Aortic Valve Surgery
The Cleveland Clinic has updated its Aortic Valve Disease: Stenosis and Regurgitation website. Aortic valve surgery is performed by heart surgeons to treat most commonly bicuspid valves. This information will help you understand the conditions that may affect the aortic valve and why surgical treatment may be necessary.
Your aortic valve
The aortic valve is located between the left ventricle (lower heart pumping chamber) and the aorta, the body’s largest artery, and it keeps one-way blood flow through the heart. To learn more about heart valves, click here.
What is aortic valve disease?
Aortic valve disease occurs when the aorta does not function properly due to stenosis, leaky leaflets, or infection of the valve. Regurgitation occurs when blood ejected by the heart flows back into the heart.
What causes aortic valve disease?
According to the American Heart Association (AHA), it can be abnormal at birth or become diseased over time, which is most commonly seen in older patients (acquired heart disease).
Congenital aortic valve disease
Patients with bicuspid aortic valves are born with them, and they affect about 1% to 2% of the population. Without the third leaflet, the valve opening may not close completely, causing regurgitation (regurgitation), or it may narrow (stenotic) and leak.
Acquired aortic valve disease
Changes in the structure of the aortic valve occur as a result of acquired aortic valve conditions such as infective endocarditis, rheumatic fever, and wear and tear, as well as rheumatoid arthritis, chronic inflammatory diseases, lupus, syphilis, and tumors.
What are the symptoms of aortic valve disease?
Even when the stenosis (narrowing) or insufficiency (leak) is severe, many patients with aortic valve disease are asymptomatic (have no symptoms). Early symptoms include fatigue, easy tiring, and swelling of the ankles; later symptoms include shortness of breath, chest pain, and loss of consciousness.
How is aortic valve disease diagnosed?
A physical exam and listening for a murmur are used to diagnose aortic valve disease, which is then confirmed by a specialized heart ultrasound called an echocardiogram. If you have symptoms, evidence of heart damage, or heart failure, surgery may be required.
Aortic valve surgery
Traditional heart valve surgery or minimally invasive approaches can be used to repair the aortic valve. Your surgeon will review your diagnostic tests to see if you are a candidate for this type of surgery. Minimally invasive surgery reduces blood loss, trauma, hospital stay, and recovery time.
Aortic valve repair
Aortic valve disease is frequently associated with an enlargement (aneurysm) of the ascending aorta, which can be repaired using a minimally invasive “J” incision surgical technique, or a David procedure in patients with leaky aortic valves and enlarged aortas.
Aortic valve replacement
If repair is not an option, your surgeon may replace the valve with a mechanical or biological replacement. About 80% of aortic valves are replaced with a bioprosthesis. Human Homografts are especially useful for endocarditis (infection). Mechanical valves are non-reactive and well tolerated by the body. The bileaflet valve is the most commonly used.
Cleveland Clinic Heart, Vascular & Thoracic Institute Cardiologists and Surgeons
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How is aortic valve surgery done?
Traditional open-heart surgery, which involves a cut (incision) in the chest, or minimally invasive methods, which involve smaller incisions in the chest or a catheter inserted in the leg or chest (transcatheter aortic valve replacement, or TAVR), are both options for aortic valve repair and replacement.
How long does aortic valve surgery take?
Depending on the number of valves that need to be repaired or replaced, the surgery can take anywhere from 2 to 4 hours or more.
How safe is aortic valve replacement surgery?
An aortic valve replacement is a major procedure with the potential for fatal complications. The risk of dying as a result of the procedure is estimated to be 1 to 3%, which is far lower than the risk of leaving severe aortic disease untreated.
How long does it take to recover from a Tavi operation?
Daily activity and exercise are important parts of your recovery; talk to your family doctor or your heart doctor about which cardiac rehabilitation program is best for you. Eating well is also important for your recovery.
Do you feel better after heart valve replacement?
Patients who have had MIVS are generally able to walk earlier than those who have had traditional open-heart surgery, and you will be encouraged to sit up and walk the day after surgery.
Can you live a normal life after aortic valve replacement?
Life expectancy after valve replacement varies depending on age, but life-table analyses of large datasets suggest that a 60-year-old’s average life expectancy after aortic valve replacement is about 12 yearssup>10/sup>.
How long is hospital stay after aortic valve replacement?
You’ll need to stay in the hospital for about a week after an aortic valve replacement, and the time it takes to fully recover varies depending on factors like your age and overall health. Your breastbone should heal in about 6 to 8 weeks, but it could take 2 to 3 months before you feel like yourself again.
Which heart valve is easiest to replace?
The aortic valve is one of the heart’s four valves, which help blood flow normally through the heart’s four chambers and out to your body. The procedure is called “minimally invasive” because it uses a smaller incision than a traditional open repair, which may result in a quicker recovery.
What is the success rate of aortic valve replacement surgery?
According to a recent study, aortic valve replacement surgery has a five-year survival rate of 94 percent.
What is the life expectancy of someone with an artificial heart valve?
For example, they calculated that a 45-year-old undergoing mechanical valve replacement has a lifetime risk of thrombo-embolism, bleeding, and re-intervention of 18, 15, and 10%, respectively, compared to 34 years in the general population.
What are the signs of a bad heart valve?
The following are some physical signs of heart valve disease:
- Shortness of breath, difficulty catching your breath, fatigue, weakness, or inability to maintain a regular activity level.
- Lightheadedness or fainting.
- Swollen ankles, feet, or abdomen.
How long is the waiting list for heart valve surgery?
From the time of placement on the waiting list, the average wait time for planned elective routine surgery is three months.
Will I have more energy after aortic valve replacement?
It may take up to two months to regain your energy, and some people report being more emotional as a result of the surgery.
Do you have to take blood thinners after Tavr?
Patients who undergo TAVR should take blood-thinning medication for 6 months after the procedure and aspirin for the rest of their lives, or as prescribed by their doctor. Patients who do not take blood-thinning medication may be at risk of developing a dangerous blood clot, which could result in a stroke.
Are you awake during Tavr procedure?
Your TAVR doctor will perform the procedure in a hospital, and depending on your health, they will determine what type of anesthesia is best for you: you may be completely asleep or awake but given medication to help you relax and block pain. Your heart will continue to beat throughout the procedure.