Aortic Valve Replacement / Repair
Aortic Valve Replacement (AVR) and Aortic Valve Repair (AVr) are surgical procedures used to treat problems with the aortic valve, the valve that controls blood flow from the heart’s left ventricle into the aorta (the main artery that supplies oxygenated blood to the body). These procedures are required when the valve becomes damaged or diseased, leading to conditions such as aortic valve stenosis (narrowing) or aortic valve regurgitation (leakage).
Aortic Valve Replacement (AVR)
In aortic valve replacement, the damaged valve is entirely removed and replaced with a prosthetic (artificial) valve.
There are two main types of prosthetic valves:
- Mechanical Valves: These are made from durable materials such as metal or carbon. They are long-lasting, but patients need to take lifelong blood-thinning medication
(anticoagulants) to prevent blood clots from forming on the valve.
- Biological (Tissue) Valves: These are made from animal tissue (usually from a pig or cow) or, more rarely, from a donated human valve. While these valves don’t last as long as mechanical valves (they may wear out after 10-20 years), they typically don’t require lifelong anticoagulation.
When is Aortic Valve Replacement necessary?
- Aortic stenosis: Severe narrowing of the valve that restricts blood flow, causing symptoms like chest pain, fainting, or heart failure.
- Aortic regurgitation: Severe leakage where blood flows back into the heart, leading to an enlarged heart or heart failure.
- When the valve is too damaged to be repaired.
Aortic Valve Repair (AVr)
Aortic valve repair involves preserving the patient’s native valve by fixing structural problems, such as deformities in the valve’s leaflets or supporting structures. This is a more complex procedure and is less commonly performed than replacement, but it can be highly effective in certain cases, especially in younger patients or those with specific types of valve defects.
Techniques used in Aortic Valve Repair:
- Leaflet repair: The valve’s leaflets (the flaps that open and close to regulate blood flow) are reshaped or reinforced to improve function.
- Aortic root repair: In some cases, the aortic root (the portion of the aorta near the valve) may be dilated, and part of the surgery may involve reshaping or reinforcing this structure.
- Annuloplasty: A ring may be used to support and tighten the valve’s base, restoring the proper function of the valve leaflets.
When is Aortic Valve Repair preferred?
- Aortic regurgitation: When the valve is leaky but structurally intact and can be preserved through repair.
- To avoid the need for a prosthetic valve, especially in younger patients or those who may not tolerate blood thinners.
- When preserving the patient’s native valve is more beneficial in the long term.
