Anyone can be a little scared when they hear the word heart surgery, right? Especially if it's a surgery that involves replacing a part of the heart that's like a valve. But don't be scared. This is a surgery that thousands of people have successfully undergone. Today, let's talk about this so-called Aortic Valve Surgery, what it actually does, and why it's important to you.
Simply put, what is this Aortic Valve?
Imagine your heart as a small, but very powerful house with four rooms. The main gate that pumps clean, oxygenated blood from this house to the entire body is the Aortic Valve . To be precise, this 'gate' is located between the main pumping chamber of the heart (the Left Ventricle) and the main blood vessel (the Aorta) that carries blood to the entire body. So now you probably understand how important it is for this gate to function properly for the entire body.
Why does this valve need surgery?
Over time, and sometimes from birth, this valve can become dysfunctional. Two main problems can occur.
| Medical condition | Simply put... |
|---|---|
| Aortic Valve Stenosis (narrowing of the valve) | What happens in this case is that the valve flaps become thick and do not open properly. This puts a lot of pressure on the heart, causing it to feel like it is stuck and has to push the blood out. |
| Aortic Valve Regurgitation (leaking valve) | What happens here is that the valve flaps don't close properly. As a result, some of the blood that was pumped out leaks back into the heart. |
These two problems put extra strain on the heart. Over time, this condition can worsen to the point of heart failure or sudden cardiac arrest . That is why it is essential to surgically repair this valve.
What types of surgeries are there?
There are two main types of surgery.
- Aortic Valve Repair: Whenever possible, doctors try to repair the defect in your own natural valve and preserve it. This involves preserving as much of your own tissue as possible.
- Surgical Aortic Valve Replacement (SAVR): Sometimes, if the valve is so damaged that it cannot be repaired, it is completely removed and a new artificial valve is implanted.
What is the new valve like?
If you are having a valve replaced, your doctor will talk to you about several options. Some are made from animal tissue (e.g., pig, cow), while others are made from human tissue. In addition, there is a type called a mechanical valve , which is made entirely of durable metal. Each type has its own advantages and disadvantages. For example, if you have a mechanical valve, you will need to take blood-thinning medication for the rest of your life. It is important to discuss this with your doctor and choose the one that is best for you.
Let's also learn about TAVR/TAVI: With the advanced technology available today, there is a method in which a tube is passed through a blood vessel in the groin or arm to the heart and replace the valve without completely opening the chest. This is called Transcatheter Aortic Valve Replacement (TAVR/TAVI) . But this cannot be done for everyone. Your doctor will decide which method is best for your situation.
How do you prepare before surgery?
Before the surgery, your doctor will examine you and order several necessary tests.
- A heart scan (Echocardiogram - Echo)
- Chest X-ray examination
- EKG test (Electrocardiogram)
- CT scan
- Cardiac Catheterization (a test in which a camera is passed through blood vessels)
- Blood and urine tests
After all of this, the doctor will give you instructions on what to do the day before the surgery. For example, not eating or drinking anything after midnight the night before the surgery, whether you need to stop taking any medications, and what time you should come to the hospital. It is very important to follow these instructions exactly.
How the surgery is performed and the approaches
During the operation, you will be fully anesthetized so you will not feel any pain. The surgeon can use two main methods to reach the heart.
| Surgical method | Description |
|---|---|
| Traditional Open-Heart Surgery | Here, a 6-8 inch incision is made in the middle of the chest to open the sternum and access the heart. |
| Minimally Invasive Heart Surgery | This is done through one or more small 2-4 inch incisions, without opening the chest completely. This results in less bleeding, shorter hospital stays, and faster recovery. |
During the operation, you will be connected to a special machine (Heart-Lung Machine) to temporarily perform the functions of your heart and lungs. The surgeon will then stop your heart and carefully repair or replace the valve. Once the work is complete, the heart will be restarted, disconnected from the machine, and the incisions will be closed. The entire operation usually takes about two hours.
After surgery... the recovery period
After the surgery, you will first be admitted to the intensive care unit (ICU) and then transferred to a regular ward. You will usually have to stay in the hospital for 5 to 7 days. After you go home, it is normal to feel very tired for a few weeks. So listen to your body and get plenty of rest.
Your doctor may recommend a cardiac rehabilitation program . This involves gradually building up your strength through exercise under the supervision of a specialist. Your doctor will tell you when you can resume activities such as lifting weights and driving. It usually takes 4 to 8 weeks to fully recover.
Some people may experience a mild depression, sadness, or hopelessness after heart surgery. This is normal and can be treated. If you experience this, talk to your doctor about it.
Symptoms that require immediate medical attention
After returning home, if you develop any of the following symptoms, call your doctor immediately or go to the nearest hospital's Emergency Department (ETU).
- Chest pain or tightness
- Fever or feeling cold
- There is pus, swelling, or redness from the surgical incision.
- Heart palpitations
- Leg swelling (Edema)
- Weight gain of more than 1.5 kg (3 pounds) in a week
Take-Home Message
- Although aortic valve surgery is a serious procedure, it is a treatment that can save your life and has successful results.
- There are different methods, such as valve repair, replacement, open surgery, or minimally invasive surgery. Your doctor will decide which method is best for you.
- It's normal to feel tired after surgery. Give your body time to heal. Follow your doctor's instructions exactly.
- Talk openly with your doctor about any fears or concerns you have about the surgery or recovery time.
- The support of your family and friends will be a great strength to you on this journey, so make them aware of this as well.
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