Have you also been told to replace a heart valve? (Surgical Aortic Valve Replacement) Don't be afraid, let's talk!

Do you sometimes feel a heaviness in your chest or difficulty breathing when you are a little tired? Or has your doctor told you that you have a problem with a valve in your heart and that you need to have it replaced surgically? It is normal to feel a little scared and worried when you hear something like this. But don't worry. Today we are talking about this surgery, which is called 'Surgical Aortic Valve Replacement' (SAVR). Let's talk about this simply and in a way that you can understand.

What exactly does aortic valve replacement mean?

Think of our heart as a water pump. The main blood vessel that pumps blood from this heart to the entire body is called the 'Aorta'. So, the 'gate' between the heart and this main blood vessel is called the Aortic valve . Every time the heart beats, this gate opens and blood flows out, and then closes again.

Sometimes, due to age or other medical conditions, this door stops working properly.

• The door doesn't open properly: This is called Aortic Stenosis . It's like a door that doesn't open all the way, so there's not enough room for blood to flow out of the heart.
• The door doesn't close properly: This is called Aortic Regurgitation . Like an old door, when it doesn't close properly, some of the blood that has come out leaks back into the back.

In both cases, the heart has to work harder than usual. It's like trying to open a stuck door. Over time, this overwork can damage the heart. It can also cause symptoms like chest pain and difficulty breathing. If left untreated, this condition can be life-threatening.

What happens before the surgery?

Because this is a major surgery, you will be examined carefully before it begins. These tests will help us choose the treatment that best suits your health.

Routine tests before surgery

Usually you will have to do several tests like this.

In addition, the medical team will advise you on how to prepare for surgery.

• How long do you need to fast (without eating or drinking) before surgery?
• Whether you need to temporarily stop taking any medications you are currently taking.
• It's time to come to the hospital.
• Things to bring to the hospital and things not to bring.

Most importantly: Don't be afraid to ask your doctor about anything you don't understand or any questions you have. If you smoke, quitting as soon as possible before surgery can greatly reduce the risk of complications.

Let's choose a new hairstyle that suits you.

The most important decision you will make before surgery is what type of new valve you will receive. There are two main types.

Your surgeon will discuss with you which valve is best for you based on your age, health, and lifestyle. Typically, mechanical valves are recommended for people under 50, and biological valves are recommended for people over 65.

How the surgery is performed step by step

This surgery usually takes two to four hours, during which you are in a deep sleep and do not feel anything.

1. First, you will be completely unconscious (`Anesthesia`) .

2. Next, you will be connected to a heart-lung machine . This machine will temporarily take over the work of your heart and lungs during the surgery. It will also be used to temporarily stop your heart (cardioplegia). This will allow the surgeon to safely perform the surgery without your heart beating.

3. The surgeon makes an incision about 6 inches long in the middle of your chest to open the breastbone (`Sternum`) and access the heart. This is called a `Sternotomy`.

4. The old, damaged aortic valve is removed and replaced with a new valve that is sewn into place.

5. Then, the opened sternum is reattached using wires. These wires are usually left in the body for life.

6. Finally, the skin incision is sewn closed.

Recovery time after surgery

After the surgery, you will have to stay in the hospital for about 5 days. During this time, the medical team will constantly monitor your condition. They will help you gradually walk and do normal activities.

It usually takes four to eight weeks to fully recover. It is normal to feel tired during this time. This is because your body is healing. After you go home, your doctor may recommend that you go to a cardiac rehabilitation program. This will teach you many things, such as getting used to exercise and eating a heart-healthy diet.

What are the benefits and risks of this surgery?

The biggest advantage of this surgery is that it can save lives . Aortic valve disease can be fatal if left untreated. The success rate is very high. For most people, the risk of death or serious complications such as stroke is very low, around 1% - 2%.

But like any surgery, there are some risks.

• Heartbeat irregularities (`Arrhythmia`)
• Need for a permanent pacemaker
• Bleeding
• Infections
• Stroke
• Death

This risk is not the same for everyone. It varies depending on things like your age and other medical conditions. Your surgeon will explain your personal risk level to you.

Is there an alternative to SAVR surgery?

Yes, for some patients, especially those who are older or at higher risk for major surgery due to other conditions, a procedure called Transcatheter Aortic Valve Replacement (TAVR) may be more appropriate. This involves inserting a new valve into the old valve through a small incision in the chest, without opening it. This is a simpler procedure and requires less recovery time. Your medical team will decide whether SAVR or TAVR is best for you.

Heart surgery, aortic valve replacement, SAVR, aortic stenosis, aortic regurgitation, heart disease