Aortic Valve Repair/Replacements

Of all the valves of the heart, the aortic valve is the most frequently diseased. As the average age of the population increases, aortic valve disease is becoming more common. The two basic types of aortic valve disease are aortic stenosis and aortic insufficiency.

Aortic Stenosis

Aortic Stenosis is a narrowing or construction of the aortic valve. Aortic stenosis impedes blood flow from the left ventricle into the aorta, and may lead to congestive heart failure.

Some of the causes of aortic stenosis include calcification of the valve due to age, congenital defects, and damage to the valve as a result of rheumatic fever.

Symptoms may include:

  • Fainting/pre-fainting episodes, and passing out
  • Chest pain (angina)/chest pressure
  • Shortness of breath
  • Fatigue

The presence of symptoms becomes an important development over the course of aortic stenosis. When symptoms are present in a patient, the odds of death from the disease process rise significantly. An operation may be necessary to prevent the death of the patient.

Any of the following conditions may indicate the need for aortic valve replacement, even in the absence of symptoms:

Evidence of weakening of the heart muscles, found during echocardiogram or heart catheterization.

Enlargement of the heart.

A pressure gradient of 50 mmHg (mercury) or greater.

A valve area of less than 1.0 cm squared.

 

Aortic Insufficiency (“leaky” valve)

Aortic insufficiency (also referred to as aortic regurgitation) occurs when the aortic valve leaks, causing blood to flow in the opposite direction when the heart beats, from the aorta into the left ventricle.

Symptoms:

  • Shortness of breath
  • Fatigue
  • Swelling in the extremities (often lower legs) and/or fluid retention (sometimes known as ascites if around the abdomen)
  • Chest pain/pressure (angina)

Even without symptoms, any of the following may indicate the need for surgery. With a leaky aortic valve, it is preferable for patients to undergo an operation before symptoms develop. Once it is weakened, the heart may not return to full health and/or optimal function post-operation.

Enlargement of the heart.

Weakening of the heart muscle (“heart failure” or “congestive heart failure”).

Enlargement of the ascending aorta (known as an aneurysm).

 

Aortic Valve Replacement

With isolated aortic valve disease where only aortic valve replacement is required, the operation may be performed without dividing the sternum, as is done in traditional valve replacement surgery. Minimally invasive aortic valve replacement involves making a 2″ incision between the right second and third rib, and a 1 1/2″ incision in the groin.

Minimally invasive aortic valve replacement surgery have many advantages including:

  • Swifter recovery, allowing a return to normal activities within two weeks, instead of the two months common to traditional surgery.
  • Hospital stays of four days or less
  • Less blood is lost, reducing the need for transfusions
  • Smaller risk of infection
  • Less cosmetic impact, smaller scars that are easier to conceal

If you believe you or a loved one may be a candidate for Aortic Valve Repair or Replacement, CONTACT US.