Other tests our doctors use to diagnose aortic valve diseases include:

• Cardiac computerized tomography (CT) scan: Creates a detailed image of your heart and valves using a special type of X-ray
• Chest X-ray: Shows your aorta and calcium buildup on the aortic valve
• Coronary angiography: Takes an X-ray of your heart and valves after a dye is injected into your heart through a catheter. A catheter is a thin tube that is inserted into a blood vessel in your arm or groin and guided to your heart.
• Echocardiogram: Produces a video of your heart and valves in action using ultrasound waves. For a closer look, your doctor may order a transesophageal echocardiogram (TEE). A small ultrasound probe is inserted into your esophagus (tube that runs from the throat to the stomach) to get detailed images of your aorta and upper heart chambers.
• Electrocardiogram (ECG): Tracks the electrical activity of your heart. An ECG can detect an irregular heartbeat and enlarged heart chambers.
• Exercise or stress ECG test: Measures how your heart responds to physical activity. If you cannot exercise, you can take a medication that mimics exercise.

Not all patients with aortic valve disease will require surgery. Depending on your age, health, condition and symptoms, we may recommend nonsurgical treatments such as medications and lifestyle changes.

Your doctor may prescribe medications to:

• Improve cholesterol
• Lower blood pressure
• Prevent blood clots
• Reduce stress on the heart

While these medications don’t cure aortic valve disease, they can control your symptoms and prevent further damage.

We can also work with you to implement lifestyle changes that may improve your condition. You benefit from specialists who can help you quit smoking, improve your diet and be more physically active.

TAVR is a minimally invasive procedure for patients with severe aortic stenosis. In the past, TAVR was only approved for high-risk patients who were not candidates for open surgery. It is now approved for all patients.

During TAVR, the doctor uses a catheter to insert a replacement valve inside the diseased valve. Because the procedure is minimally invasive, you have a faster recovery and a lower risk of postoperative infection.

Though many patients prefer minimally invasive procedures, sometimes open surgery — in which the surgeon uses a larger incision to directly access the heart — is the best option. At the Frankel Cardiovascular Center, our outcomes for open surgery are among the best in the nation.

During open surgery, the aortic valve can be replaced or repaired. Patients with stenosis typically require valve replacement. Leaky valves can often be repaired or replaced. Because replacement valves have a limited lifespan, surgeons prefer to repair a diseased aortic valve if possible, especially in younger patients.

Replacement valves can be mechanical (manufactured) or made of biological tissue:

• Mechanical valves last longer, but you must take blood thinners for the rest of your life to prevent blood clots.
• Tissue valves are made of animal or human tissue. You don’t need to take blood thinners with this type of valve, but they have a shorter lifespan than mechanical valves.

Our surgeons have developed a reputation as leaders in aortic valve open surgery. Some of the specialized procedures they perform include:

David procedure (valve-sparing aortic root replacement): This procedure is used when an aortic aneurysm or dissection occurs near the aortic root, but the valve is healthy. The surgeon replaces the damaged root with a graft and reimplants the healthy valve in the new aortic root. This allows you to keep your aortic valve, which is more resistant to infection. It also eliminates the need to take blood thinners for life.

Ross procedure: The surgeon replaces the diseased aortic valve with the pulmonary valve (one of the other four heart valves). The pulmonary valve is then replaced with a tissue valve. The Ross procedure is often preferred for younger patients because the relocated aortic valve can grow with the child. This prevents the need for future surgeries.

Y-incision/rectangular patch aortic root enlargement: This procedure was developed at the Frankel Cardiovascular Center and is recognized globally as game-changing for patients who need a new aortic valve but have a small aortic root. The surgeon enlarges the aortic root and inserts a replacement prosthetic valve that is three to four sizes larger. The larger valve results in better blood flow and a better outcome if the valve must be replaced in the future.