Aortic Stenosis

Why Does Aortic Stenosis Happen?

• Mostly due to age-related degeneration
• Calcium deposits stiffen the valve
• Similar risk factors as coronary artery disease
• Common in individuals in their 60s, 70s, and 80s

If left untreated, severe symptomatic AS is life-threatening — 50% of patients do not survive beyond 2 years once symptoms like breathlessness begin.

Signs & Symptoms of Severe Aortic Stenosis

Patients typically experience:

• Chest pain (angina)
• Shortness of breath
• Fainting (syncope)
• Fatigue & reduced activity tolerance
• Swelling or breathlessness due to heart failure

If you notice these signs, immediate evaluation is crucial.

How Aortic Stenosis Is Diagnosed?

Doctors use a combination of:

• Echocardiography – evaluates valve structure & severity
• Cardiac Catheterization – confirms severity when needed
• CT Scan, EKG, blood tests & physical examination
• STS Risk Score assessment
• Frailty evaluation (walking tests, strength tests)

A multidisciplinary Heart Valve Team reviews all findings to decide the right treatment option.

Treatment Options for Aortic Stenosis

1. Surgical Aortic Valve Replacement (SAVR)

Traditional open-heart surgery to replace the valve.
Suitable for younger patients or those with low surgical risk.

Limitations:

• 5% operative mortality risk
• Longer recovery
• Not suitable for elderly, frail or high-risk patients

2. Transcatheter Aortic Valve Replacement (TAVR)

A breakthrough minimally invasive treatment

TAVR is a catheter-based procedure where a new valve is inserted through an artery—usually from the leg—without opening the chest.

Benefits of TAVR

• Minimally invasive, no open-heart surgery
• Faster recovery & shorter hospital stay
• Lower risk of stroke
• Excellent long-term durability
• Superior valve performance due to supra-annular design
• Suitable for intermediate, high, and prohibitive surgical risk patients

TAVR has now become the preferred treatment for many patients with severe symptomatic AS.

The Medtronic Evolut™ PRO Valve System

Our center uses the latest generation Evolut PRO valve system, known for:

• Advanced sealing to reduce leakage
• Self-expanding nitinol frame that adapts to anatomy
• Low delivery profile allowing smoother navigation through arteries
• Recapturable/repositionable design for precision placement
• Proven hemodynamic performance with excellent long-term outcomes

Clinical trials (including SURTAVI) show:

• Non-inferior or superior outcomes compared to surgery
• Lower rates of disabling stroke
• Faster return to normal activity
• Durable valve performance even at 5 years

Who Is a Candidate for TAVR?

You may be eligible if you have:

• Severe symptomatic Aortic Stenosis
• Are high-risk or intermediate-risk for open-heart surgery
• Have a previously replaced surgical bioprosthetic valve that has failed (TAVR-in-SAVR)

The Heart Valve Team evaluates:

• Symptoms
• Severity of AS
• Heart function
• Surgical risk category
• Overall frailty and organ system health

A customized treatment plan is then created.

TAVR Procedure: What to Expect

1. Local anesthesia or mild sedation
2. A small incision in the leg
3. A catheter guides the new valve to the heart
4. The new valve is deployed, immediately restoring blood flow
5. Most patients walk the next day
6. Hospital discharge usually in 2–3 days

Why Choose Metro Heart Institute?

When it comes to the treatment of complex valve disease, precision, experience, technology, and outcomes matter. Backed by more than three decades of cardiac leadership, Metro Heart Institute stands as one of India’s most trusted, advanced, and outcome-driven cardiac centers.

According to AHA/ACC guidelines, patients with complex valve disease achieve the best results at specialized Heart Valve Centers of Excellence—and Metro Heart Institute embodies every characteristic of such a center.

A Multidisciplinary Heart Valve Team

Metro’s care model is built around a collaborative team that includes:

• Senior interventional cardiologists
• Cardiac surgeons
• Structural heart specialists
• Cardiac anesthesiologists
• Cardiovascular imaging experts
• Intensivists & specialized cardiac nursing teams

Every patient’s case is reviewed jointly, ensuring precise diagnosis, accurate risk assessment, and a personalized treatment plan.

When Should You Seek Treatment?

Intervention is recommended if:

• You have severe AS with symptoms
• Your heart function is reduced
• You show abnormal stress test results
• You have low-flow, low-gradient AS
• You are undergoing other cardiac surgery

If you have been diagnosed with moderate or severe AS, do not delay. Early evaluation can save your life.

Severe Aortic Stenosis is a serious condition, but with advanced treatments like TAVR, patients can live longer, healthier lives with faster recovery and excellent quality of life.

Our Aortic Valve Program combines expert cardiologists, cardiac surgeons, interventional specialists, and advanced imaging to offer comprehensive, world-class care.