Aortic stenosis is a prevalent heart valve condition, particularly affecting older adults. It involves a narrowing of the aortic valve, which impedes the heart’s ability to pump blood effectively. This article explores the life expectancy associated with aortic stenosis, both with and without intervention, and the various factors that shape individual outcomes.
Understanding Aortic Stenosis
Aortic stenosis occurs when the aortic valve, positioned between the heart’s left ventricle and the aorta, becomes stiff, preventing it from opening fully with each heartbeat. This valve regulates the flow of oxygen-rich blood from the heart to the body’s largest artery, the aorta. When the valve narrows, the heart’s left ventricle must work harder to push blood through the restricted opening, leading to increased pressure and potential thickening of the heart muscle.
Age-related calcification is the most common cause of aortic stenosis, often developing after age 60. Other causes include congenital valve defects, such as a bicuspid aortic valve, and rheumatic fever, a complication of untreated strep throat that can damage heart valves. While some individuals may live for years without symptoms, common signs of progression include chest pain or tightness, shortness of breath, and fainting, especially during physical activity.
Life Expectancy Without Intervention
When aortic stenosis progresses to a symptomatic stage and is left untreated, the prognosis becomes poor. Once symptoms like shortness of breath, chest pain, or fainting appear, the average survival for severe, symptomatic aortic stenosis is typically around 2 to 3 years without intervention. Some studies indicate life expectancy can be as low as 1 to 2 years, which is considered worse than the prognosis for many cancers.
The progressive nature of the disease means the heart works increasingly harder, eventually leading to heart failure and other complications. For patients with angina, the 3-year survival rate without treatment is around 45%; for those with syncope, it is also 45%. Patients with congestive heart failure symptoms have a 3-year survival rate of approximately 35%.
Impact of Treatment on Prognosis
Medical interventions significantly improve both life expectancy and quality of life for individuals with aortic stenosis. These treatments aim to relieve symptoms, enhance heart function, and extend survival. The two main treatment options are surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI), also known as transcatheter aortic valve replacement (TAVR).
SAVR is an open-heart surgery to replace the diseased aortic valve. For low-risk patients, median survival after SAVR has been reported to be over 15 years, with a 5-year survival rate of approximately 93%. TAVI is a less invasive procedure, involving threading a new valve through a catheter to replace the old valve without opening the chest. In elderly patients, TAVI has shown survival rates similar to that of the general population of the same age. Both procedures restore proper blood flow and reduce strain on the heart, leading to improvements in symptoms and longevity.
Factors Influencing Individual Outcomes
Several factors can influence an individual’s life expectancy with aortic stenosis, even after treatment. A patient’s age at diagnosis plays a role, as older individuals may have other co-existing medical conditions that affect their overall health. The severity of the stenosis and how quickly it progresses also impacts outcomes; faster progression is associated with worse results.
The presence of other medical conditions, such as coronary artery disease, kidney disease, diabetes, and high blood pressure, can significantly affect prognosis and treatment considerations. Overall health and fitness levels also contribute to an individual’s ability to undergo and recover from interventions. Adherence to post-treatment care and lifestyle recommendations, including managing other health conditions, further influences long-term survival and quality of life.