Fact or Fiction: Aortic Stenosis Can Be “Fatal”

By Adam Pick on March 5, 2013

A common question I receive from patients diagnosed with aortic stenosis is, “Can this disease really be fatal?”

To provide our community with an expert response to that question, I interviewed Dr. Marc Gillinov at the recent STS conference in Los Angeles. So you know, Dr. Gillinov is a cardiac surgeon at the Cleveland Clinic, co-author of Heart 411 and… a super nice guy.



I hope this video helped you learn more about aortic stenosis and the life threatening realities of this disease. If you would like to see other videos about aortic valve stenosis, click here.

Many thanks to Dr. Gillinov for his ongoing support of our patient community. We really appreciate his time, energy and contribution to our educational efforts. To read over 35 patient testimonials for Dr. Gillinov, click here.

Keep on tickin!

P.S. Here is a written transcript of my video interview with Doctor Gillinov:

Dr. Marc Gillinov, MD: Hi, I am a heart surgeon at the Cleveland Clinic. I have been in practice at the Cleveland Clinic for 15 years and over that time I have done about 6,000 heart operations. Though in the last few years, 99% of my practice is heart valve surgery.

Adam Pick: Can you share with us what attracted you to pursuing cardiac surgery as your career?

Doctor Gillinov: It is a very personal thing for me. When I was 16 years old, my dad had heart surgery. I decided to deal with this… I am going to get a job in heart surgery. I could not do heart surgery then, I was 16 of course. The first time I actually saw real life heart surgery, it absolutely blew me away. I thought that is the most amazing thing I have ever seen. I have got to learn how to do it.

Adam: What is aortic stenosis?

Dr. A. Marc Gillinov: Aortic stenosis is a condition which the aortic valve has narrowed. You can think of the aortic valve as the door between the heart and the rest of the body. Every drop of blood your heart pumps has to pass thru the aortic valve. Now shut that door halfway, you have blocked the flow of blood. Blocking that flow of blood with a narrowed aortic valve, that is aortic stenosis.

Adam Pick: What causes aortic stenosis?

Marc Gillinov, MD: There are two big categories. The first, people who are born with, what we call a bicuspid valve, meaning their aortic valve has 2 that is the bi, cusps 2 parts. Bicuspid valves over time wear out and often become narrowed or stenotic. Then there are the people who would have what we call a normal valve, they were born with a tricuspid or three-leaflet valve, their valves over time become stiff and covered with calcium. We are not actually sure what causes that, but we do know how to fix them.

Adam Pick: Can aortic stenosis be harmful to the patient?

Dr. Marc Gillinov, MD:  Aortic stenosis is fatal. I am going to repeat that because that is really important. If untreated, aortic stenosis is fatal. If you have severe aortic stenosis, surgery will save your life.

Adam Pick: Does aortic stenosis progress fast or slow?

Doctor Gillinov: In most people, aortic stenosis progresses relatively slowly. The area of the valve will decrease by a 10th of a cm2 per year. However, when someone gets to an area or valve area of 1 square centimeter or less, that is when you start thinking of surgery. If your valve area is 1.7-1.8 cm2 you have got a few years.

Adam: Dr. Gillinov, what is your best piece of advice for someone who has received the diagnosis that they have aortic stenosis?

Dr. Gillinov: I have three things to tell the person who has aortic stenosis: 1. Get an echo every year. You do not want to lose track of it. Even though you feel fine you get an echo on it once a year; 2. When your aortic valve area gets so small that you have what we call severe or critical aortic stenosis, it is time for surgery. Do not put it off; 3. When you come to surgery, you choose your type of valve. Many times a surgeon will tell the patient, “You are young. You get a mechanical valve. You are old, you get a tissue valve.” The real choice is up to the patient. You should get the valve that fits you and your lifestyle. It is your choice.

Written by Adam Pick
- Patient & Website Founder

Adam Pick, Heart Valve Patient Advocate

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

W. David Brown says on March 5th, 2013 at 4:09 pm

I was born with a Bicuspid Valve, at the age of 67 was told I had almost waited to long. I had a St. Jude Mechanical Valve operation. Am now almost 72 and still ticking thanks to Dr. Cameron at Johns Hopkins in Baltimore,MD

Leslie Bartlett says on March 5th, 2013 at 5:34 pm

When the surgeon came out to tell my wife he had not been able to kill me, he said my valve was in such condition that I had hours or at most a few days to live. It’s spread is insidious and the change so slow that it goes un- noticed until quite dangerous.
Aortic bovine replacement 10-15-10

Chris says on March 5th, 2013 at 9:46 pm

Can’t thank those at Cleveland enough. I had an Edwards Carp valve as a matter of urgency one Christmas seven years ago and am kite surfing tomorrow.
My surgeon, a giant with what seemed to be small hands spoke as did others about valve choices.
Found it impossible to make any decision and left it up to those very clever, wonderful people.
The pain…never dreamed anything could hurt that much….durability aspect of the valve….still glad I never had a mechaical model.

Anne Shannon says on March 5th, 2013 at 10:37 pm

I had a my aortic valve replaced on July 16, 2010, when I was 69. After much research, I decided to go to Cleveland Clinic. It’s the smartest thing I’ve ever done. Dr. Mihaljevic was my surgeon and he performed a minimally invasive procedure. I had my surgery on Friday afternoon and was released from the hospital on Monday morning. On Tuesday I flew back to Denver. I never spent a day in bed and had very minimal discomfort.

A doctor friend in Denver told me that when considering surgery, you go to the place where they do the most of the surgery you are having. Great advice! I have never regretted that decision and I have felt 110% ever since! Thanks to Adam for opening my eyes to the benefits of a second opinion!

Renee says on March 6th, 2013 at 3:26 am

On the 23 July 2012 I was diagnosed with severe aortic stenosis with less than 6 months to live, and now not even 6 months after my operation (10/9/2012), my heart from being alarmingly very large shows a mildly dilated left ventricle (3/3/2013)…and to think they were not happy about operating as my heart was too weak. Now is this good news or what!!!

Dale says on March 6th, 2013 at 3:01 pm

A very informative and professional video. Great job, Adam!

I had my aortic valve replaced three years ago at age 59. I’m one of those people with a bicuspid aortic valve, and my stenosis was severe, and about to be critical. I have a Edwards-Carpentier bovine valve, which seems to be doing a fantastic job! My surgeon (at Tufts Medical Center in Boston) was excellent and I received excellent care there. I feel great, and it’s great to be alive.

derek says on March 8th, 2013 at 4:32 pm

I have been diagnosed severe stenosis of the aotic valve, the consultant is reluctant to operate due to me having pulmonanary fibrosis and and does not think that my heart will not stand the op. (O2 transfer is 40)However, I have just had an operation, chopping off my leg with full general anasestic, with no problems. Do i take the chance, with another surgeon?

Kevin says on March 12th, 2013 at 4:58 pm

I have recently had an Echocardiogram that indicates that I have severe aortic stenosis and LVH. Due to unmovable family obligations I cannot have an aortic valve replacement operation until October, 2013, six months away. Should I have the interventionalist doctor do the heart catheter now, or wait until I am closer to October?.

Kelly says on March 27th, 2013 at 1:19 am

I was born with aortic stenosis and just had my valve replaced on February 18th by Dr. Gary Grosner in Buffalo, NY. I had a bovine valve replacement because I am only 29 years old and want the option to have children eventually. I went into a-fib as a result of the surgery, but with a beta blocker and Coumadin, I’m out of a-fib and have been since I left the hospital 9 days after surgery. I too was in severe-critical condition before the surgery and since my replacement, I feel like a million bucks! Dr. Grosner and his team at Buffalo General Hospital did a beautiful job and I feel like I have my life back. Aside from the usual sternum and incisional pain, I really feel quite good. I start cardiac rehab on Thursday and I’m looking forward to getting into shape and losing some weight. With my doctor’s help, I feel like I have a second chance at life. It’s been a truly amazing experience and even though it’s been tough, I feel like I can get through anything now.

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