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Alternative NamesBalloon valvuloplasty; Mini-thoracotomy aortic valve replacement or repair; Cardiac valvular surgery; Mini-sternotomy; Ring annuloplasty - minimally invasive; Robotically-assisted endoscopic aortic valve repair
Definition Return to top
Blood flows out of your heart and into the aorta through a valve. This valve is called the aortic valve. It opens up so blood can flow out. It then closes, keeping blood from flowing backwards.
Aortic valve surgery is done to either repair or replace the aortic valve in your heart.
Minimally invasive aortic valve surgery is done through much smaller incisions (cuts) than the large cut needed for open aortic valve surgery.
Description Return to top
Before your surgery you will receive general anesthesia. This will make you unconscious and unable feel pain.
There are several different ways to do minimally invasive aortic valve surgery. Techniques include laparoscopy or endoscopy, robot-assisted surgery, and percutaneous surgery.
You will not need to be on a heart-lung machine for any of these surgeries, but your heart rate will be slowed by medicine or a mechanical device.
If your surgeon can repair your aortic valve, you may have:
If your aortic valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your aortic valve and sew a new one into place. There are two main types of new valves:
Once the new or repaired valve is working, your surgeon will
The surgery may take 1 to 3 hours.
Aortic valve surgery is also now being done through a groin artery. No incisions are made on your chest. The doctor sends a catheter (tube) with a balloon attached on the end to the valve. The balloon stretches the opening of the valve. This procedure is called percutaneous valvuloplasty.
Why the Procedure is Performed Return to top
Aortic valve surgery is done when the valve does not work properly. Surgery may be done for these reasons:
A minimally invasive procedure has many benefits. There is less pain, blood loss, and risk of infection. You will also recover faster than you would from open heart surgery.
Risks Return to top
Risks for any anesthesia are:
Additional risks vary by the patient’s age. Some of these risks are:
Before the Procedure Return to top
Always tell your doctor or nurse:
You may be able to store blood in the blood bank for transfusions during and after your surgery. Ask your surgeon about how you and your family members can donate blood.
For the 2-week period before surgery, you may be asked to stop taking drugs that make it harder for your blood to clot. These might cause increased bleeding during the surgery.
During the days before your surgery:
Prepare your house for when you get home from the hospital.
The day before your surgery, shower and shampoo well. You may be asked to wash your whole body below your neck with a special soap. Scrub your chest 2 or 3 times with this soap. You also may be asked to take an antibiotic, to prevent infection.
On the day of your surgery:
After the Procedure Return to top
After your operation, you will spend 3 to 7 days in the hospital. You will spend the first few hours in an intensive care unit (ICU). Nurses will monitor your condition constantly.
Usually within 24 hours, you will be moved to a regular room or a transitional care unit in the hospital. You will slowly resume some activity. You may begin a program to make your heart and body stronger.
You may have 2 to 3 tubes in your chest to drain fluid from around your heart. These are usually removed 1 to 3 days after surgery.
You may have a catheter (flexible tube) in your bladder to drain urine. You may also have intravenous (IV, in the vein) lines for fluids. Nurses will closely watch monitors that display information about your vital signs (pulse, temperature, and breathing). You will have daily blood tests and EKGs to test your heart function until you are well enough to go home.
A temporary pacemaker may be placed in your heart if your heart rhythm becomes too slow after surgery.
Once you are home, recovery takes time. Take it easy, and be patient with yourself.
Outlook (Prognosis) Return to top
Mechanical heart valves do not fail often. However, blood clots develop on them. If a blood clot forms, you may have a stroke. Bleeding can occur, but this is rare.
Biological valves tend to fail over time. But they have a lower risk of blood clots.
Techniques for minimally invasive heart valve surgery have improved greatly over the past 10 years. These techniques are safe for most people, and they reduce recovery time and pain.
References Return to top
Fullerton DA, Harken AH. Acquired heart disease: valvular. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 62.
Popma JJ, Baim DS, Resnic FS. Percutaneous coronary and valvular interfention. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 55.
Otto CM, Bonow RO. Valvular heart disease. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 62.Update Date: 3/13/2009 Updated by: Larry A. Weinrauch MD, Assistant Professor of Medicine, Harvard Medical School, Cardiovascular Disease and Clinical Outcomes Research, Watertown, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.