Revolutionary technology: This is how researchers are fighting against aortic valve stenosis!

Revolutionary technology: This is how researchers are fighting against aortic valve stenosis!

Aortic valve stenosis is a heart valve disease that particularly affects people over the age of around 60. Calcification of the aortic valve, which lies between the left ventricle and the aorta, impedes blood flow, which leads to a noticeable reduction in physical performance. Loud uni-bonn.de There is still insufficient understanding of how aortic valve stenosis develops and there is currently no way to actively stop the disease. Prof. Dr. Daniela Wenzel from the Ruhr University Bochum emphasizes that replacing the heart valve is often the last option when other treatment options have been exhausted.

A research team from the Collaborative Research Center “Aortic Diseases” is intensively studying the endothelial cells of the aortic valves. These cells have an important function as they prevent platelets from sticking and clots from forming. To isolate the cells, a special technique was developed in which a defective aortic valve is pressed between two glass plates so that the cells stick. The density of the endothelium is then examined by staining, with a high permeability to blood proteins in particular indicating a disease.

Clinical features of aortic stenosis

Clinical examination of patients with aortic valve stenosis often reveals a small blood pressure amplitude and a sluggish pulse increase, known as pulsus tardus et parvus. Auscultation of the heart may raise suspicion of the disease by a loud, fusiform holosystole that is usually heard over the second right parasternal intercostal space. In severe stenosis, the systolic eruption may only occur after the first heart sound, while the second heart sound is often quiet. In the case of severe aortic stenosis, the appearance of a fourth heart sound can also be an indicator of the disease.

Various technical procedures are used to diagnose aortic stenosis. Aortic dilatation and elongation can be seen on a chest x-ray; cardiac enlargement only becomes apparent when dilatation is advanced. The ECG may show a positive Sokolow-Lyon index, indicating left ventricular hypertrophy. Echocardiography provides accurate assessment of cardiac structure and function, with transesophageal echocardiography providing the best visualization.

Therapy paths and innovative procedures

An innovative procedure for treating aortic valve stenosis is catheter-assisted aortic valve replacement (TAVI), which was first used in 2002 by French cardiologist Alain Cribier. This minimally invasive procedure has revolutionized the treatment of aortic valve stenosis by allowing faster wound healing, less pain and faster mobilization of patients. TAVI is now the standard procedure for patients over 75 years of age with intermediate and high risk. In this procedure, the new heart valve is attached to a catheter and pushed through small incisions in the narrowed heart valve, usually through the artery in the groin.

The valves used in TAVI are made of biological prosthetic tissue, such as bovine or porcine cardiac sacs, embedded in wire mesh. These valves have a similar durability to biologically implanted heart valves. In addition, TAVI valves can be implanted into existing biological valves, enabling a valve-in-valve procedure. Studies have shown that TAVI is safe and successful even in younger and lower-risk patients. According to the German Heart Report 2020, around 60% of TAVI patients are between 80 and 90 years old, and 30% are between 70 and 80 years old.

Aortic valve stenosis remains a significant health challenge. Ongoing research aims to better understand the disease mechanisms and potentially develop new drug interventions. Future therapies based on current findings could also help to significantly improve the quality of life of affected patients. Further information on heart disease and in particular aortic valve stenosis can be found at herzstiftung.de as well as doccheck.com.