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.