Aortic Valve Surgery

Your aortic valve separates your heart from the main artery in your body. Blood flows from your heart through this valve to deliver oxygen and nourishment to the rest of your body.

The aortic valve can be come weak or diseased. This generally happens in older people.

• If the valve does not close all the way, blood can leak back into the heart. This is called aortic regurgitation.
• If the valve does not open all the way, the heart needs to work harder to maintain blood flow out of the heart. This is called aortic stenosis.    

Aortic valve disease can cause symptoms such as weakness and fatigue, chest pain, shortness of breath, dizziness or fainting. Many people regain quality of life – and enjoy longer lives – after having an aortic valve replacement. There are two ways to replace the aortic valve: Open Heart Surgery and Minimally Invasive Surgery.

Minimally Invasive Aortic Valve Replacement

Traditionally, aortic valves were replaced by open-heart surgery. However open-heart surgery may be more risky for some people who are older, frail or who have other health problems. More recently, heart specialists have begun using minimally invasive techniques such as video-assisted or robotic-assisted surgery and transcatheter aortic valve replacement (TAVR).

Heart specialists in the Sutter Network are experienced in TAVR, and participated in the original clinical trials for this innovative procedure. Using a catheter that goes through an artery, the doctor inserts a collapsible replacement valve into your body’s own aortic valve. When expanded, the new valve pushes tissue on the old valve out of the way and immediately begins regulating blood flow. Your experience is similar to having heart catheterization. TAVR can sometimes be done under light to moderate sedation, avoiding the risks associated with general anesthesia. TAVR requires a very small incision at most, and leaves all your chest bones in place.

The TAVR procedure takes about two hours. Most people spend three days or less in the hospital. Typically, people fully recover within two to three weeks.

Minimally invasive aortic valve replacement such as TAVR is an alternative for people at moderate to high risk of complications from open-heart surgery – those who are older, frail or who have a history of history of health problems such as stroke, heart attack, atrial fibrillation, COPD, peripheral artery disease, diabetes and high blood pressure.

No procedure is without risks. The risks from TAVR include bleeding, stroke, irregular heart rhythm, need for pacemaker and, in rare cases, death. Most people who have the TAVR procedure enjoy greater quality of life and life expectancy.

Open Heart Valve Replacement

During traditional surgical aortic valve replacement, patients are placed under general anesthesia. The surgeon makes an incision on the chest and cuts through the sternum (breastbone) to get access to the heart and aorta. During the surgery, the heart is stopped and the patient is connected to a heart-lung bypass machine. This keeps the blood flowing through the body while the surgeon removes the old valve and sews a new valve into place.

There are two types of artificial heart valves:

• Mechanical valves are made of metal, and may last as long as 25 years. However, patients with mechanical valves need to take blood-thinning medication such as warfarin for the rest of their lives.
• Biological valves are made of human or animal tissue, and typically last 10 to 15 years. Patients with biological valves typically do not need to take blood thinners.

Open-heart valve replacement surgery takes about three to five hours. Typically, people recover in six to 12 weeks, the time it takes for the breastbone to heal.

Open-heart valve replacement surgery is often suggested for people who are in good physical health and strong enough to heal well after surgery.