Harvard Heart Letter

No-surgery aortic valve replacement okay for some, not all

Seek help from a heart team when considering your options.

Age and unhealthy habits can harm the aortic valve, a three-flapped structure that ensures the one-way flow of blood from the heart's main pumping chamber to the rest of the body. In some people, the aortic valve becomes encrusted with calcium deposits that stiffen and narrow it, restricting blood flow. When people with this condition (called aortic stenosis) start feeling symptoms — such as dizziness, breathlessness, fatigue, and loss of appetite — quality of life goes inexorably downhill unless the valve is replaced.

Until recently, replacing the aortic valve required open-heart surgery. Now that the FDA has approved a no-surgery technique for replacing a failed aortic valve (see illustration), many people with aortic stenosis are asking, "Can I get this?" Maybe — the FDA has for now restricted its use to people who are not good candidates for open-heart surgery.

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