Aortic valve surgery - open

Definition

Blood flows out of your heart and into a large blood vessel called the aorta. The aortic valve separates the heart and aorta. The aortic valve opens so blood can flow out. It then closes to keep blood from returning to the heart.

You may need aortic valve surgery to replace the aortic valve in your heart if:

Open aortic valve surgery replaces the valve through a large cut in your chest.

The aortic valve can also be replaced using minimally invasive aortic valve surgery. This is done using several small cuts.

Alternative Names

Aortic valve replacement; Aortic valvuloplasty; Aortic valve repair; Replacement - aortic valve; AVR

Description

Before your surgery you will receive general anesthesia. You will be asleep and pain free.

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 3 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

Risks for any anesthesia are:

Possible risks from having open heart surgery are:

Before the Procedure

Always tell your health care provider:

You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your provider how you and your family members can donate blood.

If you smoke, you must stop. Ask your provider for help.

For the 1 week period before surgery, you may be asked to stop taking medicines 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.

Shower and wash your hair the day before your surgery. You may need to wash your whole body below your neck with a special soap. Scrub your chest 2 or 3 times with this soap.

On the day of your surgery:

After the Procedure

Expect to spend 4 to 7 days in the hospital after surgery. You will spend the first night in the ICU and may stay there for 1 to 2 days. There will be 2 to 3 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) lines to deliver fluids. Nurses will closely watch monitors that display your vital signs (your pulse, temperature, and breathing).

You will be moved to a regular hospital room from the ICU. Your heart and vital signs will continue to be monitored until you 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.

You may have a pacemaker placed in your heart if your heart rate becomes too slow after surgery. It may be temporary or permanent.

Outlook (Prognosis)

Mechanical heart valves do not fail often. However, blood clots can develop on them. If a blood clot forms, you may have a stroke. Bleeding can occur, but this is rare.

Biological valves have a lower risk of blood clots, but tend to fail over an extended period of time. For best results, choose to have your aortic valve surgery at a center that does many of these procedures.

References

Otto CM, Bonow RO. Valvular heart disease. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 63.

Rosengart TK, Anand J. Acquired heart disease: valvular. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 60.


Review Date: 1/31/2017
Reviewed By: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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