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What is an aortic valve replacement?
The aortic valve is one of 4 valves in the heart that work together to keep blood flowing in the right direction. If the aortic valve stops working properly, it may need to be replaced.
Why is an aortic valve replacement performed?
The aortic valve must open fully and close fully with each heartbeat so the heart can pump enough blood around the body.
If either function is affected, the heart must work much harder to try and deliver enough blood to the body and it can become overworked.
Signs the aortic valve is not working properly include being short of breath, tired or having a build-up of fluid in the body.
Valves may be faulty at birth, or become damaged due to illness. The heart valves are assessed by an ultrasound of the heart structure called an echocardiogram (sometimes called an ‘echo’).
How to prepare for an aortic valve replacement
Tests are done to provide information about the heart. They include a blood test, chest x-ray and an electrocardiogram (ECG) to test the electrical properties of the heart.
If you are having these tests, your doctor or hospital staff will give you instructions on how to prepare for the surgery. If you are a smoker, it’s a good idea to quit long before the procedure to decrease the risks.
What happens during the procedure?
The standard procedure is done under a general anaesthetic, so you will be completely unconscious.
The surgeon will cut through the breastbone to reach the heart and a machine will take over the working of the heart and lungs during surgery.
The faulty valve will be replaced with a new valve, either made of human or animal tissue (called a biological valve) or of metal (called a mechanical valve). During the surgery you may need a blood transfusion.
Newer techniques involve smaller cuts or no cuts to the chest wall. Transcatheter Aortic Valve Implantation (TAVI) is done by inserting a balloon catheter into an artery and guiding it to the heart. The balloon is gently inflated to open up the aortic valve. The doctor then inserts the new valve, which inflates to push aside the old valve.
Your doctor will be able to discuss the risks and benefits of each procedure with you.
What to expect after an aortic valve replacement
You will be taken to the intensive care unit for monitoring, then to a ward until you are ready to leave hospital.
Full recovery from aortic valve replacement can take from several weeks to months, during which you may have pain and tiredness.
You will need to take anti-clotting medication for life if you receive a mechanical valve, or for a few months after receiving a biological valve.
What can go wrong?
Possible risks include:
- bleeding
- infection
- poor healing of the wound
- changes to the heart rhythm
- damage to the heart
- problems with your kidneys or lungs, particularly if you have a pre-existing condition
