Aortic Valve Surgery

Your aortic valve is a one way valve that regulates blood flow from your heart to your aorta, which is the largest artery in your body. Aortic valve disease occurs when your aortic valve does not work properly.

The cardiovascular specialists at UPMC provide expert treatment for aortic valve disease using minimally invasive and open-chest techniques for aortic valve repair and replacement.

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What Is Aortic Valve Surgery?

Aortic valve surgery treats problems with your aortic valve caused by aortic valve disease. It can be performed using traditional open heart surgery or minimally invasive procedures.

Types of Aortic Valve Surgery

Your doctor may repair or replace your aortic valve depending on your condition. Your doctor's recommendation is based on many factors, including your age, general health, the condition of your damaged valve, the presence of other health conditions, and the expected benefits of surgery.

Types of aortic valve surgery include:

Aortic valve repair or reconstruction

Although the aortic valve is usually replaced, in the case of a leaking aortic valve, aortic valve repair surgery may be an option. The goal of aortic valve repair surgery is to restore your aortic valve to its full function.

Because aortic valve repair involves using your own tissue you will not need to take blood-thinning medications, which are required when mechanical aortic valves are used.

Certain conditions, such as a bicuspid aortic valve, may be repaired by reshaping your aortic valve leaflets, allowing the valve to open and close more completely. Bicuspid aortic valve repair may be an option to treat leaking valves, but it cannot be used to treat a narrowed, bicuspid aortic valve.

Experts at UPMC also perform the Ozaki aortic valve replacement procedure using tissue from the sac around your heart, called the pericardium.

Aortic valve replacement

If aortic valve repair surgery is not an option, your surgeon may replace your aortic valve with a bioprosthetic valve or a mechanical valve.

Bioprosthetic valves consist of pig (porcine) or cow (bovine) heart tissue, and while they do not typically require blood thinners, they have limited durability and do not last forever.

Mechanical valves are made of metal and can last a lifetime. However, they require lifelong blood thinners. Your doctor will discuss valve options with you and recommend which valve type may be best for you based on your age, health, and other medical problems.

Minimally invasive aortic valve surgery

Our surgeons have the skills and experience required to successfully perform aortic valve repair and replacement using advanced minimally invasive techniques. Minimally invasive procedures access your valve through much smaller incisions without cutting your breastbone. Your surgeon will determine if you are a candidate for any of these less invasive approaches. This decision may depend on your age, anatomy, distance of the aorta from the chest wall, your overall health, and other medical problems. The benefits of minimally invasive approaches include:

Fewer postoperative restrictions.
Less surgical trauma.
Shorter hospital stays.
Shorter recovery time.
Smaller scar.

Our surgeons offer the latest minimally invasive treatment options for aortic valve disease, including:

Intercostal surgical aortic valve replacement (iSAVR) or Minimally Invasive Aortic Valve Replacement — Aortic valve replacement surgery can be performed using iSAVR, or minimally invasive aortic valve replacement. This approach allows your surgeon to access your heart through the space between your ribs on the right side of your chest without dividing any major muscle groups, ribs, or cartilage.
Aortic Valve Replacement through Mini Sternotomy —Aortic valve replacement can be performed with traditional open heart surgery approach, but through a smaller incision in the middle of the chest called a mini-sternotomy. In a mini sternotomy, the surgeon only divides the top third of the breastbone, rather than the entire breastbone.
Transcatheter aortic valve replacement (TAVR) — TAVR treats aortic valve stenosis by replacing your aortic valve with a bioprosthetic valve using a catheter inserted into your groin, neck, or upper chest

Conditions we treat with aortic valve surgery

Aortic valve disease occurs when your aortic valve does not work properly. This can be caused by:

Aortic valve regurgitation — Aortic valve regurgitation is caused by a weakness in your valve that prevents it from closing completely. Regurgitation causes blood that is pumped out of your heart to immediately flow back into your heart after your heart stops squeezing and relaxes.
Aortic valve stenosis— Aortic valve stenosis is a narrowing of your aortic valve that prevents blood from leaving the heart.

Why Would I Need Aortic Valve Surgery?

You may need aortic valve surgery if you have been diagnosed with aortic valve disease, such as aortic valve stenosis or aortic valve regurgitation.

Who’s a candidate for aortic valve surgery?

If your aortic valve disease is causing problems with blood flow or other symptoms, you may be a candidate for aortic valve surgery. Your doctor will recommend the best approach to treat your condition.

What Are the Risks and Complications of Aortic Valve Surgery?

Some people with severe aortic valve disease are at increased risk of complications or death from aortic valve surgery. Aortic valve surgery may be a treatment option, but it isn’t right for everyone.

How serious is aortic valve surgery?

For many people, aortic valve surgery carries a low risk of complications. However, as with any surgery, there are some risks, including:

Arrythmias, possibly requiring a pacemaker.
Infection.
Major bleeding.
Other serious life-threatening events or even death.
Stroke.

What Should I Expect from Aortic Valve Surgery?

If your doctor recommends aortic valve surgery, our team of heart valve experts will start by doing a thorough exam. During your aortic valve surgery exam, you may meet with:

A heart surgeon.
An interventional cardiologist.
Advanced practice providers.

Our experts use the latest diagnostic tests to learn about your heart valve condition, including:

Cardiac catheterization —This diagnostic procedure involves inserting a tiny, hollow tube (catheter) through a large artery in your leg or arm leading to your heart to provide images of your heart and blood vessels. This procedure is helpful in determining the type and extent of certain valve disorders.
Chest x-ray — A chest x-ray is a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. An x-ray can show enlargement in any area of the heart.
CT angiogram — A CT angiogram is an imaging test that looks at the arteries that supply your heart muscle. This test uses a powerful x-ray machine to produce images of your heart and heart vessels.
Electrocardiogram (ECG or EKG) — This test records the electrical activity of your heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage.
Echocardiogram (Echo) — This noninvasive ultrasound test uses sound waves to evaluate your heart's chambers and valves. The echo sound waves create an image on a monitor as an ultrasound transducer is passed over your heart.
Magnetic resonance imaging (MRI) — MRI is a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
Transesophageal echocardiogram (TEE) —TEE is a form of echocardiography that is performed by inserting a probe with a transducer into your esophagus rather than placing the transducer on your chest as in a traditional echocardiogram. A TEE provides a clearer image of your heart because the sound waves do not have to pass through skin, muscle, or bone.
Two-dimensional echocardiogram (2D Echo) —This test uses ultrasound to display a cross sectional "slice" of your beating heart, including the chambers, valves, and the major blood vessels that exit from the left and right part of your heart.

Your doctor may also order other tests, such as:

An exercise stress test.
Bloodwork and urine tests to look for signs of infection prior to valve replacement.
Lung function tests.
Ultrasound of your carotid artery.

Before: How to prepare for aortic valve surgery

Your doctor will explain the aortic valve surgery procedure to you and give you a chance to ask questions. To prepare for aortic valve surgery, you should:

Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
Fast for a certain time before the procedure. Your doctor will tell you how long to fast (usually overnight).
Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.

On the day of your aortic valve surgery procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.

After open aortic valve surgery, you should expect to stay in the hospital for several days. For TAVR, you should expect to be in the hospital one night. Your doctor will let you know how many nights you can expect to stay for the type of procedure you are having.

You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should also arrange for someone to drive you home from the hospital after you are discharged.

How long does aortic valve surgery take?

Your aortic valve surgery could take as little as an hour or up to several hours, depending on the type of procedure you are having.

During your aortic valve surgery

During aortic valve surgery, your damaged valve will be repaired or replaced with a new valve. Your doctor may perform a minimally invasive procedure or open-chest surgery, depending on your condition.

Depending on the type of procedure you are having, you may be placed under general anesthesia or connected to a heart-lung bypass machine that will take over the function of your heart and lungs during your operation.

Your doctor will provide you with more details about the approach he or she plans to use before surgery.

Recovery after aortic valve surgery

When your open aortic valve surgery is completed, you will be moved to the ICU.

Following your TAVR procedure, you will be taken to the recovery unit for observation and monitoring for several hours before you are moved to a regular room.

Your doctor will provide more information about your recovery and your hospital stay — including when you can resume your normal activities.

What is lifelike after aortic valve replacement?

If you receive a mechanical aortic valve replacement, you will need to take blood-thinning medication after aortic valve surgery. Follow your doctor’s instructions and go to all your follow-up appointments.

How long does it take to recover from aortic valve surgery?

If you have an open surgical procedure, your recovery may take up to three months. A complete recovery after a minimally invasive procedure typically takes about 4-6 weeks (about 1 and a half months).

When to call your doctor about aortic valve surgery complications

You should call your doctor if you are experiencing any unusual symptoms, including:

A fever of more than 100.0°F.
Burning or pain in your chest.
Difficulty breathing.
Difficulty swallowing, throat pain, or bloody cough.
New or increasing shortness of breath.
Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
Rapid or pounding heartbeat.
Redness or rash on your chest or back.
Severe pain, coldness, numbness, or discoloration in the limb where the catheter was inserted.

What’s the prognosis after aortic valve surgery?

Most otherwise healthy patients continue to lead active, normal lives after aortic valve surgery.

What is the life expectancy of a person after aortic valve surgery?

For most people, life expectancy after aortic valve surgery is the same as anyone else who does not have heart problems. Talk to your doctor if you have questions about your life expectancy after your aortic valve surgery procedure.

What’s the success rate of aortic valve surgery?

Aortic valve surgery success rates vary depending on the type of procedure you’re having. However, most people who have aortic valve surgery have outstanding outcomes, reduced symptoms, and improved quality of life.

Why Choose UPMC for Aortic Valve Surgery?

The cardiovascular specialists at UPMC are among the most experienced in Pennsylvania at performing aortic valve surgery and minimally invasive transcatheter aortic valve replacement (TAVR) procedures. Our team regularly participates in the latest clinical trials and delivers outstanding treatment outcomes.

By UPMC Editorial Staff. Last reviewed on 2024-10-01 by Elissa Castor, PA-C.