What is the aortic valve?
The aortic valve is one of the four heart valves. It normally has three leaflets. When the pumping chamber (left ventricle) of the heart ejects, blood goes through the valve and to the rest of the body. An abnormal valve may either leak (insufficiency/ regurgitation) or be too tight (stenosis). Either problem may be severe enough to require surgery.
What are the symptoms of aortic valve problems?
A diseased aortic valve may lead to heart failure. The symptoms are tiredness on exertion, shortness of breath, trouble breathing lying down, or abnormal heart rhythms. Aortic regurgitation will eventually lead to enlargement of the heart and heart failure symptoms. Aortic stenosis may be asymptomatic, or the patient may experience chest pain, fainting, breathlessness, or heart failure. With severe aortic stenosis there is a 2% incidence of sudden death each year.
How is the operation performed?
Aortic valve replacement is open heart surgery and requires the use of the heart lung machine. The incision is a median sternotomy over the breast bone. The heart is stopped with a special chemical solution and the aortic valve is exposed through the aorta. The valve may be with a mechanical valve or a bioprosthesis (tissue valve) depending on the needs of the particular patient. The heart will start back on its own when allowed to fill with blood and the new valve function is checked with an echocardiogram.
AVR with tissue valve
What types of valves are used?
Two basic categories of valves are implanted. The first is a mechanical valve, in our practice we use a St. Jude Valve. It is made of synthetic pyrolite carbon with a cloth sewing ring. St. Jude Valve
The second type of valve is known as a “tissue” valve. It is either a porcine (pig) valve or constructed from bovine (cow) pericardium. It may not require the long term use of Coumadin.
What about my medicines after surgery?
Your cardiologist will assist in placing you back on your home medicines at the appropriate point after surgery. In general, medications for diabetes, hypertension, and cholesterol will need to be continued at home.
What is the recovery period?
The average patient stays in the intensive care unit 1 night and 5 to 7 days in the hospital. The patient then is discharged home and gradually increases activity over the next 4 to 6 weeks when full recovery is achieved.
St. Jude Valve
What is the mortality rate?
The mortality rate from heart surgery depends on the patient’s overall health, age, heart function, and magnitude of the surgery. The overall mortality rate from aortic valve replacement is 3%.
What are the common complications of aortic valve replacement?
The usual complications from any major surgery apply. Those are infection, bleeding, lung or kidney dysfunction, stroke, and heart damage. After aortic valve replacement a small percentage of patients require a pacemaker.
Can I stay alone after surgery?
You may, although most patients stay with a family member or friend for the first 1 or 2 weeks.
Will I need home health?
All patients are assigned a home health visiting nurse. They will check on the patient as needed usually a couple of times a week for the first few weeks.
Aortic tissue valve
When can I drive?
This is an individual decision. Most patients wait to drive until their first post op visit at 3 or 4 weeks. Many young and active patients drive sooner if they are not in pain and not taking pain medications.
When can I go back to work?
Patients performing a desk job may return to work in 3 or 4 weeks. Patients who work hard physically usually take 6 to 8 weeks off.