Think of your heart as a house with four rooms. There are doors between these rooms that allow blood to flow back and forth. One such important 'door' in the heart is the Aortic Valve. This is the gate that controls the flow of blood from the heart to the main artery (Aorta) that carries blood to the entire body. This gate opens and closes with every heartbeat. So imagine, what happens if something is damaged in this gate? That's when the problems begin.
Simply put, what is Aortic Valve Repair?
Aortic valve repair is a type of heart surgery that involves repairing a defect in the main gate of the heart, the aortic valve, which we discussed above, and restoring it to proper functioning.
Imagine if you couldn't close a door in your house properly. In the same way, some people's aortic valve doesn't close properly and blood starts to leak (aortic regurgitation) . This is called aortic regurgitation in medical science. When this happens, some of the blood that should go from the heart to the body leaks back into the heart. Then the heart has to work harder to pump the amount of blood needed by the whole body. When this happens over time, the heart can be damaged. That's why people with severe aortic regurgitation and those who have symptoms need to have surgery to repair or replace this valve.
Usually, doctors replace this valve with a completely new one. However, some patients can repair and use their own valve. This is not possible for everyone. Surgeons consider many factors when selecting a person for this surgery. The doctor will decide whether it is best for you to repair the valve or to insert a new one, based on many factors, such as the shape of your valve and the extent of the damage.
What should you do before surgery?
When preparing for surgery, the most important thing is to have the tests done beforehand. The surgeon needs to know for sure whether your aortic valve can actually be repaired. If the valve parts are severely damaged, it may be better to have a new valve installed rather than repair it.
The main test for this is a Transesophageal Echocardiogram (TEE) . This involves inserting a small camera-equipped tube down your throat to take very clear, close-up pictures of your heart. This allows your doctor to get a good look at the condition of the valve and other parts of your heart.
Remember, all of these tests are done to give you the safest and most effective treatment possible, so don't be afraid.
In addition to this TEE test, you will need to have several other tests.
| Name of the test | What do you see in that? |
|---|---|
| Cardiac Catheterization | Check for blockages in the veins that supply blood to the heart (coronary arteries). |
| Chest X-ray | Check the general condition of the heart and lungs. |
| Computed Tomography (CT) scan | Get detailed 3D images of the heart and aorta. |
| Electrocardiogram (ECG) | Check the heart's electrical activity and heartbeat pattern. |
| Blood and urine tests | Check your general health and kidney function. |
Your doctor will give you clear instructions on how to prepare for surgery. It is very important to follow those instructions exactly. If there is anything you do not understand, be sure to ask your doctor or nurse. Those instructions may include things like:
- The time to stop eating and drinking before surgery.
- Whether you need to temporarily stop taking any of the medications you usually take.
- Time to come to the hospital for surgery.
- What to bring to the hospital and what to leave at home.
How is the surgery done?
Aortic valve repair surgery is usually done as open-heart surgery . That is, surgery is done through a single large incision in the middle of the chest. However, in some cases, surgery is done through smaller incisions (minimally invasive surgery).This can also be done in a different way. The surgery is performed by making several small incisions in the chest. The surgeon will tell you which method is best for you.
These are the steps in which the surgery usually takes place:
1. Anesthesia: First, you will be given medication to put you completely asleep. So you will not feel anything or any pain during the surgery.
2. Making the incision: Next, the surgeon makes one or more incisions in the chest to reach the heart. In open surgery, an incision is made about 6 inches long in the middle of the breastbone ( sternum ).
3. Connection to a heart-lung machine: During the surgery, you will be connected to a heart-lung machine to do the work of your heart and lungs. This machine circulates blood throughout your body and adds oxygen to the blood.
4. Valve repair: The surgeon will then repair your aortic valve. The way this is done will vary from person to person. It will depend on the shape of your valve and the damage to it. For example, an annuloplasty is a procedure that strengthens the valve's base (ring) and allows the valve to close properly. It also uses various techniques, such as changing the shape of the valve's leaflets and attaching tissue pieces to holes or tears in them.
5. Fixing additional problems: If there are other problems with the heart or aorta at this time, for example, an aneurysm , they will also be repaired during this surgery.
6. Finishing the surgery: Once all necessary repairs are complete, the surgeon will close and stitch the incisions. The medical team will then take you to a recovery room.
What happens after the surgery?
After the surgery, you will stay in the hospital for about three to seven days. During this time, the medical and nursing teams will monitor you closely . They will check to see if your recovery is going well. They will help you gradually walk and move around.
Before you go home, you will be told about cardiac rehab programs. These will greatly help your recovery process.
What are the benefits of this surgery?
The main advantage of aortic valve repair surgery is that you get to keep your own natural valve. This can help you avoid some of the risks associated with having a new valve. In particular, it can help you avoid the need to take anticoagulants for the rest of your life. Your doctor will tell you more about the benefits of this surgery, depending on your situation.
What are the risks of surgery?
Aortic valve repair is a major surgery. Therefore, it carries some risks. But don't worry, these risks can be minimized under the supervision of an experienced medical team.
The main complication that can occur is the need for further surgery . There are several reasons why this can happen:
- Blood leaking from the valve even after surgery ( recurrent aortic regurgitation ).
- Infection of the valve ( endocarditis ).
- Parts of the repaired valve not working as expected.
In addition to these, there are several common risks that may arise during any aortic valve surgery:
- Abnormal heart rhythm ( arrhythmia )
- Allergy to anesthetic drugs
- Excessive bleeding
- Heart attack
- Heart failure
- Stroke
Everyone's risk level is different. Your surgeon will talk to you about your risks before surgery. It's important that you have a good understanding of all the possible complications and how they might affect you. Be sure to ask if there's anything you don't understand. People who have serious health problems before surgery (for example, severe heart failure) may have slightly higher risks.
How long does it take to recover?
It will take you about four to eight weeks to fully recover from surgery. If you had minimally invasive surgery, your recovery time may be shorter.
It is normal to feel tired for a few weeks after surgery. It is important to rest . Don't do too much work all at once. Your doctor will tell you when it is safe for you to resume normal activities (such as driving or going to work). Participating in cardiac rehabilitation programs can also help you get used to a healthy lifestyle and become active again safely.
If you have these symptoms, call your doctor immediately!
It is very important to notify your doctor immediately if you develop any symptoms of complications after you go home from surgery. Be especially aware of the following symptoms:
| Symptom | What to pay attention to |
|---|---|
| Chest pain or tightness | Sudden or increasing chest pain. |
| Pus draining from the cut | Yellow, green, or foul-smelling fluid oozing from the incision site. |
| Fever or chills | A fever or chills for no reason can be a sign of an infection. |
| Palpitations | Feeling like your heart is beating fast or irregularly. |
| Pain/redness/swelling around the incision | If the pain, redness, or swelling around the incision is getting worse. |
| Swelling of the legs or feet (Edema) | Sudden swelling of the legs, ankles, or feet. |
| Sudden weight gain | Weight gain of more than 1.5 kg within a week (a sign of fluid retention in the body). |
A few more important things to know
Aortic valve repair surgery is performed much less frequently than aortic valve replacement surgery. In fact, less than 5% of aortic valve surgeries are repair surgeries. The main reason for this is that it is a highly specialized and complex surgery. Therefore, this surgery is not performed in every hospital or by every surgeon.
This surgery treats a condition called aortic regurgitation (a leaky valve) . Sometimes, valve-sparing aortic root replacementThis valve repair is also done as part of a surgery called a aortic aneurysm repair. This involves repairing and preserving your own valve while treating a swelling (aneurysm) in the main part of the aorta that connects to your heart.
It's normal to feel scared and nervous because this is a major surgery. But remember, when this surgery is performed by an experienced surgeon, your heart will receive the care it needs to work better and stronger in the long term. As you prepare for surgery, discuss any questions and concerns you may have with your medical team. They will explain everything to you.
Take-Home Message
- Aortic valve repair is a heart surgery that repairs and restores your own heart valve, rather than replacing it with a new one.
- The main advantage of this is that you get to preserve your own natural valve, which largely eliminates the need to take lifelong blood-clotting medications.
- This surgery is not for everyone. Your surgeon will decide whether this surgery is best for you, depending on the condition of your valve.
- It can take about 4-8 weeks to fully recover after surgery. During this time, it is very important to follow the doctor's instructions exactly.
- If you develop any unusual symptoms after going home, such as chest pain, fever, or swelling of the incision, notify your doctor immediately.
💬 Comments (0)
No comments yet. Be the first to share your thoughts here.
Add Your Comment