Aortic Valve Surgery vs. Valve Replacement

The aortic valve is one of the valves of the heart. It has three flaps, called leaflets. The aortic valve is responsible for regulating the main supply of blood to the body’s major vessels. When there is a problem with the aorta or the valve, it can lead to serious heart problems. The surgeons at Sentara perform minimally invasive aortic valve repair or replacement to treat aortic valve conditions.

Aortic Valve Disorders: Advanced Care in Virginia

There are two main disorders of the aortic valve:

  • Aortic stenosis. This is when the aorta narrows, making it difficult for the blood to flow freely.
  • Aortic insufficiency. In this condition, the valve does not close tightly, allowing blood to leak back toward the heart.

We recommend minimally invasive surgery to treat these conditions, to prevent even more serious problems surrounding the heart and weakening the heart muscle. Most often, aortic valve disease calls for replacement of the aortic valve, but in a few cases, it can be repaired.

What Causes Aortic Valve Disorders?

Aortic valve stenosis and aortic valve insufficiency are generally caused by one of three conditions:

  • Rheumatic fever. One of the most serious side effects of rheumatic fever is its damage to the heart, specifically, the aortic valves. An adult who had rheumatic fever as a child has scar tissue on the heart valves. The scar tissue interferes with the proper action of the valve. The scars harden the leaflets, preventing them from opening and closing properly. This makes the heart work harder to pump the blood, while narrowing the opening through which blood flows. The scar tissue also attracts calcium deposits, which cling to the leaflet surface, further restricting blood flow.
  • Calcium buildup. Age is the biggest cause of this valve disorder. Blood contains calcium, a mineral, which accumulates over time in hard deposits within the blood vessels and valves. The anatomy of the valve also makes it susceptible to calcium deposits. A three-leaflet valve is the ideal shape for aortic valves to open and close as blood flows through. Some people, mostly men, have a bicuspid valve, which has two leaflets. These seem especially prone to collect calcium, which eventually interferes with the valve efficiency.
  • Heart defect from birth. A congenital defect, in which the valve has two leaflets instead of three, makes the heart more susceptible to developing aortic valve stenosis. Another congenital valve defect is smaller valve openings. In this case, the surgeon may attempt a balloon valvuloplasty to enlarge the aortic valve opening. The surgeon threads a thin tube through a blood vessel into the heart valve. It is then inflated, into a balloon shape, to stretch the opening. The surgeon then collapses it and removes it from the infant. 

Aortic Valve Repair and Replacement: What to Expect

We will discuss the different types of procedures with you. Often, the surgeon doesn’t know until he or she sees the valve during surgery whether it can be repaired or whether it need to be replaced. Therefore, we will discuss both options with you before the procedure. We will also discuss the different types of valve available for replacement: mechanical and biological. Learn more about valve repair vs. valve replacement.

Recovery from Aortic Valve Surgery

On average, patients who have had minimally invasive heart surgery with no complications are in the hospital for three to four days. In comparison, the average stay after a full, open-chest surgery is five to seven days. 

The process of healing from even small incisions may make you uncomfortable at first. Talk to your doctor or nurses if you think medication will be helpful. They can also recommend alternative pain relief remedies, such as warm compresses.