Introduction

Aortic valve surgery is a major heart procedure performed to repair or replace a damaged aortic valve. This surgery is often necessary when the valve doesn’t open or close properly, affecting blood flow and leading to life-threatening complications. Understanding its causes, procedure, recovery, and risks is crucial for patients and their families.

Aortic Valve Surgery

Aortic valve surgery is a type of heart surgery done to treat issues affecting the aortic valve — one of the heart’s four main valves. This valve allows blood to flow from the heart’s left ventricle into the aorta, the body’s main artery, and then to the rest of the body.

When the aortic valve doesn’t work properly due to narrowing (aortic stenosis) or leaking (aortic regurgitation), it can disrupt blood flow, strain the heart, and eventually lead to heart failure. Aortic valve surgery corrects this issue by either repairing or replacing the valve with an artificial or biological one.

Why is Aortic Valve Surgery Needed?

The aortic valve can get damaged due to several medical conditions. The most common reasons for needing surgery include:

1. Aortic Stenosis :- This occurs when the valve becomes narrowed or stiff, making it hard for blood to flow through. It often results from age-related degeneration, calcium buildup, or congenital defects like a bicuspid valve (having two leaflets instead of three).

2. Aortic Regurgitation :- This happens when the valve doesn’t close properly, allowing blood to leak backward into the heart. Over time, this leads to increased strain on the heart muscle.

3. Congenital Heart Defects :- Some people are born with a malformed aortic valve that may require early surgery.

4. Infective Endocarditis :- A serious infection of the valve that can cause it to function improperly.

5. Rheumatic Fever :- This inflammatory disease can damage heart valves, especially in developing countries.

Symptoms That May Lead to Surgery

When the aortic valve is not functioning properly, it can cause noticeable symptoms, especially during physical activity. These symptoms include:

Chest pain or tightness
Shortness of breath
Fatigue
Dizziness or fainting
Irregular heartbeat (palpitations)
Swollen ankles or feet
Heart murmur detected by a doctor

If these symptoms worsen or if tests show that the heart is under stress, surgery may be recommended.

Diagnosis Before Surgery

Before recommending aortic valve surgery, doctors will conduct a variety of tests, such as:

Echocardiogram (Transthoracic or Transesophageal) :- Provides images of the heart to assess valve function.
Electrocardiogram (ECG) :- Measures the electrical activity of the heart.
Chest X-ray :- Shows the size and shape of the heart and aorta.
Cardiac MRI or CT Scan :- Offers detailed images of the heart’s structure.
Cardiac Catheterization :- Measures pressure inside the heart and checks for blockages.

These diagnostic tests help in determining the severity of the valve damage and the best surgical approach.

Types of Aortic Valve Surgery

There are several surgical options based on the condition of the valve and patient health:

1. Aortic Valve Replacement (AVR) :- This is the most common type. The damaged valve is removed and replaced with one of the following:

Mechanical Valve :- Made of durable materials, lasting a lifetime but requiring lifelong blood thinners.
Biological Valve :- Made from animal tissue or human donor tissue, doesn’t usually need blood thinners but may wear out over time.

2. Aortic Valve Repair :- In select cases, especially in children or early-stage valve issues, the existing valve can be reshaped or patched without full replacement.

3. Transcatheter Aortic Valve Replacement (TAVR) :- A minimally invasive procedure suitable for patients who are at high risk for open-heart surgery. A catheter is inserted through the groin or chest to place a new valve inside the damaged one.

The Surgical Procedure: Step-by-Step

1. Preparation :- The patient undergoes anesthesia and is connected to a heart-lung bypass machine. Incisions are made in the chest to access the heart.

2. Valve Removal or Repair :- The surgeon opens the heart and removes the damaged valve. Either a new valve is sewn in place, or the existing valve is repaired.

3. Closure :- Once the valve is replaced, the heart is restarted. The chest is closed with sutures, and the patient is taken to the ICU for recovery.

Surgery duration typically ranges from 2 to 4 hours.

Recovery After Aortic Valve Surgery

1. Hospital Stay :- Usually 5 to 10 days, with 1–2 days in the intensive care unit (ICU). Heart function is monitored closely.

2. At-Home Recovery :- Most people can return to regular activities in 6–12 weeks. Avoid lifting heavy objects or driving until cleared by a doctor. Cardiac rehabilitation is recommended to strengthen the heart and improve fitness.

3. Lifestyle Modifications :- To ensure long-term valve function and heart health:

Eat a heart-healthy diet (low salt, low fat)
Quit smoking
Exercise regularly
Take prescribed medications (especially for mechanical valve patients)
Attend regular follow-up appointments and echocardiograms

Life After Aortic Valve Surgery

With successful surgery and proper care, most patients enjoy a good quality of life and significantly reduced symptoms. The life expectancy post-surgery improves dramatically, especially when the procedure is done before irreversible heart damage occurs.

Patients with mechanical valves need lifelong anticoagulation therapy (blood thinners) and regular blood monitoring. Those with biological valves may need a second replacement after 10–20 years depending on wear.

When to See a Doctor

Immediate medical advice is needed if you:

Have worsening chest pain or shortness of breath
Notice swelling in your legs or feet
Feel dizzy or faint
Experience abnormal heart rhythms
Notice signs of infection (fever, wound redness)

Conclusion

Aortic valve surgery is a life-saving procedure for many patients suffering from aortic valve disease. Whether it’s done through open surgery or a less invasive method like TAVR, it helps restore normal blood flow, relieve symptoms, and improve heart function.

Advancements in medical technology have made this surgery safer and more accessible. With proper diagnosis, timely treatment, and post-surgical care, patients can lead a healthier and more active life.