AORTIC VALVE REPLACEMENT
An aortic valve replacement is a type of open-heart surgery used to treat issues with the heart's aortic valve.
The aortic valve controls the flow of blood out from the heart to the parts of the body.
An aortic valve repair or replacement involves removing a faulty or damaged valve and replacing it with a new valve gotten from synthetic materials or animal tissue.
It's a major surgery that isn't suitable for everybody and can take a long time to recover from.
When is it essential to replace the aortic valve?
The aortic valve may be required to be replaced for 2 reasons:
The valve becomes narrowed (aortic stenosis) – the opening of the valve gets smaller, obstructing the flow of blood out of the heart
The valve is leaky (aortic regurgitation) – the valve lets blood to flow back through into the heart
The problems can get worse over time and in serious cases can lead to life-threatening problems such as heart failure when left untreated.
There are no drugs to treat aortic valve problems, so replacing the valve will be suggested if you're at risk of serious complications but are otherwise fit enough to have surgery.
How is an aortic valve replacement carried out?
An aortic valve replacement is performed under general anesthetic.
This implies you'll be asleep during the operation and won't feel any pain while it's carried out.
During the procedure:
A large cut (incision) about 25cm long is made in the chest to access the heart – although sometimes a smaller cut can be made
Your heart is stopped and a heart-lung (bypass) device is used to take over the job of your heart at the course of the operation
The damaged or faulty valve is removed and replaced with the good one
Your heart is restarted and the opening in the chest is closed
The surgery usually takes a few hours. You will discuss with your doctor or surgeon before the procedure to decide if a synthetic or animal tissue replacement valve is most suitable for you.
Recovering from an aortic valve replacement
You'll normally need to stay in hospital for about a week after an aortic valve replacement, although it may be 2 to 3 months before you completely recover.
You should take things easy when you first get back home, but you can start to gradually return to your regular activities over the next few weeks.
You'll be given certain advice about any side effects you can expect while you recover and activities you should avoid.
You won't often be able to drive for around 4 to 6 weeks and you'll probably require 6 to 12 weeks off work, depending on your job.
Risks of an aortic valve replacement
An aortic valve replacement is a big surgery and, like any type of surgery, comes with a risk of complications.
Some of the major risks of an aortic valve replacement include:
• Having lung, bladder or heart valve infections
• Blood clots
• A temporarily uneven heartbeat (arrhythmia)
• Decreased kidney function for a few days
The risk of dying from an aortic valve replacement is around 1 to 3%, however this risk is much smaller than that of leaving serious aortic valve problems untreated.
Most people who survive the operation have a life expectancy close to normal.
Alternatives to an aortic valve replacement
An aortic valve replacement is the most effective remedy for aortic valve conditions.
Alternative procedures are normally only used if open heart surgery is too risky.
Possible alternatives may include:
Transcatheter aortic valve implantation (TAVI) – the replacement valve is directed into place through the blood vessels, instead of through a large cut in the chest
Aortic valve balloon valvuloplasty – the valve is widened with the aid a balloon
Sutureless aortic valve replacement – the valve is not protected using stitches (sutures) to reduce the time spent on a heart-lung machine.
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