does not grow. Some patients may need several surgeries.

Because aortic stenosis can be a lifelong condition, patients who have the defect will need regular checkups with a cardiologist to make sure that the narrowing is not getting worse.

Many children who have their aortic stenosis addressed and followed by Norton Children’s Heart Institute cardiologists can enjoy most regular activities after their recovery. Kids and teens with moderate or severe aortic stenosis should talk with their cardiologist before playing competitive sports.

Why Choose Norton Children’s Heart Institute

The Adult Congenital Heart Association has recognized Norton Children's Heart Institute for its expertise treating adult congenital heart disease.

  • Norton Children’s Hospital has been a pioneer in pediatric cardiothoracic surgery, performing Kentucky’s first pediatric heart transplant in 1986 and becoming the second site in the United States to perform an infant heart transplant.
  • The American Board of Thoracic Surgery has certified our cardiothoracic surgeons in congenital heart surgery.
  • The Adult Congenital Heart Association has accredited Norton Children’s Heart Institute’s Adult Congenital Heart Program as the only comprehensive care center in Kentucky and Indiana treating adults born with a heart defect.
  • More than 5,000 children a year visit Norton Children’s Heart Institute for advanced heart care.
  • Norton Children’s Heart Institute has offices across Kentucky and Southern Indiana to bring quality pediatric heart care closer to home.
  • The Jennifer Lawrence Cardiac Intensive Care Unit (CICU) at Norton Children’s Hospital is the largest dedicated CICU in Kentucky, equipped with 17 private rooms and the newest technology available for heart care.
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