Comments on: Aortic Valve Gradient For Aortic Stenosis – What Is It?

By: Marie Gabriel

Marie Gabriel — Tue, 08 Feb 2011 20:23:06 +0000

I am female 70 years old, no high blood pressure or diabetes, I am 5 ft 2 inches and weigh 115 lbs. I have aortic value stenosis classified as severe. I have been working out a a gym until recently, (doc suggested I stop) but have no symptoms of angina, dizziness, chest pain or shortness of breath.
If I have aortic replaced now what is possibility I will need another replacement in the future.

By: Douglas I. Pereira

Douglas I. Pereira — Wed, 15 Sep 2010 06:10:31 +0000

Jim,

All mechanical valves have a gradient that is intrinsic to their design (friction, that metal and plastic is heavier than normal valve tissue, etc.), and manufacturers do their best to keep it as low as possible. The gradient of a mechanical aortic valve is usually around 8 to 22 mmHg, which is near the gradient of a normally functioning (albeit mildly stenotic) natural valve.

Also, newer mechanical aortic valves have lower gradients, due to improvements in technology, so ask your cardiac surgeon to use the newest model available if they recommend a mechanical valve.

If you have serious health conditions (i.e. COPD, diabetes, renal disease), anticoagulation is contraindicated, or you are elderly, and you have “poor inotropic reserve” (i.e. the aortic valve gradient fails to rise at least 20% when dobutamine is infused, which means your left ventricle has failed from the strain), your cardiac surgeon will likely recommend a biological valve, which has no gradient, doesn’t require lifelong anticoagulation (which has huge risks), but will eventually become stenotic after around a decade or two, and require replacement (but technology is improving, and valve lifetimes are being extended every day).

So it’s a trade-off between re-operation and the risks of anticoagulation, and only you and your cardiac surgeon can make that decision as to what’s best for your situation.

By: James (Jim) Rohan

James (Jim) Rohan — Tue, 20 Jul 2010 16:30:36 +0000

One year ago I had my aortic valve replaced and last week my doctor performed an echocardiogram. I received a call from the doctor’s office giving me the results and it was for that the replacement valve was gradient. I have a followup appointment in September, but after doing some research believe that the replacement valve having this situation might be cause for another surgery to replace the replacement. Could you give me some additional data on how common this situation is and am I correct in assuming I am heading for another open heart surgery?

Thanks
Jim