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Aortic valve surgery - open
Aortic valve surgery is done to replace the aortic valve in your heart.
Blood flows out of your heart and into the aorta through a valve. This valve is called the aortic valve. It opens up so blood can flow out. It then closes, keeping blood from flowing backwards.
In open surgery, the surgeon makes a large cut in your breastbone to reach the heart and aorta.
Aortic valve replacement; Aortic valvuloplasty; Aortic valve repair; Replacement - aortic valve
Before your surgery you will receive general anesthesia. This will make you unconscious and unable to feel pain.
If your aortic valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your aortic valve and sew a new one into place. There are two main types of new valves:
Once the new valve is working, your surgeon will:
This surgery may take 2 to 5 hours.
Sometimes other procedures are done during open aortic surgery. These include:
Why the Procedure Is Performed
You may need surgery if your aortic valve does not work properly. You may need open-heart valve surgery for these reasons:
Risks for any anesthesia are:
Possible risks from having open heart surgery are:
Before the Procedure
Always tell your doctor or nurse:
You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your surgeon how you and your family members can donate blood.
For the 2-week period before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These might cause increased bleeding during the surgery.
During the days before your surgery:
Prepare your house for when you get home from the hospital.
The day before your surgery, shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest two or three times with this soap. You also may be asked to take an antibiotic to prevent infection.
On the day of your surgery:
After the Procedure
Expect to spend 5 to 7 days in the hospital after surgery. You will spend the first night in the ICU and may stay there for 1 or 2 days. Two to three tubes will be in your chest to drain fluid from around your heart. These are usually removed 1 to 3 days after surgery.
You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV, in a vein) lines to deliver fluids. Nurses will closely watch monitors that show information about your vital signs (your pulse, temperature, and breathing).
You will be moved to a regular hospital room from the ICU. Your nurses and doctors will continue to monitor your heart and vital signs until you are stable enough to go home. You will receive pain medicine to control pain around your surgical cut.
Your nurse will help you slowly resume some activity. You may begin a program to make your heart and body stronger.
A temporary pacemaker may be placed in your heart if your heart rate becomes too slow after surgery.
Mechanical heart valves do not fail often. However, blood clots develop on them. If a blood clot forms, you may have a stroke. Bleeding can occur, but this is rare.
Biological valves tend to fail over time. But they have a lower risk of blood clots.
For best results, have aortic valve surgery at a center that does many of these procedures.
Fullerton DA, Harken AH. Acquired heart disease: valvular. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 62.
Chiam PTL, Ruiz CE. Percutaneous transcatheter aortic valve implantation: Evolution of the technology. American Heart Journal. Feb 2009;157(2).
Otoo CM, Bonow RO. Valvular heart disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 62.
Reviewed by:Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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