Do you have difficulty breathing, chest pain, or feel tired all the time? Perhaps your doctor has told you that there is a small problem with a valve in your heart. It is normal to feel a little scared and worried when you hear that story. But don't worry, today we are talking about this, specifically about surgery for the Aortic Valve. We will talk about this in a way that you understand, as if you were talking to a friend.
Simply put, what is Aortic Valve surgery?
Imagine that our heart is the main motor that pumps blood throughout the body. The main gate that sends blood out of this motor is the Aortic Valve . It is through this gate that oxygen-rich, clean blood goes to the entire body through the largest blood vessel in the body (Aorta). So now you probably understand how important it is for this gate to work properly.
Sometimes this valve stops working properly. This is called Aortic Valve Disease. This can happen in two main ways:
1. Aortic Valve Stenosis: This means that the valve does not open properly and is blocked. Then the heart has to work very hard to pump blood out. It's like opening a rusty door with difficulty.
2. Aortic Valve Regurgitation: This is when the valve does not close properly, causing blood to leak backward. This allows some of the pumped blood to flow back into the heart.
When this type of problem occurs, the treatment is called Aortic Valve surgery. In this, doctors either repair the damaged valve or completely remove it and install a new valve .
Although this surgery may sound like a big deal when you hear about it, it will solve your heart problem and give you a great chance to live a healthy life again. It will also help protect you from the major risks of heart attack and heart failure that may occur in the future due to this condition.
How serious is this surgery?
To be honest, Aortic Valve surgery is a serious surgery . Because it takes several weeks to fully recover after this. Also, as we talked about earlier, this Aortic Valve is a vital part of our body for survival. Therefore, this surgery is performed with great care and by a team of expert doctors. But remember, today thousands of people around the world have successfully undergone this surgery and are living healthy lives.
What types of surgeries are there?
There are two main types of surgery. Your doctor will decide which is best for you.
| Type of surgery | Simply put... |
|---|---|
| Aortic Valve Repair | This involves repairing the damage to your own valve without removing it. The goal here is to preserve as much of your own tissue as possible. |
| Aortic Valve Replacement (SAVR) | In this procedure, the damaged valve is completely removed and a new valve is implanted in its place. This is the most common surgery. |
For some people, a modern method called ``Transcatheter Aortic Valve Replacement - TAVR/TAVI'' is used, in which a tube is passed through a blood vessel in the leg without opening the chest. But it is not possible for everyone. Your doctor will explain to you the method that is right for you.
If you are replacing a valve, what kind of valve do you use?
New valves can come in two main types. Both have advantages and disadvantages.
1. Tissue Valves: These are made from animal (cow or pig) heart tissue. The advantage of these is that once they are inserted, you don't have to take anticoagulants for the rest of your life. The disadvantage is that they can wear out after about 10-15 years, and you may need to have another surgery.
2. Mechanical Valves: These are made of durable materials like carbon. They last a lifetime. There is no need for surgery again. But the main disadvantage is that there is a risk of blood clots in this valve, so you have to take anticoagulant medication (like Warfarin) every day for the rest of your life . Also, you have to have regular blood tests while taking this medication.
Your doctor will discuss with you which type of valve is best for you based on your age, lifestyle, and health condition.
How do we prepare before surgery?
Before the surgery, the doctor will do several tests to see how ready your body is for it.
- Echocardiogram (Echo): This allows you to clearly see the function of the heart and valves.
- Electrocardiogram (EKG): Tests the electrical activity of the heart.
- Chest X-ray: An X-ray examination of the chest.
- Cardiac Catheterization: In this, a small tube is passed through a blood vessel into the heart to check for blockages in the coronary arteries.
- Blood and urine tests: Check things like kidney function.
After these tests, the doctor will give you a set of instructions. It is very important to follow them exactly .
- You will be asked to avoid eating or drinking after midnight the night before the surgery.
- You may be asked to stop taking some of the medications you are currently taking or change the dosage.
- He will tell you when to come to the hospital.
If there is anything unclear about these things, ask the doctor again to find out for sure.
What happens during the surgery?
It's normal to feel a little scared when you think about this process, but all of this happens without you realizing it, while you're in a deep sleep.
1. First, you will be given anesthetic drugs and put to sleep .
2. Then the surgeon makes an incision in the chest and reaches the heart.
3. You will be connected to a heart-lung machine . This machine temporarily takes over the work of your heart and lungs during surgery. This means that the oxygen and blood supply to your body is provided through this machine.
4. The heart is then temporarily stopped so that the surgeon can operate on a still heart.
5. Next, the aortic valve is repaired or replaced.
6. After the valve's work is finished, the heart is restarted .
7. You will be disconnected from the heart-lung machine.
8. The incision will be stitched closed and you will be transferred to a recovery ward (ICU).
The surgery can usually take two hours or more.
What is the surgery procedure?
| Method | Description |
|---|---|
| Traditional Open-Heart Surgery | In this, a 6-8 inch long incision is made in the middle of the chest and the sternum is opened to access the heart. |
| Minimally Invasive Surgery | In this method, the surgery is performed through one or more small 2-4 inch incisions, rather than opening the entire chest. This method results in less bleeding, shorter hospital stays, and faster recovery. |
Your doctor will choose the most appropriate method for you based on the severity of your condition, other medical conditions, and your body type.
How is the recovery time after surgery?
After the surgery, you will first be admitted to the Intensive Care Unit (ICU) . There, your heart rate and blood pressure will be closely monitored. After a day or two, you will be transferred to a general ward. The entire hospital stay can last between 5 and 7 days.
It can take between 4 and 8 weeks to fully recover after going home. If the surgery was done with minimal incisions, you may recover a little faster.
You will feel very tired in the first few weeks. That is very normal. Give your body rest. At the same time, it is also very important to start walking and doing small exercises as your doctor says. Many hospitals have cardiac rehabilitation programs . Participating in this will be a great help in your recovery process.
The doctor will tell you to come see him about a week after the surgery and again in about 6 weeks. Be sure to go at that time.
Some people may experience a minor mental breakdown, sadness, or depression after a major surgery like this. This is also a common condition for many people. If you feel like this, talk to your doctor, a family member, or a trusted friend about it.
What are the benefits and risks of this surgery?
The biggest advantage of this surgery is that it is a life-saving surgery . It completely cures a heart condition that can be fatal if left untreated. This surgery not only increases your lifespan, but also eliminates everyday symptoms such as shortness of breath and fatigue, making life much easier.
Like all surgeries, this one has some risks.
- Allergy to anesthetic drugs
- Bleeding
- Infections of the incision, heart, or lungs
- Blood clots and stroke
- Heart rhythm irregularities `(Arrhythmia)` (often temporary)
- Temporary decrease in kidney function
These risks may vary depending on your age and other medical conditions. But remember, your medical team will take every step possible to minimize these risks.
What are the times when you should talk to the doctor?
If you experience any of the following symptoms after returning home, you should call your doctor immediately .
| Warning signs to look out for | |
|---|---|
| - Chest pain or tightness | - Swelling, redness, or pus draining from the incision |
| - Feeling feverish or cold | - Feeling like your heart is beating fast (Palpitations) |
| - Swelling of the legs or feet (Edema) | - Weight gain of more than 1.5 kg within a week |
It's normal to be scared of the idea of heart surgery. But talk to your doctor about it. Ask all the questions you have. Talk to your family and friends about it and get their support. This is not something you have to face alone. With the right medical care and the support of your loved ones, you can recover quickly and live a healthy life again.
Take-Home Message
- Aortic valve surgery is a serious, but life-saving and quality-of-life-improving treatment.
- Follow the doctor's instructions carefully before the surgery. Ask and answer any questions you may have.
- It takes time to heal. Give your body the rest it needs . At the same time, gradually become more active as per your doctor's instructions.
- Watch out for warning signs after surgery, such as chest pain, fever, and wound swelling. If you experience any of these, tell your doctor immediately.
- It's normal to feel sad and anxious after surgery. Don't be afraid to talk about it and ask for help .
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