We can really make a difference for children with aortic valve stenosis. For many kids, undergoing (catheterization) means they're very likely to get through childhood without ever needing surgery on their aortic valve, and that's tremendously satisfying.
--Audrey Marshall, MD, cardiologist, Boston Children's Hospital
The human heart is like a busy factory with two strong pumps: The ventricles, and two “receiving docks,” called the atria. These chambers work together to ensure that oxygen-rich blood moves out into the body, and that de-oxygenated blood comes back to the heart and lungs in return. Just like any other factory, however, the heart’s essential functions can be seriously disrupted if just one piece of machinery is compromised.
The diagram below depicts the structures of the heart.
The aortic valve:
- is a one-way valve located between the left ventricle—the pump that pushes blood out to the body—and the aorta, the major blood vessel that carries blood to different parts of the body
- keeps blood from leaking back into the ventricle once it’s been pumped out into the aorta
- typically has three leaflets, or flaps of tissue that separate to allow blood out of the ventricle when the ventricle pumps—and then fall back together when the ventricle relaxes in order to keep blood from leaking backwards
When a child has aortic valve stenosis, the leaflets that make up his aortic valve get stuck and can’t separate fully. This causes a problematic blockage that increases the pumping work of the left ventricle, and may lessen the amount of blood that goes out of the ventricle to the body through the aortic valve.
- In the most severe cases, aortic valve stenosis occurs before a baby is born, and may affect the baby shortly after birth.
- Less severe forms of the disease may be “silent”—causing no visible symptoms—until later in life.
- Aortic valve stenosis can occur by itself, or as part of a group of abnormalities affecting the left side of the heart.
- Rarely, children can develop aortic stenosis as a complication of rheumatic fever.
- Although a physical exam and an electrocardiogram may suggest a possible diagnosis of aortic valve stenosis, an echocardiogram is the definitive test to confirm the condition. Echocardiograms are painless, do not require an IV and only take about an hour.
- Some children don’t need treatment until they are older, and some may not require any intervention at all during their childhood. Children with no outward symptoms can do very well for a long time with only regular monitoring by their clinical team.
- Babies with severe aortic valve stenosis are likely to require interventional catheterization or valve surgery.
- Aortic valve stenosis can affect each child differently. Your physician is always the best resource for providing detailed information about your child’s individual situation, and for recommending treatment options that best meet the needs of your child and your family.
The detailed information on the following pages will help you, your child and your family gain a better understanding of aortic valve stenosis and a clearer picture of what to expect in the weeks and months ahead.
How Boston Children's Hospital approaches aortic valve stenosis
Boston Children's Hospital Cardiovascular Program team has extensive experience treating fetuses, babies, children, adolescents and adults with aortic valve stenosis. Thanks to available diagnostic procedures and imaging technology, the condition can be detected even when the only noticeable symptom is a soft heart murmur. This gives clinicians the opportunity to start monitoring kids with aortic valve stenosis right away, and to easily “stay on top of” the condition’s progression with regular echocardiograms and exams.
Here at Boston Children’s, our specialized training in pediatric cardiology means that we understand the unique challenges, circumstances and intricacies of working with young people who have heart problems like aortic valve stenosis. In addition to our medical expertise, we provide patient-centered care that always recognizes your child as an individual—and we offer resources to meet the needs of your entire family.
With more than 80 cardiac experts on our staff, Children’s operates the largest pediatric heart program in the nation. Every year, we treat thousands of patients who are living with aortic valve stenosis and a broad spectrum of other cardiac problems. We use sophisticated diagnostic and imaging procedures, including echocardiography and interventional catheterization, and offer dozens of specialized services in such areas as heart valve replacement, cardiac anesthesia, robotic surgery and fetal cardiology.
Our Department of Cardiology and Department of Cardiac Surgery clinicians will work closely with you to determine the right treatment plan for your child. We consider you an invaluable member of the treatment team, and always welcome your input and questions.
Watch a valve implantation procedure at Boston Children's
View the webcast.
Aortic valve stenosis: Reviewed by Audrey Marshall, MD
© Boston Children's Hospital, 2010