aortaklaff

The aortaklaff, or aortic valve, is the semilunar valve between the left ventricle and the ascending aorta. It regulates blood flow into the systemic circulation and prevents backflow during diastole.

Anatomy: It has three cusps—right coronary, left coronary, and non-coronary—anchored to a fibrous annulus. Each cusp forms a leaflet with an aortic sinus; the coronary arteries originate at the ostia near the cusps. The valve opens during systole and closes in diastole.

Function: It coordinates with the left ventricle to maintain unidirectional flow and minimize left-ventricular workload. Structural disease can cause stenosis (narrowing) or regurgitation (leakage), affecting the heart’s efficiency and signaling potential symptoms.

Disorders: The main problems are aortic stenosis and aortic regurgitation. Causes include age-related calcific degeneration, bicuspid aortic valve, rheumatic disease, and less commonly infective endocarditis or connective tissue disorders. Root dilation can accompany valve disease and contribute to symptoms.

Diagnosis: Symptoms such as exertional dyspnea, chest pain, or syncope may reflect stenosis; shortness of breath and edema can indicate regurgitation. On examination there may be a systolic ejection murmur with stenosis or a diastolic murmur with regurgitation. Echocardiography is the primary diagnostic test, providing valve area, gradients, and regurgitant volume. CT and MRI may be used to assess anatomy and aortic root dilation.

Treatment: Mild disease is monitored. Severe symptomatic disease usually requires valve replacement, by surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR/TAVI), depending on risk and anatomy. Valve prostheses can be mechanical or bioprosthetic, influencing anticoagulation considerations. Outcomes improve after restoration of valve function.