Definition

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:

• Mechanical—It is made entirely out of artificial materials.
• Bioprosthetic—This valve is made out of a combination of artificial materials and tissues from a pig, cow, or other animal.
• Homograft or allograft—The valve is harvested from a donated human heart.
• Ross procedure—In selected patients less than 50 years of age, another one of the patient’s own heart valves, the pulmonic valve, may be removed from its original location and sewn in to take the place of the faulty aortic valve. A homograft is then sewn in to take the original place of the pulmonic valve.

Reasons for Procedure

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:

• Rheumatic valve disease—a complication of streptococcal throat infection, which can damage the valve
• Endocarditis—an infection inside the heart that involves the valves
• Aortic aneurysms—an abnormal widening or outpouching of the aorta
• Aortic dissection—bleeding into the wall of the aorta, usually due to the presence of an aortic aneurysm

Possible Complications

If you are planning to have a valve replacement, your doctor will review a list of possible complications, which may include:

• Infection
• Bleeding
• Irregular heart beat
• Scarring
• Blood clot formation resulting in a stroke or kidney damage
• Valve that does not function correctly
• Complications from anesthesia

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:

• Smoking
• Drinking
• Chronic disease such as diabetes or obesity

Your risk of complications may also be increased if you have:

• Other heart conditions
• Lung conditions

What to Expect

Call Your Doctor

It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
• Shortness of breath, lightheadedness, or fainting
• Cough or chest pain
• Persistent nausea or vomiting
• Pain that you cannot control with the medications you were given
• Difficulty urinating, or pain, burning, frequency, urgency, or bleeding with urination
• Pain or swelling in your feet, calves, or legs

If you think you have an emergency, call for emergency medical services right away.