Aortic Valve Repair or Replacement

UW Health heart surgeons can address problems with the valves that serve the heart.UW Health heart surgeons perform aortic valve surgery when your valve is severely malformed or diseased. This disease can be caused by aortic stenosis, aortic insufficiency/regurgitation, or by a bicuspid aortic valve.

 

Your valve will either be repaired or replaced with a new, properly functioning valve. If the valve needs to be replaced, this is done using a biologic (tissue) or a mechanical (metal) valve. Aortic valve replacement is the most common surgical intervention for aortic valve disease.

 

Valve Selection

 

There are a few things to consider when deciding on a valve type. You will work with your heart surgeon to decide which valve is right for you.

  • Tissue Valves: These valves are typically made from pig or cow tissue. In some cases, a donated human valve is used. The valves are pre-treated so they do not require you to take anti-rejection medications. Tissue valves tend to wear out faster in younger, more active people  due to the increased blood flow demands on the valve. They typically last around 10 years before needing to be replaced. A second open heart surgery may be needed at that time.
  • Mechanical Valves: Mechanical valves are man-made metal valves designed to last your lifetime. They do not wear out. There is an increased risk of blood clots with this type of valve. To prevent this, lifelong anticoagulation therapy with medications such as Warfarin is required.

What happens during the aortic valve repair/replacement surgery?

  • Aortic valve replacement is an open heart surgery done under general anesthesia. You are asleep during the surgery and have a breathing tube to breathe for you.
  • During surgery, your blood is circulated by a machine (cardiopulmonary bypass or “bypass”) that takes over the work of your heart. It allows your heart to be stopped while the surgeon is doing the operation.
  • An incision is made through your breastbone, which is then spread open to expose your heart. Small incisions are made in the heart to access your valve.
  • Once the valve is exposed, the surgeon examines your valve carefully to see if a repair is possible. If a repair can be done, the surgeon removes the diseased portion of the valve and reconstructs it to improve closure and prevent leakage. The specific technique used depends on the type of valve disorder you have.
  • If a valve replacement is needed, the surgeon will remove the diseased valve and replace it with a new, properly functioning valve.
  • Once the repair/replacement is complete, the valve is tested to make sure it is functioning properly. You are weaned off the bypass machine as your heart pumps on its own again. Your breastbone is closed with special wires to keep it stable during the healing process. The tissue and skin incisions are then closed.
  • Once your surgery is done, you are brought up to the Cardiac Surgery unit to recover. Your breathing tube is removed as soon as you are able to breathe on your own again.

What can I expect after aortic valve repair or replacement surgery?