All You Need to Know About Aortic Valve Replacement

Heart Valve Replacement

Heart valve replacement is the esoteric thing that nobody thinks until it affects themselves or someone they love. Then suddenly, seeking knowledge becomes a top priority. For that reason, gathered here is all you need to know about aortic valve replacement. 

What Is the Aortic Valve?

The aortic valve is one of four different valves that control blood flow through the heart. It is located between the left ventricle (the heart’s main pumping chamber) and the aorta (the primary source of oxygenated blood to the body). Each ventricle contraction causes the aortic valve to open and allows blood to flow into the aorta. When the ventricle relaxes, the valve seals off, blocking blood flow back into the ventricle. 

Why Does an Aortic Valve Need Replacement?

Several kinds of aortic valve disease are severe enough to require valve repair or replacement. These include the following:

• Congenital Heart Disease – Some people are born with deformities of the aortic heart valve, which can cause problems such as stenosis or aortic valve regurgitation. Common issues that can cause this are being born with a valve that is the wrong size or shape, an aortic valve without enough flaps, or an aortic valve that does not have an opening to allow blood flow. 
• Aortic Valve Regurgitation – This condition may occur due to degeneration of the valve, abnormal shape at birth, or infection. Blood flow from the aortic valve is meant to be one-way, from the ventricle to the aorta. When a person has aortic valve regurgitation, the valve allows blood to flow back from the aorta into the ventricle. 
• Aortic Valve Stenosis – This occurs when the valve becomes narrowed or obstructed, making it difficult for the heart to pump oxygenated blood into the aorta. Aortic valve stenosis can be caused by birth defects (congenital disease), aging, or thickening of closure flaps, and post-inflammatory disorder. 

Replacement or Repair?

The decision on whether to repair or replace an aortic valve is dependent on certain factors. Some mild cases of aortic valve dysfunction are so mild that a doctor may just choose to monitor the condition, though this is rare. Aortic valve disorders are caused by mechanical dysfunction and cannot be treated with medication. 

Age, overall health, and present comorbidities are factors in whether a heart valve will be replaced or repaired. Repairs are generally the first choice if possible due to the lower risk of infection, decreased need for blood thinners, and the ability to preserve the valve’s strength and function.

Mayo Clinic clarifies, “However, most valves cannot be repaired, and heart valve repair surgery is often harder to do than valve replacement. Your best option will depend on your situation, as well as the expertise and experience of your health care team.”

Your medical team will do a risk vs. benefit analysis and thorough testing to decide which of these procedures is right for you. 

Types of Aortic Valve Replacement

Aortic valve replacement surgery can be performed in two main ways: 

1. Open
2. Minimally invasive

Open Heart Aortic Valve Replacement Surgery

Open heart surgery is more common due to the specialization of minimally invasive techniques. Aortic valve replacements are also often performed along with CABG (coronary artery bypass surgery). All procedures are done under anesthesia.

A traditional aortic valve replacement surgery involves a surgeon making a six to eight-inch incision down the sternum center. The breastbone is divided to provide direct access to the heart (open heart surgery). The surgeon will then physically replace the abnormal heart valve. 

Minimally Invasive Aortic Valve Replacement Surgery

This form of surgery is executed by surgeons making small incisions that allow less invasive access to the valve. A minimally invasive aortic valve replacement surgery can be performed with the following techniques:

• Mini sternotomy
• Mini-thoracotomy
• Robot-assisted surgery
• Percutaneous surgery

Robot-assisted surgery allows the surgeon to complete the procedure with a robot arm and follow a projected image of the heart. An additional technique is called transcatheter aortic valve replacement (TAVR). In this procedure, a small cut is made in the groin or left chest. A replacement valve is passed through a blood vessel or the heart and moved up to the aortic valve. This is the least invasive procedure and does not require a patient to be on a heart-lung machine during surgery. 

How Long Does Aortic Valve Replacement Surgery Take?

Traditional aortic valve replacement surgery is done through the sternum generally takes four to eight hours, depending on the type of replacement. 

The time required to perform an aortic valve replacement surgery depends on both the type of replacement, any additional procedures performed alongside the replacement, and the type of procedure used. 

In general, the less invasive surgical procedures such as mini sternotomy, mini-thoracotomy, robot-assisted surgery, and percutaneous surgery take around four to six hours to perform. TAVR may take only three hours. 

How Long is the Recovery for an Aortic Valve Replacement?

A general idea can be given regarding recovery time for aortic valve replacement, but keep in mind that individual recovery time can be affected by personal factors such as overall health, the procedure performed, and complications. 

Aortic valve replacements are typically performed through open-heart surgery. After surgery, a patient will spend at least a day in the intensive care unit (ICU), where they’re given nutrients, medication, and fluids through an IV line. They are closely monitored here for a period determined by both the procedure and any complications. 

After the ICU, the patient is moved to a traditional hospital room for several days. Medical professionals will monitor vitals (heart rate, breathing, and blood pressure), work with the patient on pain management, and watch for infection signs. Physical, occupational, and respiratory therapists will facilitate the gradual increase of movement and walking and offer breathing exercises to encourage recovery. 

The doctor may impose exertion limitations for some time, based on individual recovery. They will communicate when a patient may return to regular activity. 

Heart Treatment Online

If you have more questions about aortic valve replacement, are worried about your heart, or want to know more about heart disease treatment or medication, talking to an online doctor is the best place to start. 

With our partners at PlushCare, you can talk to a board-certified doctor virtually and get heart disease treatment and management tips online. Doctors can provide you with lifestyle habits and prescription medications if they think it is necessary to help you live a healthy life.

PlushCare offers top-tier care for all patients and was recently awarded by Forbes as a top startup of 2021. 

Click here to make an appointment with a PlushCare doctor.