Aortic Valve Repair and Replacement

The aortic valve is a crucial part of the heart, responsible for controlling blood flow from the heart to the rest of the body. When the aortic valve becomes damaged or diseased, it can lead to serious health problems, including heart failure, stroke, and even death. Aortic valve repair and replacement are surgical procedures used to treat aortic valve disease.

Types of Aortic Valve Disease

• Aortic Stenosis: a condition where the aortic valve becomes narrowed, restricting blood flow from the heart.
• Aortic Regurgitation: a condition where the aortic valve leaks, allowing blood to flow back into the heart.
• Aortic Valve Endocarditis: a condition where the aortic valve becomes infected.

Aortic Valve Repair

Aortic valve repair is a surgical procedure that aims to preserve the patient's native valve. The goal of repair is to restore normal valve function, eliminating the need for long-term anticoagulation therapy. There are several techniques used in aortic valve repair, including:

• Valve Resuspension: repairing or replacing the valve leaflets to improve valve function.
• Annuloplasty: repairing the valve annulus (the ring-like structure that supports the valve) to improve valve function.
• Leaflet Repair: repairing or replacing individual valve leaflets to improve valve function.

Aortic Valve Replacement

Aortic valve replacement is a surgical procedure where the diseased valve is replaced with an artificial one. There are two main types of artificial valves used in aortic valve replacement:

• Mechanical Valves: made from materials such as titanium or pyrolytic carbon, these valves are durable and long-lasting but require lifelong anticoagulation therapy to prevent blood clots.
• Bioprosthetic Valves: made from animal tissue (such as pig or cow tissue), these valves are more prone to wear and tear but do not require long-term anticoagulation therapy.

Surgical Approaches

There are several surgical approaches used in aortic valve repair and replacement, including:

• Open-Heart Surgery: a traditional approach where the chest is opened to access the heart.
• Minimally Invasive Surgery: a smaller incision is made to access the heart, reducing recovery time and scarring.
• Transcatheter Aortic Valve Replacement (TAVR): a minimally invasive approach where the artificial valve is inserted through a small incision in the leg and guided to the heart using a catheter.

Risks and Complications

As with any surgical procedure, there are risks and complications associated with aortic valve repair and replacement, including:

• Bleeding and Hemorrhage: excessive bleeding during or after surgery.
• Infection: risk of infection at the surgical site or in the artificial valve.
• Stroke: risk of stroke due to blood clots or other complications.
• Heart Failure: risk of heart failure due to inadequate valve function or other complications.

Recovery and Follow-Up

After aortic valve repair or replacement, patients typically require several days to weeks of recovery in the hospital. Follow-up care includes regular check-ups with the cardiologist and surgeon to monitor valve function and overall health.

Frequently Asked Questions (FAQs)

What is aortic valve repair and replacement?
Surgical procedures to fix or replace the aortic valve in the heart.

Why is aortic valve repair or replacement needed?
To treat aortic valve disease, such as stenosis or regurgitation.

What are the symptoms of aortic valve disease?
Chest pain, shortness of breath, fatigue, and dizziness.

How is aortic valve repair performed?
Through open-heart surgery or minimally invasive techniques.

What types of replacement valves are used?
Mechanical or tissue valves, including bioprosthetic and homograft valves.

What are the risks of aortic valve repair and replacement?
Bleeding, infection, stroke, and heart attack.

How long does recovery take after surgery?
Several weeks to several months.

Can aortic valve repair or replacement be done minimally invasively?
Yes, through transcatheter aortic valve replacement (TAVR) or other techniques.

What is the success rate of aortic valve repair and replacement?
Generally high, with improved survival and quality of life.

Do patients need to take medication after surgery?
Yes, to prevent blood clots and manage heart function.