Aortic Valve Replacement

Aortic Valve Replacement

Aortic Valve Replacement - Procedure, Cost and Success Rate

Aortic Valve Replacement is a surgery carried out to treat a severe medical ailment, Aortic stenosis, which is a condition that is a result of the aortic valve of the heart getting narrowed over time. This valve, under normal conditions, is responsible for allowing blood flow to be pumped from the main chamber of your heart to the rest of the body organs. However, when this valve's opening is considerably narrowed, the pressure on the heart muscle increases. This in turn, likely leads to numerous symptoms of chest discomfort, shortness of breath, leg swelling, fatigue, lightheadedness, syncope (passing out spells), and even sudden death. Surgical Aortic Valve Replacement is also carried out to treat Aortic regurgitation, a medical ailment in which the aortic valve does not close entirely causing the blood to leak back into the heart. However, Aortic regurgitation is not as severe as  Aortic stenosis.

Aortic Valve Disease: What is it?

The ineffective functioning of the aortic valve is known as aortic valve disease. One or more of the following may be to blame:

Blood flow is restricted due to aortic valve stenosis, which occurs when the valve's leaflets become rigid, fused, thickened, and inflexible. Calcium deposits on the aortic valve leaflets contribute to the progression of aortic valve stenosis by further restricting leaflet movement. Both bicuspid and tricuspid aortic valves are susceptible to stenosis.

The leaky aortic valve, also known as valvular insufficiency, incompetence, or simply regurgitation: Incomplete closure of the valve leaflets is a common problem. When the heart relaxes after contracting, the blood discharged into the heart creates a regurgitation process. Flaccid leaflets, aberrant congenitally malformed valves, endocarditis, the difficulty of the leaflets to seal securely owing to holes in the leaflets, dilatation of the aorta, and rheumatic valve disease may all induce regurgitation.

When is the Replacement of the Aortic Valve Essential?

It's possible that the aortic valve has to be changed for one of these two reasons:

  1. The aperture of the valve has gotten narrower due to the narrowing of the valve, which prevents blood from flowing freely out of the heart and into the body. This condition is known as aortic stenosis.
  2. Regurgitation is when the valve does not close tightly enough, allowing blood to flow backward into the heart.

If treatment is not sought, the symptoms may get more severe over time and, in extreme situations, may result in life-threatening conditions, such as heart failure. Because no medications can address abnormalities with the aortic valve, valve replacement surgery is the only option if you are at risk of significant consequences but are otherwise healthy enough to undergo the procedure.

Causes of Aortic Stenosis

In adults, there are main conditions that drive the body towards Aortic Stenosis

  • The most common cause of aortic stenosis is degenerative (age-related calcium deposits).
  • Congenital disorders (bicuspid aortic valve) which is the progressive wear and tear of a bicuspid valve present since birth.
  • Scarring of the aortic valve due to rheumatic fever as a child or young adult.

Symptoms of Aortic Stenosis

Aortic valve stenosis can range on the scale from mild to severe. Aortic valve stenosis signs and symptoms generally manifest as a result of severe narrowing down of the valve. More often, these symptoms are recorded as a result of strenuous physical activity.

  • Abnormal heart sound (heart murmur) that can be heard through a stethoscope
  • Chest pain (angina) or tightness within the chest
  • Feeling faint/dizzy or fainting as a result of activity
  • Shortness of breath, especially out of the activity
  • Fatigue, especially during times of increased activity
  • Heart palpitations and convulsions: sensations of a rapid, fluttering heartbeat
  • Not eating enough ( mainly in children with Aortic Stenosis)
  • Not gaining enough weight (mainly in children with aortic valve stenosis.

Types of Valves

The valve that the surgeon uses during the Aortic Valve Replacement Surgery is mainly of two types i.e. Mechanical and Biological. 

1. Mechanical Valves

Mechanical valves are made of artificial elements like Titanium, Teflon, Carbon. They last a long time and don't wear off in the body after replacing the original aortic valve. However, after the implantation of Mechanical valves in the body, your doctor may advise you to take blood-thinning medication for the rest of your life.

2. Biological Valves

Biological valves, as the name suggests are made of composite or bio-prosthetic materials, often extracted from animal tissue of a cow or a pig. These valves, however, have a lifetime of 15-20 years, which means you may be required to get a second valve replacement done later. These valves may not require you to consume blood-thinning medicines. Biological valves are more commonly used in aortic valve replacement operations than mechanical valves.

Aortic Valve Replacement Procedure

Before your heart valve replacement surgery, a strong dosage of anaesthesia is administered to you in order to put you into a deep sleep till the time the surgery is performed. As soon as you are induced sleep, the surgeon makes a wide cut around the breastbone area to get access to your heart where the aortic valve replacement will take place. In order to perform the surgery, the surgeon needs to a motionless and bloodless field. In order to keep the body functioning even when the heart is stopped, a device known as a heart-lung bypass machine is hinged to the body which is which will pump the blood in your body just like the original heart does. This device will function till the time the aortic valve replacement surgery is complete. The diseased aortic valve is removed and replaced with a mechanical or bioprosthetic valve. The surgeon ensures that all new connections to the valves are made fine before the heart is restarted. The incision is then closed with stitches.

How Long Does Heart Valve Surgery Take?

Valvular heart disease, commonly known as heart valve disease, is the leading cause of valve replacement and other surgical operations involving the heart. Surgery on a heart valve requires cutting through the breastbone and opening the chest. Recovery time is often several weeks, and the procedure might take two or more hours. Although certain forms of valvular heart disease may benefit from newer, less invasive treatments, they are only performed at a few specialized medical facilities.

Life After a Heart Valve Change

After surgery on a aortic valve, it is essential to take preventative measures to lower the likelihood that you may have future heart complications or need other cardiac procedures. Following surgical repair of a valve, there is a significantly increased possibility that the valve may get infected. To reduce the likelihood of contracting an infection, you must take preventative measures, such as practicing proper oral hygiene. After you have had heart surgery, it is essential to take care of your breastbone so that it can mend adequately. The following is a look at when it is safe to resume several activities that are typically done:

  • According to the RTA, driving is prohibited for four to six weeks unless otherwise directed by a medical professional since focus, reaction time, and vision are often impaired for six weeks.
  • You can return to work-related duties as soon as your focus, self-confidence, and physical capacities allow it. Most individuals return to light office work after six weeks and return to more physically demanding work after three months.
  • It's natural to lose the desire for sexual activity for a while, but, just as with other exercises, you should be back to usual by the time you reach the three-month mark. Sexual intercourse demands around the same strength as climbing 2 flights of stairs, and you'll typically be ready to ease this from about week 3 gradually.
  • Cooking, flower arrangement, cleaning up, dusting, washing dishes and clothing, and so on may all be begun early; however, defer the more challenging jobs to your family.
  • You may start watering the garden during your first week back, and by week three, you'll be ready to undertake some light weeding and trimming. Digging into soft soil is possible by the sixth week, while hedge pruning may be done by the eighth week.

Surgical Aortic Valve Replacement Risks

Surgical Aortic Valve Replacement is a very delicate surgery which may carry some risks. However, if you get the Surgical Aortic Valve Replacement done from well-renowned hospitals in India, therefore, Surgical Aortic Valve Replacement in India is a very good option. Here are the few risks of heart valve replacement:

  • High fever
  • Great pain at the incision site.
  • Breathlessness 
  • Swelling in some body parts like abdomen or legs
  • Nausea
  • Blood pressure
  • Extreme weakness for the first few weeks

Aortic Valve Replacement Recovery

Aortic Valve Replacement Recovery takes about 3-4 months whereas a patient, you have to keep away from activities that cause any exertion. Most people return to their homes after spending 4-7 days in the hospital post surgery while 15-20% may need to spend a while at the rehabilitation centre for complete recovery.

Aortic Valve Replacement Surgery Success Rate

The Success rate of heart valve replacement is around 91%, while the replacement of the aortic valve has a success rate of approximately 94%. These rates are determined by the patient's age and general state of health.

Aortic Valve Replacement Surgery FAQs

Should one take aortic valve disease lightly?

Checkups are essential for those with congenital cardiac defects like the bicuspid aortic valve. Possible symptoms of the valve disease may not manifest until later in life. There may be a need for maintenance or replacement of the valve if it becomes constricted or leaks. Limescale deposits on the control mechanism.

When an aortic valve malfunctions, what steps are taken to fix it?

Damage to the aortic valve may only be prevented for so long before it has to be repaired or replaced. Even if their aortic valve condition is mild or asymptomatic, some patients nevertheless require surgery. Aortic valve repair and replacement are standard procedures that need open-heart surgery.

When the aortic valve fails, what happens?

Heart failure occurs when the aortic valve does not open regularly and allows blood to flow out of the heart. When this happens, blood might pool in the lungs or back up in other heart parts. Since this is an issue, the heart muscle will strive to pump more blood into the body.

Is it possible to fix a heart valve without operating on it?

Although untreated, this illness may cause significant health issues; nonetheless, it is curable and, with the advent of a less invasive technique employing the MitraClip, is increasingly being treated. This technology allows doctors to repair damaged heart valves without having open heart surgery on their patients.

Can you describe the sensation of a heart with a damaged valve?

One of the most common forms of cardiac disease affects the valves (valvular heart disease). Insufficient blood can pass through the heart or be distributed to the body's other organs if the leakage is significant. Thus, mitral valve regurgitation may cause extreme exhaustion or difficulty breathing.

How long does heart valve surgery take?

A typical heart valve operation will take four to six hours. Most of the time, a TAVR procedure takes approximately 90 minutes.

Is heart valve replacement surgery dangerous?

Heart valve surgery is a major surgery that is used to treat valvular heart disease, which is when one or more of the heart's four valves stop working right. When any of these parts don't work appropriately, blood flow and the blood vessels' network that carry oxygen to all of the body's organs are disrupted. So, it is best to visit a cardiovascular surgeon as quickly as possible if the first signs of a heart valve illness appear.

What should you do to be careful after heart valve replacement surgery?

Always do what your doctor tells you to and take the medicines they give you. Also, good nutrition can help you get better faster, so eat a heart-healthy diet. Plan your meals so you don't fall off the wagon. During the time you are getting better, make sure you take it slow and gradually progress to the level of activity you were doing before. Make sure to talk to your doctor before you start any complex physical activity. Lastly, get at least 2 hours and 30 minutes a week of moderate physical activity after consulting your physician.

How does life after a heart valve change?

You'll begin feeling better almost immediately. Your condition will get better slowly, and you'll realize that you will feel a little bit good each day. However, you must make a few changes to your life to maximize the benefits of your new or fixed heart valve.

Can you live with aortic valve regurgitation?

Individuals with minor aortic regurgitation typically live long, healthy lives without requiring treatment. However, if the illness worsens and impairs the heart's capacity to pump blood, you may need surgery to avoid catastrophic consequences like congestive heart failure.

Why would a cardiologist recommend heart valve endoscopy?

Cardiopulmonary endoscopy is a straightforward, safe, and efficient method for assessing the heart chambers and pulmonary artery system. It can be carried out using a sterile flexible fiberoptic endoscope. It enables pulmonary embolectomy and excludes potentially life-threatening operations and techniques.

What is the success rate of aortic valve replacement?

The success rate of Aortic valve replacement is 98.1%. However, these rates vary according to the patient's age and general health status.