December 3, 2009
By: David Jaffe
Aortic valve stenosis is a congenital heart disease affecting the aortic valve of the heart. The aortic valve is most commonly a bicuspid valve, but may be a tricuspid valve as well. When there is stenosis or hardening of such valve, the left ventricle of the heart has to pump blood out of the heart through the aorta more vigorously during systole, resulting in hypertrophy or thickening of the left ventricle. As the ventricle thickens and the valve deteriorates, the patient gets closer and closer to myocardial infarction, which results in dead heart tissue and produces cardiac arrest and death. When an infant or young child has aortic valve stenosis, it is incumbent upon the treating pediatric cardiologist to monitor such condition closely including through the use of serial testing, including stress tests, electrocardiograms, Doppler echocardiograms, and/or catheterization, where appropriate.
Even with proper monitoring, the chances are by the time an aortic valve stenosis patient reaches the age of 40 or so, he or she will need a valve replacement. Presently, the Ross procedure, which involves removing the patient's ventricular valve to replace the aortic valve, is the most advanced surgical alternative.
The advantages of inserting a valve from the patient are that the patient will probably not have to be on Coumadin or another blood thinner for the rest of his or her life to prevent the possibility of blood clots or emboli, which could be fatal. With proper treatment and monitoring, a young person with a mild aortic valve stenosis can lead a normal and healthy life. However, he or she must be monitored very carefully to detect symptoms such as difficulties with breathing, especially upon exertion and changes in the overall health of his or her heart over time.
I have successfully litigated two cases involving children with aortic valve stenosis and an alleged failure to diagnose. In both cases, the patient died and a wrongful death action was brought.
Through the use of prominent nationally recognized experts in the area of exercise and general pediatric cardiology, I was able to demonstrate that there was a failure to properly test, recognize the severity of, monitor, and/or follow up on the patient's aortic valve stenosis before an untimely death occurred due to such failures.
Currently, in cases of aortic valve stenosis, if detected early enough, even in regard to an embryo or a very young infant, surgical procedures can be performed using catheters and other techniques which will correct the aortic valve insufficiency and enable the patient to live a long and healthy life.