What Is Aortic Valve Stenosis?
Aortic valve stenosis is a narrowing of the aortic valve — the "exit gate" from the heart. The left ventricle must work harder than normal to push blood through a restricted opening. The greater the narrowing, the heavier the load on the heart.
In children, the most common cause is a bicuspid aortic valve — a valve that forms with two leaflets instead of the normal three. This is the most prevalent congenital heart defect, occurring in 3–5% of all newborns with cardiac abnormalities.
"My goal with every patient is the same: protect the valve. A growing child should live with their own valve for as long as possible — a prosthesis always comes with limitations."
Symptoms
Mild stenosis may cause no symptoms at all and be discovered only during a routine examination. As the degree of narrowing increases, the following may appear:
- Rapid fatigue and reduced exercise tolerance
- Chest pain during physical activity
- Dizziness or fainting episodes
- In newborns — severe breathlessness, pallor, poor feeding
- Heart murmur detected by a physician
Critical stenosis in newborns is a medical emergency requiring immediate intervention.
Treatment Approach
The choice of treatment depends on the degree of stenosis, the child's age, and their overall condition. We follow a staged approach:
- Observation: mild stenosis without symptoms requires regular monitoring with echocardiography
- Balloon valvuloplasty: a catheter-based procedure that widens the valve without open-heart surgery — often the first line of intervention
- Surgical valve repair: when the valve structure allows for correction while preserving the native valve
- Ross procedure: the child's own pulmonary valve is moved to the aortic position — the gold standard when a prosthesis must be avoided
- Valve replacement: reserved as a last resort, typically in adolescents when anatomy does not permit other options
Important: Balloon valvuloplasty is not a cure — it reduces the gradient but does not eliminate the abnormality. After the procedure, regular follow-up is essential. In many cases, surgical correction will eventually be required.
The Ross Procedure — Why It Matters for Children
When a prosthetic valve becomes unavoidable, the Ross procedure is the preferred choice. The patient's own pulmonary valve is transplanted to the aortic position. The pulmonary valve is then replaced with a donor graft.
The key advantage: the Ross valve grows with the child, does not require lifelong anticoagulation therapy, and has excellent long-term results — especially important for girls of childbearing age.
What is the difference between balloon valvuloplasty and surgery?
Balloon valvuloplasty is performed via catheter — no incision, no cardiopulmonary bypass, shorter recovery. Surgery allows for more precise correction of valve anatomy. The choice depends on the specific case.
Can a child with aortic stenosis participate in sport?
It depends on the severity of stenosis. Mild forms often allow normal physical activity. Moderate and severe stenosis requires restriction of competitive sport until correction. Each case is assessed individually.
What is the Ross procedure?
The Ross procedure moves the patient's own pulmonary valve to the aortic position. The result is a living valve that grows with the child and requires no lifelong anticoagulation — the gold standard for children when a prosthesis cannot be avoided.
How do I book a consultation?
Call +994 70 660 96 50 or write on WhatsApp. The clinic is located at Yeni Klinika, Azadlig str. 112.