Aortic valve replacement is a procedure in which aortic valve is replaced with an artificial heart valve. The aortic valve can be affected by a range of diseases. The valve can either become leaky (aortic insufficiency) or partially blocked (aortic stenosis). Current aortic valve replacement also includes in open heart surgery via a sternotomy, minimally invasive cardiac surgery (MICS) and transcatheter aortic valve replacement (TAVR).
The aortic valve functions as one-way valve between the heart and to rest of the body. Then the blood is pumped from the left ventricle of the heart, through the valve, and down the aorta, which in turn supplies blood to all of the organs in the body .Between heart contractions, the valve closes, preventing blood from flowing backwards into the heart.
The function of the aortic valve is then twofold:
- It provides a route for which blood can leave the heart.
- It prevents blood that it has already left the heart from leaking backwards into the heart.
Damage to the aortic valve can occurs congenital defect, the natural aging process, and from the infection or scarring. This damage may cause the valve either in “leak”, resulting in “aortic insufficiency” or to become it “restricted” and not open fully, resulting in “aortic stenosis”. Both aortic insufficiency and aortic stenosis create an extra workload for the heart. Ultimately resulting in weakening of the heart muscle and eventual heart failure. Once if the valve becomes damaged, it might need to be replaced, in order to prevent from the heart failure and premature death.
Surgery to replace an aortic valve slideshow.gif is done for aortic valve stenosis and aortic valve regurgitation. During the surgery, the damaged valve will be removed and it is replaced with an artificial valve. The valve replacement is typically an open-heart surgery.
A minimally invasive surgery or a catheter procedure to replace the aortic valve may be an option for some people.
How is the surgery done?
During the open-heart valve surgery, doctor makes a large incision in the chest. Blood is circulated outside of the body through a machine to add oxygen to it (cardiopulmonary bypass or heart-lung machine). The heart will be cooled to slow or stop the heartbeat. So that the heart will be protected from damage while the surgery is done to replace the valve with an artificial valve.
When it is necessary to replace the aortic valve?
The aortic valve is to be replaced for two reasons:
- The valve becomes narrow (aortic stenosis) and then the opening of the valve becomes smaller, obstructing the flow of blood out of the heart
- The valve is leaky (aortic regurgitation) then the valve allows blood to flow back through into the heart
The problems can get worse over time and in severe cases can lead to life-threatening problems such as heart failure, if left untreated.
How is an aortic valve replacement carried out?
An aortic valve replacement is to be carried out under the general anaesthetic. This means you’ll be asleep during the operation and won’t feel any pain while it’s carried out.
During the procedure:
- A large cut (incision) about 25cm long is made in your chest to access your heart – although sometimes a smaller cut may be made
- Heart is stopped and a heart-lung (bypass) machine is used to take over the job of the heart during the operation
- The damaged or faulty valve is removed and replaced with the new one
- your heart is restarted and the opening in your chest is closed
Risks of an aortic valve replacement:-
An aortic valve replacement is a big operation and, like any type of surgery, carries a risk of complications.
Risks of an aortic valve replacement includes are as follows:
- Wound, lung, bladder or heart valve infections
- Blood clots
- A temporarily irregular heartbeat (arrhythmia)
- Reduced kidney function for a few days
The risk of dying from an aortic valve replacement is around 1-3%, although this risk is much smaller than that of leaving severe aortic valve problems untreated.