Aortic Valve-Sparing Surgery

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At UW Health Heart and Vascular Care in Madison, Wisconsin, a new advanced surgical procedure called aortic valve-sparing surgery allows surgeons to replace the diseased part of the aortic root and still preserve the patient's native aortic valve.
The aortic root is the section of the aorta that is connected to the heart. It includes the aortic valve. An aortic aneurysm is a bulge in the wall of the aorta. If an aortic root aneurysm enlarges, the aortic root must be replaced with a graft. This prevents life-threatening aortic rupture or dissection.
Traditional surgery for aortic root aneurysms has involved replacing the aortic valve with a mechanical valve. If possible, however, it is always preferable to preserve the natural valve rather than replacing it.
This operation, called the reimplantation technique, or David procedure, was originally described by Tirone David, MD, the chief of cardiac surgery at the University of Toronto. UW Health is proud to offer this procedure.
Advantages of Aortic-Valve Sparing Surgery
Whenever possible, it is always preferable to repair a heart valve rather than replace it. Patients whose aortic valves are replaced with mechanical valves must take blood thinners for the rest of their lives to prevent blood clots. If the valve is replaced with a biological valve, blood thinners are not necessary, but the valve will wear out after 10 to 12 years and must be replaced again.
For some patients who have an aortic root aneurysm, aortic valve-sparing surgery is the preferred method of repair. In the procedure, the aortic root is replaced with a graft, but the patient's own aortic valve is preserved. It is important to understand, however, that patients must have a normal aortic valve for this operation to work.
The primary advantage of the valve-sparing procedure is that it eliminates the need for blood-thinning medications after surgery. The valve-sparing procedure also reduces the risk of stroke and bacterial infection that can be associated with valve replacement.
What to Expect After Surgery
After aortic valve-sparing surgery, you will be moved to the intensive care unit (ICU). You will remain in the ICU for at least one night while we monitor your heart function and other vital signs. Once you are stable enough to leave the ICU, you will be moved to a regular hospital room. Most patients are able to go home five to eight days after surgery.
Once you are home, it will take about six weeks for your breastbone to fully heal and for you to regain strength in your upper body.
If you have another invasive procedure after surgery, such as dental work or a colonoscopy, you must notify your doctor beforehand. Your doctor will prescribe preventive antibiotics to reduce the risk of infection while the aortic valve heals.
You will return to the surgery clinic for follow-up four weeks after surgery.