When patients have aortic stenosis, regurgitation, or insufficiency, an aortic valve replacement is the optimal surgical treatment.
Prosthetic valves can be either mechanical or biological. Mechanical valves are made of metal, last longer, and require anticoagulation. Biological valves are made of human or animal tissue and require less anticoagulation. Biological valves have a shorter life span.
A recently developed alternative to open-heart surgery, Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure, performed by inserting a catheter through the groin to make the aortic valve repair.
Patients can be back on their feet and enjoying life in just a few days. The Food and Drug Administration has approved TAVR for use in patients ineligible for traditional aortic valve surgery because of age, comorbidities, previous open-heart surgery, or other high risks.
Clinical trials are currently ongoing in moderate-risk patients.
Your surgeon will give specific instructions before aortic valve replacement surgery, including risks, which include bleeding, infection, and adverse reaction to anesthesia.
Please be sure to contact your insurance company regarding coverage.
You will also meet with the anesthesiologist prior to the surgery to go over your medical history. Please do not eat after midnight the night before your surgery.
On the day of surgery, you will arrive at the hospital, register, and change into a gown. A nurse will review your chart to make sure there are no problems. The anesthesiologist will then start an IV and you will be taken to the operating room, where the surgeon will verify your name and procedure before any medication is given. Once you are under anesthesia, surgery will begin.
The surgeon will begin by making an incision in the midline of your chest and spread the chest cavity to get to the heart. You will then be placed on cardiopulmonary bypass – which allows the blood to be pumped to the body, bypassing the heart except for the coronary arteries – while the heart is stopped temporarily.
An incision is made in the aorta to access the aortic valve, and it is then replaced. Your aortic valve leaflets are removed before the prosthetic valve is placed.
The heart is then closed and restarted, and the blood is allowed to flow back through the heart. Pacing wires are placed on the heart in case there are any irregular heart rhythms during the recovery period in the hospital, and the chest is closed with wires and stitches.
After aortic valve replacement surgery, you will be taken to the intensive care unit and monitored. Pain is likely, so you will be given pain medication appropriately. You may also be on a respirator for up to a day after the surgery. It’s important to keep the incision areas clean and dry. The length of your hospital stay depends on how quickly you’re able to recover and perform some physical activity.
Please contact your doctor immediately if you experience fevers, severe pain, redness, swelling, warmth where the incisions were made, or drainage from the incisions. Your surgeon will give specific instructions about recovery time.
To meet with an aortic valve replacement specialist at UT Southwestern's facilities in Dallas or for more information about our services, request an appointment or call 214-645-8300.