What is the aortic valve?
The aortic valve is one of the four heart valves. It typically has three leaflets. When the heart contracts, oxygenated blood is ejected and flows through this valve to the rest of the body. An abnormal aortic valve may either leak (insufficiency/regurgitation) or be too tight (stenosis). Either problem may be severe enough to require valve replacement.
What are the symptoms of aortic valve problems?
Aortic regurgitation will eventually lead to enlargement of the heart and heart failure symptoms, such as shortness of breath with activity or lying flat. Aortic stenosis may be asymptomatic but can cause symptoms such as chest pain (angina), fainting (syncope), shortness of breath or heart failure. With severe aortic stenosis, there is a 2% incidence of sudden death each year and, once symptoms appear, there is almost a 50% chance of dying within two years.
How is the operation performed?
Your primary care doctor may discover a murmur while listening to your heart. An echocardiogram is then typically ordered to assess whether your valves are stenotic or regurgitant, and the size and function of your heart. Your valve disease will then be quantified as mild, moderate or severe.
How is this diagnosed?
Aortic valve replacement (AVR) can be performed through a median sternotomy, minimally invasively using an anterior thoracotomy incision or hemisternotomy, or percutaneously (transfemorally or transapically) for patients who are not candidates for traditional aortic valve replacement. For traditional AVR, the patient is placed on the heart–lung machine, the heart is stopped and the valve excised, and a new prosthetic valve is sewn into place. The valve may be replaced with a mechanical valve or a bioprosthesis (tissue valve), depending on the needs of each individual. Your surgeon will discuss the particular pros and cons of the different types of valves, and the best operative approach for you.