Aortic Valve Repair
The heart has four valves. These are:
For efficient heart function, the valves must be able to open fully while the blood is passing through, then close tightly afterwards. Simply put, blood should flow only in one direction.
Abnormal or sick valves allow less blood to pass through and/or make it leak backwards. This may be due to:
To resume efficient function, sick valves need to undergo a surgical procedure called valve repair or valve replacement.
This is the preferred treatment because results have been proven good. The faulty valve is repaired by:
This is done only when repair is not possible. The diseased valve is removed and replaced with either a man-made metallic valve or a biological valve (from pig, cow or human tissue).
Metal valve vs. biological (or bioprosthetic) valve
Conditions that may require aortic valve repair or replacement
Aortic insufficiency (also known as aortic regurgitation)
The aortic valve is unable to snugly close, allowing blood that has already flowed out to the aorta to flow back to the left ventricle of the heart. This might be due to softening or weakening, tear, or a disfigurement of the flaps.
The aortic valve is unable to open fully, thereby allowing only a small amount of blood to pass through towards the aorta. This might be due to scarring, adhesion or sticking together (fusion) of the flaps of the valve, or the presence of waxy deposits or plaques in the valves.
The procedure is performed in the operating room by a heart surgeon under general anesthesia. Tubes for delivery of oxygen and IV fluids are hooked up and the middle part of the front of the chest is opened to expose the heart. The patient is put on heart-lung bypass machine (also called cardiopulmonary bypass pump) to ensure continuous oxygenated
blood flow to all parts of the body except, of course, the heart.
Meanwhile, the heart is made to stop beating by either lowering its temperature or injecting a substance to make it stop. Actual repair or replacement of the faulty valve is done (utilizing any of the specific procedures listed under valve repair and valve replacement above).
The heart resumes its beating either by itself or through the use of mild electric shocks.
When the heart is seen to be beating normally again, the heart-lung bypass pump is withdrawn and excess blood around the operation area is suctioned off and a drainage system is set up.
The chest opening is then closed and dressed, and the surgery is considered officially over.
After heart surgery, the patient is made to recover for a few days in an intensive care unit where his vital signs are closely monitored. Once he awakens and is stronger, he is transferred to the post-surgery unit. Most often, pain medication, antibiotics and anti-coagulant are given. When the range and duration of movement and physical activity have increased (usually in 5-15 days), the patient is made to go home. In a month or two, the patient may feel stronger than he was before the operation.
Recuperating at home, the patient needs to consider certain things, such as:
It is best to have a detailed talk with your doctor regarding these before going home. So, make sure that all necessary contact numbers are listed down.
Nowadays, the success rate of open heart surgeries, valve repair and replacement included, has gone up. More so if the disorder or defect is corrected at a stage before severe irreversible complications have set in. Other determining factors for the success of valve repair and replacement are age (the younger the better), previous lifestyle (those who didn't smoke, drink, and used to eat healthy diets tend to fare well), and, of course, the new lifestyle the patient chooses.