Aortic valve disease includes:

• Aortic stenosis: When a valve is fused closed or hardened. Aortic stenosis can lead to an obstruction that will force the heart’s lower left chamber (left ventricle) to work harder to pump blood into the aorta.
• Aortic regurgitation or aortic insufficiency: When an aortic valve is leaky and doesn’t close as it should. This means blood leaks back into the left ventricle. Over time, the ventricle becomes bigger and the heart must work harder to move the blood into the body.

Some valve defects have both issues. A stiff valve may block blood flow from the heart, and if it also doesn’t close as it should, blood can leak back into the ventricle. Aortic valve disease forces the left ventricle to work harder and, with time, the ventricle can fail.

The board-certified and fellowship-trained specialists at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, have the skill and experience to provide a precise diagnosis for aortic valve disease and develop a customized treatment plan for you and your child.

Norton Children’s Heart Institute is the leading provider of pediatric heart care in Louisville and Southern Indiana.

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

Aortic Valve Disease Symptoms

Children with aortic valve disease may not show signs for many years. Signs and symptoms may include:

• Chest pain or tightness
• Dizziness
• Fainting
• Fatigue
• Heart murmur or irregular heartbeat
• Not eating enough
• Not gaining enough weight
• Shortness of breath, particularly after exercise or while lying down
• Swelling in ankles and feet

A child can be born with aortic valve disease or develop it later in life. A normal aortic valve has three cusps, or leaflets. Some children are born with a bicuspid valve, which has only two leaflets. Children with a bicuspid valve usually do not need any care for the condition until adulthood.

Untreated strep throat can develop into rheumatic fever, which in turn can attack heart valves including the aortic valve and cause stenosis or insufficiency. Taking a full course of prescribed antibiotics is vital to treat strep throat.

Diagnosing Aortic Valve Disease

In infants, low energy, poor feeding/nursing and difficulty breathing may signal a valve issue. In older children, fainting or chest pain also may indicate a problem.

Though valve disease may have no warning signs, doctors may hear a heart murmur — a specific “whooshing” sound — through a stethoscope. The following tests may provide more details:

• Cardiac MRI (magnetic resonance imaging): A test that uses radio waves, magnets and a computer to form 3D pictures of the heart. These pictures can show structural issues (such as an enlarged valve).
• Chest X-ray: This shows pictures of the heart and lungs, and can show heart issues, extra blood flow or fluid in the lungs due to valve defects.
• Echocardiogram (echo): This test uses sound waves (ultrasound) to produce images of the heart and blood vessels’ structures on a screen. It can show the structure and function of the heart. Norton Children’s Heart Institute has 28 tele-echo locations in Kentucky and Southern Indiana so many patients don’t have to travel far from home for an echocardiogram.
• Electrocardiogram (ECG or EKG): This is a test that checks the heart’s electrical activity to show damage or irregular rhythms.
• Heart catheterization: This invasive procedure studies the structure, function, and provides direct pressure measurements and of the heart. It also may be a means for treating aortic valve stenosis using balloon-tipped catheters (balloon aortic valvuloplasty).

Aortic Valve Disease Treatment

At Norton Children’s Heart Institute, aortic valve repair is possible through a number of different options. Young children with aortic stenosis can have their valves opened either by a balloon catheterization procedure or by open heart surgery.

Older children and young adults may require surgery for aortic stenosis or aortic insufficiency and some people with significant aortic valve disease may need an aortic valve replacement. Your pediatric cardiologist and pediatric cardiothoracic surgeon at Norton Children’s Heart Institute will be able to discuss with you the different options of replacement valves in order to find which option is best to fit your needs.

Why Choose Norton Children’s Heart Institute

• 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 Adult Congenital Heart Disease Program as the only comprehensive care center in Kentucky and Indiana treating adults born with a heart defect.
• More than 17,000 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.