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Five things you should know about your aortic health

The aortic valve, which separates the heart from the aorta, is a crucial component of your circulatory system.
The aortic valve, an important component of your circulatory system, opens and closes an average of 34.2 million times a year. University of Minnesota Health Cardiothoracic Surgeon Gabe Loor, MD, offers a few tips for aortic valve health.

Did you know that your aortic valve—which separates the left ventricle of the heart from the aorta—opens and closes roughly 34.2 million times each year? Or that a relatively common genetic abnormality can cause the valve to malfunction?

We posed a few questions about the aortic valve to University of Minnesota Health Cardiothoracic Surgeon Gabriel Loor, MD. Loor is a member of the University of Minnesota Health Aortic Center, which provides comprehensive medical and surgical care for aortic conditions and emergencies.

How hard does the aortic valve work?
The aortic valve is the gateway that separates the heart from the body's largest artery, the aorta. The valve is made up of three leaflets, which open to allow blood to be pumped out to the body and then close to prevent blood from returning to the heart. The aortic valve opens and closes an average of 34.2 million times per year. The pressure difference between the aorta and the heart causes it to open and close with every heartbeat.

How can I keep it healthy?
Many of the same things that cause heart disease—such as diabetes, cholesterol, smoking and obesity—also lead to calcium buildup on the valve. Avoiding smoking, exercise regularly and monitor your weight and cholesterol to ensure your aortic valve stays healthy over your life.

What is a heart murmur?
A murmur is a sound that is detected with a stethoscope when there is turbulent flow across the aortic valve. A calcium buildup or a leaky aortic valve can cause a murmur. Care providers who discover a murmur may schedule an echocardiogram to examine the valve in greater detail. However, only occasionally will a murmur indicate disease so advanced that it requires treatment.

Calcium buildup occurs in response to cells that die and decay. Smoking, high blood pressure, diabetes or cholesterol can injure the lining of the aortic valve leaflets. The body’s inflammatory response leads to the death of nearby cells, which release stores of calcium. Over time the dead group of cells and calcium accumulate and get densely packed into a core. If this collection of calcium continues to build it can start to narrow the diameter of the valve, causing a heart murmur.

What if I have a bicuspid valve?
Bicuspid valves are present in 1 to 2 percent of the population. Ordinarily, people are born with three leaflets that make up the aortic valve. This is known as a tricuspid valve. Occasionally, a person will only be born with two leaflets, which is known as a bicuspid valve. People with a bicuspid valve are more likely to have aortic stenosis, or narrowing of the aorta; a leaky aortic valve, known as aortic regurgitation; or aortic aneurysms, which occur when a portion of the aortic wall weakens and bulges outward. Just because a person has a bicuspid valve does not mean he or she will have a health problem related to the valve. However, people with bicuspid valves should have an echocardiogram every year, or every other year, depending on the presence or absence of any abnormalities. Because bicuspid valves are genetic, it is important that first-degree relatives—including children, siblings and parents—also receive an echocardiogram.

What happens if my aortic valve needs treatment?
Surgery on the aortic valve aims to replace the valve with a biological or mechanical valve. The surgery is extremely safe and replacement valves are very durable. Our University of Minnesota Health Heart Care team offer minimally invasive options, which can speed recovery times and reduce post-surgical pain for patients. For patients who may be unable to undergo surgery because of health complications or previous procedures, University of Minnesota Heart Care offers an innovative procedure called Transcatheter Aortic Valve Replacement (TAVR).