Aortic Valve Replacement

The aortic valve is located between the heart and the aorta (the largest artery in your body). The valve opens and closes every time your heart beats. When it opens, blood goes from your heart into your aorta and on to the rest of your body. When your aortic valve closes, it keeps blood from flowing the wrong way back into your heart.

When the aortic valve stops functioning properly, you may need to have surgery to replace it.

What are the most common aortic valve problems?

Aortic Stenosis. This is the most common valve issue. It afflicts mainly the elderly, whose valve flaps or “leaflets” become thick and brittle over time. When this happens, the aortic valve opening narrows and restricts blood flow. The heart muscle needs to push extra hard to pump blood out, leading to thickened muscle.

Younger patients who experience narrowing of the aortic valve opening are usually born with valves that have two leaflets instead of three. These are called bicuspid valves (as opposed to normal tricuspid valves). The narrowing is sometimes associated with aortic aneurysms.

Whatever the cause of the narrowing, eventually the heart won’t pump enough blood to the body. The condition can be life threatening. The patient can develop heart failure, dizziness, fainting, chest pain, angina and shortness of breath.

Aortic Regurgitation. The valve doesn’t close all the way. Blood flows backward into the heart. This is most often caused by a congenital tissue abnormality or an infection of the valve.

Both aortic regurgitation and aortic stenosis are often best treated by replacing the aortic valve.

What is a minimally invasive aortic valve replacement?

In the past, the only way for surgeons to access the heart and replace an aortic valve was to split a patient’s breastbone.

Thanks to technological advances, many surgeries can now be completed with a minimally invasive procedure that is just as successful. Cardiac surgeons make a small incision in the right chest between the ribs to make the fix. In experienced hands, this approach allows for faster recovery and less blood transfusion.

In rare cases, the better option may be for surgeons to make a small incision in just the upper part of the breastbone.

What are replacement aortic valves made of?

Mechanical valves are made of carbon. They last longer but tend to form blood clots on their surfaces. Clots can cause stroke and improper functioning of the valve. If you have a mechanical valve, you will need to take blood thinners for the rest of your life to prevent clots. Your doctor will continually check your blood to ensure you’re receiving the right amount of medicine. Too little and clots could still form. Too much could cause excessive bleeding, especially after an injury.

Biological valves come from animal tissue. They don’t last as long as mechanical valves, especially in younger patients. But they don’t lead to clots as often, and you won’t need blood thinners.