Aortic Valve Replacement Surgery
Surgery to replace an aortic valve is done for aortic valve stenosis and aortic valve regurgitation. During this surgery, the damaged valve is removed and replaced with an artificial valve. The valve replacement is typically an open-heart surgery.
A minimally invasive method to replace the aortic valve may be an option for some people. These methods include minimally invasive surgery or a catheter procedure.
How is it done?
During open-heart valve surgery, the doctor makes a large incision in the chest. Blood is circulated outside of the body through a machine to add oxygen to it (cardiopulmonary bypass or heart-lung machine). The heart may be cooled to slow or stop the heartbeat so that the heart is protected from damage while surgery is done to replace the valve with an artificial valve.
The artificial valve might be mechanical (made of man-made substances). Others are made out of animal tissue, often from a pig.
What To Expect After Surgery
You will recover in the hospital until you are healthy enough to go home. Depending on your overall health, you will likely go home a few days after surgery.
Surgery will likely involve a long recovery over several weeks. You will probably need to take 4 to 12 weeks off from work. It depends on the type of work you do and how you feel. In some cases, full recovery may take several months.
Why It Is Done
Aortic valve regurgitation
If your chronic regurgitation is getting worse and you have symptoms, you will likely have surgery. You might have surgery before you get symptoms, especially if your regurgitation is getting worse. If you have acute regurgitation, surgery will likely be done right away.
For help with this decision, see Aortic Valve Regurgitation: Deciding About Surgery.
Aortic valve stenosis
Valve replacement is recommended based on many things including how severe the stenosis is, whether you have symptoms, and how well your heart is pumping blood. It is typically recommended when a person has severe stenosis.
For help with this decision, see:
How Well It Works
Aortic valve regurgitation
Valve replacement surgery can fix aortic valve regurgitation. It helps relieve symptoms and prevent heart failure. And it helps people live longer.1
Aortic valve stenosis
Valve replacement surgery is an effective treatment for people who have severe aortic valve stenosis.2 If you don't have surgery after your stenosis is severe, you may die suddenly or develop heart failure. Surgery can relieve symptoms, improve your quality of life, and help you have a more normal life span.
Valve replacement surgery has a high rate of success and a low risk of causing other problems if you are otherwise healthy. Although most people have successful outcomes, there is a risk of death and serious problems during surgery. Valve replacement surgery is high-risk for people who have a failing left ventricle and who have had a heart attack. About 5 or less out of 100 people who have valve surgery die.3
If you have severe aortic valve regurgitation or stenosis, the risks of not replacing the valve may be greater than the risks of surgery, unless you have other health problems that make surgery too dangerous.
Even if valve replacement surgery is a success, you may have problems after surgery, such as:
- An increased risk of blood clots. These can break off and cause a stroke or heart attack. To reduce the risk of blood clots, you will take a blood-thinning medicine.
- A need for another replacement valve. This will depend on the type of valve you get and how long you live after you have the surgery.
- Incomplete relief from symptoms. Some types of valves do not have openings as wide as a normal valve for a person your size. This can limit how well the valve works to relieve your symptoms.
- A valve that fails. There is a small chance that the valve will not work. Your doctor will need to check from time to time to make sure that your valve is working.
What To Think About
If you decide to have surgery, you and your doctor will decide which type of valve is right for you.
- Freeman RV, Otto CM (2011). Aortic valve disease. In V Fuster et al., eds., Hurst’s The Heart, 13th ed., vol. 2, pp. 1692–1720. New York: McGraw-Hill.
- Nishimura RA, et al. (2014). 2014 AHA/ACC guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation, published online March 3, 2014. DOI: 10.1161/CIR.0000000000000031. Accessed May 1, 2014.
- Otto CM, Bonow RO (2012). Valvular heart disease. In RO Bonow et al., eds., Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 2, pp. 1468–1539. Philadelphia: Saunders.
Current as of: August 8, 2014