Cardiothoracic Surgery

Aortic Valve Replacement

Illustration of heart beat waves

What is the Aortic Valve?

After your blood is oxygenated in your lungs it drains to the left ventricle and pumped through the aortic valve to the aorta and distributed throughout you body. The aortic valve allows blood to leave the left ventricle and not re-enter after each heartbeat. When this valve malfunctions an aortic valve replacement may be necessary.

Symptoms of an aortic valve that requires medical attention include:

The aortic valve cannot close completely. When the aortic valve cannot close all the way, blood passes backward to the left ventricle. this makes it more difficult for blood to drain from the lungs and the lungs can fill up with fluid. This is also called aortic regurgitation.

The aortic valve cannot open completely. When the aortic valve cannot open completely, the flow of blood into the lungs is slowed. This is also called aortic stenosis.

What Is Aortic Valve Replacement?

If a patient has an aortic valve which is not functioning, they can develop symptoms such as dizziness, chest pain or shortness of breath. These problems can lead to worsening heart function or death and the valve should be replaced.

An aortic valve replacement is a surgical procedure that removes the faulty valve and replaces it with a new, working one. This new valve can be either mechanical or biological.

A mechanical valve is made from synthetic materials. Usually, plastic, carbon, or metal is used. the benefits of this valve is that it is very durable and can last a very long time. The downside, however, is that blood tends to stick to mechanical valves, so patients who have had aortic valve replacement with a mechanical valve must take blood thinners for the rest of their lives.

A biological valve is made from animal tissue, either directly donated from another person or crafted from the patient's own tissue. A biological valve is not as DURABLE as a mechanical valve but does not require the regular intake of blood thinners. Because they are not as durable as mechanical valves, biological valves may need to be replaced. In children this can be even more frequent.

What Is the Aortic Valve Replacement Procedure Like?

Prior to an aortic valve replacement surgery, patients are put under general anesthesia. This means they will be asleep and feel no pain. Once patients are satisfactorily sedated, the surgery can begin.

Surgeons have a number of techniques they can employ in order to make aortic valve replacement as non-invasive as possible.

Surgeons may divide the breastbone and stop the heart in order to perform surgery on the aorta. This requires a blood-lung machine and is considered open-heart surgery.

Surgeons may choose to make a small incision and only divide the top half of the breastbone. This grants access to the heart and the aorta for the aortic valve replacement procedure.

After the surgical procedure, the surgeon will close any incisions he or she has made and insert catheters around the heart to drain any fluid that may build up as a result of the procedure.

From start to finish, aortic valve replacement surgery takes anywhere from two to four hours.

How Do I Prepare for Aortic Valve Replacement Surgery?

Prior to having major surgery, there are a number of precautions that must be taken by both the doctor and the patient.

Always alert your healthcare provider if you are pregnant and inform them about all the drugs, you are currently taken.

You may be asked to store your own blood in a blood bank for possible blood transfusion during or after the surgery. Your family members may also be matches who can provide blood.

You may be asked to not eat or drink for a period of time before surgery. Ask your doctor if you can have water.

If you are a smoker, you should stop for at least two weeks before surgery.

What Is the Recovery Like After Aortic Valve Replacement?

Patients should expect to stay in the hospital for about a 5 days after aortic valve replacement, including up to three days in the intensive care unit (ICU).

Recovery after that depends on the age, health, and lifestyle of the patient. The period immediately after the procedure will require rest and limited activity, but a doctor may prescribe an exercise routine after a full recovery has been made.

Most people find they can return to their jobs after four to six weeks.

What Are the Risks of Aortic Valve Replacement?

As with all surgeries, aortic valve replacement comes with certain risks. These may include bleeding, blood clots, stroke, kidney failure, infection, and a medication reaction used in the surgery, and breathing problems.

Occasionally, a pacemaker might need to temporarily be installed if the rate and rhythms of the heartbeat are slowed significantly after the surgery.

As a rule, aortic valve replacement procedures are very safe. Mechanical valves are associated with a higher risk of blood clotting, which can lead to stroke. Biological valves are less susceptible to blood clotting, but can also fail over time. Discuss the difference between a mechanical and biological valve with your doctor.