Surgery for Aortic Valve Disease

In this open heart procedure, the damaged aortic valve is removed and replaced with an artificial valve made from animal tissue or a synthetic material.

This can be performed in several ways, including the following:

• a mini-thoracotomy, which is a minimally invasive procedure in which surgeons reach the aorta through an incision between the ribs
• a partial mini-sternotomy, in which the breastbone is partially divided
• a traditional sternotomy, also known as open heart surgery, in which the breastbone is fully divided

An aortic valve replacement typically requires less than one day in the intensive care unit (ICU) and four to seven days in the hospital. Your doctor restricts your activity for up to six weeks after open heart surgery to allow the bones and muscles time to heal.

Also called the David Procedure, valve-sparing aortic root replacement is performed to preserve the aortic valve instead of replacing it with an artificial valve.

Doctors repair the aortic valve using a synthetic tube called a graft, which is implanted into the aortic root, the part of the aorta that extends from the heart. It can be used to treat severely leaking valves in people with aortic valve regurgitation.

This procedure is most commonly used in people under 60 who have connective tissue disease such as Marfan syndrome or a thoracic aneurysm, a bulge in the aortic root, along with aortic valve regurgitation. This procedure can help you avoid the need for lifelong use of anticoagulant medication, also known as a blood thinner, or additional surgery to replace animal tissue valves, which have a finite lifespan.

In this open heart surgery, your surgeon clamps the aorta and cuts it open. The coronary arteries, which supply blood to the heart, are temporarily detached. A heart–lung machine performs the work of these organs during the procedure.

Doctors measure the valve and select a synthetic graft to fit its size. They place the graft onto the aortic valve and suture it into the aorta. Then they suture the valve to the inside of the graft. Surgeons reattach the coronary arteries through holes made in the graft and then suture the graft to the aorta.

People who have this procedure typically spend one day in the ICU and five to six days in the hospital. Your doctor restricts your activity for up to six weeks after open heart surgery to allow the bones and muscles time to heal.