Aortic Valve Replacement
by Rosalyn Carson-DeWitt, MD
The aortic valve is located between the pumping chamber on the left side of the heart and the aorta, which is a major artery. The aorta carries oxygen-rich blood from the heart to the rest of the body. The valve should be closed while the heart is filling with blood. When the heart chamber squeezes to push blood into the aorta, the valve should open fully to allow blood flow.
Aortic valve replacement is an open-heart surgery. It is done to replace a failing aortic valve with a new one. The replacement valve may be:
Reasons for Procedure TOP
Aortic valve replacement is done when the aortic valve is not working properly. The amount of oxygen-rich blood getting out to the body can be significantly decreased with a faulty valve.
Sometimes, the aortic valve is misshapen due to a birth defect. This is called congenital aortic valve disease. Other times, the aortic valve works well for years before becoming too stiff or too floppy to open and close fully. This is called acquired aortic valve disease. Sometimes this happens due to normal aging. With age, calcium build-up on the valve causes it to malfunction. The valve problem may also occur as a result of other conditions, such as:
Possible Complications TOP
If you are planning to have a valve replacement, your doctor will review a list of possible complications, which may include:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Your risk of complications may also be increased if you have:
What to Expect TOP
Prior to Procedure
Your doctor will likely do the following:
Leading up to your procedure:
Aortic valve replacement is done with general anesthesia. You will be asleep.
Description of the Procedure TOP
An incision will be made down the middle of your chest. The breastbone will be separated so that your heart can be reached. A heart-lung machine will be attached. The machine will act as your heart and lungs. This allows the doctor to stop your heart to safely work on the heart valve.
An incision will be made in the aorta. The damaged valve will be cut out and a new valve will be sewn into place. The aorta will then be sewn back together. The heart will be started up again and the heart-lung machine will be removed. The breastbone will be wired together. The skin incision in the chest will be sewn back together.
After the Procedure TOP
You will be monitored in an intensive care unit after surgery. When you awaken, you will notice that you are attached to a number of devices, including:
How Long Will It Take? TOP
About 2-4 hours
How Much Will It Hurt? TOP
Anesthesia will block pain during the surgery. The incision in the chest and breastbone will cause pain after the surgery. You will be given pain medicine to help manage the pain.
Average Hospital Stay TOP
The usual length of stay is 5-7 days. The length of stay will depend on your overall health and your recovery progress. Your doctor may choose to keep you longer if complications occur.
Postoperative Care TOP
At the Hospital
You will usually be in the intensive care unit for 1-2 days. Then you will be moved to a regular hospital room, where you will stay for several more days. You will be allowed to walk soon after your surgery.
You may be given a device called an incentive spirometer. You will be asked to use it every couple of hours during the day. This helps keep your lungs as open as possible. This can help you avoid pneumonia.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chances of infection such as:
You can expect to be able to resume your normal activities within about six weeks of surgery. You should follow your doctor’s directions regarding when you can begin to drive, exercise, lift things, and exert yourself.
Call Your Doctor TOP
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, call for medical help right away.
American Heart Association
Cleveland Clinic Heart Center
The Society of Thoracic Surgeons
Heart and Stroke Foundation of Canada
Townsend CM, et al., (eds). Sabiston Textbook of Surgery. 17th ed. St. Louis, MO: WB Saunders Co.; 2004.
Zipes DP., ed. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed St. Louis, MO: WB Saunders Co.; 2005.