Aortic Valve Surgery and its Symptoms, Diagnosis, and Risks

Introduction

The human heart has four valves that keep blood flowing in the right direction. One of these valves—the aortic valve—plays a critical role in pumping oxygen-rich blood from the heart to the rest of the body. When this valve becomes diseased or damaged, it can compromise your heart’s function and your overall health. That’s where aortic valve surgery comes into play.

In this detailed guide, we will explain what aortic valve surgery is, the symptoms that indicate a problem with the aortic valve, how it’s diagnosed, and the risks associated with the procedure.

What is Aortic Valve Surgery?

Understanding the Aortic Valve

The aortic valve is located between the left ventricle (the heart’s main pumping chamber) and the aorta (the main artery that carries blood to the body). It functions as a one-way gate that opens to let blood out of the heart and closes to prevent it from flowing backward.

When this valve becomes narrowed, stiff, or leaky, the heart has to work harder to pump blood. Over time, this added strain can lead to serious problems like heart failure, arrhythmias, or even sudden cardiac arrest.

Purpose of Aortic Valve Surgery

Aortic valve surgery is done to correct problems with the aortic valve. The goal is to improve blood flow, restore heart function, and relieve symptoms. Depending on the severity of damage, the valve may either be repaired or replaced.

There are three main types of aortic valve surgery:

• Aortic Valve Repair :- The existing valve is reshaped or patched.

• Aortic Valve Replacement (AVR) :- The damaged valve is replaced with a mechanical or biological prosthetic valve.

• Transcatheter Aortic Valve Replacement (TAVR) :- A less invasive method where the valve is replaced via a catheter, suitable for high-risk patients.

Symptoms of Aortic Valve Disease

Many people may not notice symptoms in the early stages. However, as the valve becomes more dysfunctional, symptoms begin to appear and worsen over time.

1. Chest Pain (Angina) :- Occurs especially during physical activity when the heart struggles to pump blood through a narrowed or leaky valve. It may feel like pressure, tightness, or burning in the chest.

2. Shortness of Breath :- Patients may feel winded during normal activities or even at rest. This is a sign that the heart is not delivering enough oxygen to meet the body’s needs.

3. Fatigue and Weakness :- People often feel unusually tired, especially after exertion. This happens because the body isn’t getting enough oxygenated blood.

4. Dizziness or Fainting (Syncope) :- As the heart struggles to pump blood, the brain may receive inadequate blood supply, causing dizziness or fainting spells. This is especially common in aortic stenosis.

5. Heart Palpitations :- Irregular or rapid heartbeat sensations can occur due to the heart compensating for the faulty valve.

6. Swollen Ankles and Feet :- Fluid buildup, especially in the lower limbs, may occur as heart failure develops due to a failing aortic valve.

7. Heart Murmur :-  Detected by a doctor using a stethoscope. A murmur is a “whooshing” sound caused by turbulent blood flow due to a valve defect.

Diagnosis of Aortic Valve Disease

Diagnosing aortic valve issues involves a combination of physical exams, imaging tests, and other diagnostic tools to assess the severity and cause of valve dysfunction.

1. Physical Examination :- Doctors listen to the heart using a stethoscope to detect murmurs or abnormal sounds. Blood pressure and pulse may also be evaluated.

2. Echocardiogram (Echo) :- A key diagnostic tool. It uses ultrasound to create images of the heart and show how well the aortic valve opens and closes. There are two types:

• Transthoracic Echocardiogram (TTE) :- Done externally using a probe on the chest.

• Transesophageal Echocardiogram (TEE) :- Provides a clearer view via a probe inserted down the esophagus.

3. Electrocardiogram (ECG or EKG) :- Records the heart’s electrical activity to detect abnormal rhythms or signs of heart enlargement due to valve issues.

4. Chest X-Ray :- Shows the size and shape of the heart and whether there’s fluid in the lungs—an indicator of heart failure.

5. Cardiac MRI or CT Scan :- Provides detailed images of the heart’s structure and valve function.

6. Cardiac Catheterization :- Used especially before surgery to check for blockages in coronary arteries and to measure pressure inside the heart chambers.

All these tests help doctors decide if surgery is needed and what kind of intervention would be most effective.

Risks and Complications of Aortic Valve Surgery

Although aortic valve surgery is often life-saving, like any major surgical procedure, it comes with certain risks and possible complications.

1. Bleeding :- Bleeding can occur during or after surgery. In some cases, a blood transfusion may be required.

2. Infection :- There’s a risk of infection at the incision site, within the chest, or in the prosthetic valve (prosthetic valve endocarditis).

3. Blood Clots :- Especially with mechanical valves, blood clots can form and cause stroke or valve malfunction. That’s why lifelong anticoagulants are often prescribed.

4. Heart Rhythm Problems (Arrhythmias) :- Irregular heartbeats may occur post-surgery, and some patients may need a pacemaker.

5. Valve Dysfunction or Failure :- Although rare, the replaced valve may not function correctly or may wear out over time (especially in biological valves).

6. Stroke :- A serious but uncommon risk. It can happen due to blood clots or air bubbles reaching the brain during surgery.

7. Kidney Dysfunction :- Some patients experience a temporary decline in kidney function due to the heart-lung bypass machine.

8. Anesthesia Complications :- All surgeries requiring general anesthesia carry risks such as breathing difficulties or allergic reactions.

9. Death :- Although rare with modern techniques and experienced surgeons, the mortality risk increases in elderly patients or those with other serious health conditions.

Conclusion

Aortic valve surgery is a crucial and often life-saving procedure for people suffering from aortic valve diseases like stenosis or regurgitation. Recognizing symptoms early, getting the right diagnosis, and understanding the risks can lead to better outcomes and faster recovery.

While surgery may sound daunting, advancements in both open-heart and minimally invasive procedures like TAVR have made it safer than ever. With appropriate post-surgical care and follow-up, patients often return to normal or even improved levels of activity.