November 18, 2017

Aortic Valve Repair

Aortic valve surgery is performed by heart surgeons to treat aortic valve disease, aortic valve stenosis, and aortic valve regurgitation.

What is the aortic valve?

The aortic valve is located between the left ventricle (lower heart chamber) and the aorta, which is the largest artery in the body. The function of valves is to maintain one-way blood flow through the heart.

What is aortic valve disease?

Aortic valve disease occurs when the aortic valve does not work correctly. Examples are:

Aortic valve stenosis: Stiff, fused, inflexible valve leaflets that lead to the narrowing of the aortic valve which limits or blocks the blood flow. Aortic valve stenosis occurs when calcium is deposited on the valve leaflets, limiting their mobility. Stenosis can occur in patients with a normal heart valves.

Aortic valve regurgitation: An insufficiency, incompetence or ‘leaky valve’.  When the valves do not close completely. Regurgitation causes the valve to leak, which limits the flow of blood through the aortic valve. Regurgitation may occur because of floppy leaflets (prolapse), infection of the valve (endocarditis), enlargement of the aorta (aneurysm), rheumatic valve disease.

What are the symptoms of aortic valve disease?

Initial symptoms of aortic valve disease usually include:

  • Fatigue or loss of energy
  • Swelling of the ankles (edema)
  • Palpitations (feeling extra or fluttery heart beats)

Advanced symptoms may include:

  • Shortness of breath
  • Chest pain (angina)
  • Loss of consciousness

How is aortic valve disease diagnosed?

The diagnosis of aortic valve disease is made after your physician performs a physical exam, reviews the symptoms and evaluates the results of diagnostic tests. During your physical exam, the doctor will first listen to your heart with a stethoscope. Using a stethoscope, he may hear a murmur, which represents turbulent blood flow across an abnormal valve.

The diagnosis of aortic valve disease is confirmed by a special heart ultrasound called an echocardiogram. An echocardiogram allows the doctor visualize the heart valves and determine the severity of the valve disease. In most patients, a normal echocardiogram (in which a probe is placed onto the skin of the chest to transmit images) is enough to visualize the valve. Sometimes a transeophageal echocardiogram (TEE) – where the probe is passed through the mouth into the esophagus, is needed to more closely look at the valve.

How is aortic valve disease treated?

Aortic Valve Surgery: There are two types of surgery, aortic valve repair or replacement.

Aortic Valve Repair versus Aortic Valve Replacement

Aortic Valve Repair
While an aortic valve is usually replaced, aortic valve repair may be an option. 

Aortic Valve Replacement

First, the surgeon will cut out the existing valve. Once the damaged or old valve has been removed, the patient’s aorta will be fitted for a new valve.
Measured and fitted
Biological/Mechanical valve tightly sewn in
Testing of functional valve
Patient taken off of heart-lung machine
–     Heart takes over blood-pumping function once the team has confirmed the valve is working well without leakage