TALK TO AN AORTIC NURSE

Symptomatic patients who have severe aortic stenosis or chronic, severe aortic regurgitation may be candidates for aortic valve heart surgery. Aortic valve disease that requires surgery is usually treated with either repair of the damaged valve, or, if the damage is too severe, replacement of the damaged valve.

There are risks with every surgery, varying with each person and the procedure performed. Our approach is to ensure patients receive the best surgical option available at the lowest risk. Your risk depends on your heart function, age and overall health. Your cardiac surgeon will answer your questions and discuss in detail:

• Type and severity of valve disease
• Coexisting medical conditions or problems
• Surgery options
• Surgical risks
• Your specific plan of care

This discussion becomes the framework by which the patient and cardiac surgeon collaboratively determine if aortic valve repair or aortic valve replacement is the best surgical option. It is our priority to repair rather than replace heart valves whenever possible to preserve a patient’s own heart valve so that blood-thinning (anticoagulation) medications may not be required.

Aortic Valve Repair 

Cardiac surgeons at the Center for Heart Valve Disease repair a patient’s own native valve when possible. Valve repair often provides the best long-term outcome of restoring proper valve function. The most common reason for valve repair is regurgitation or a “leaking” valve. Unfortunately, valve repair in patients with aortic stenosis that involves leaflet decalcification (reversal of the hardening, or calcification, of heart valve leaflets) is not a feasible treatment option.

Aortic valve repair involves a surgical procedure during which the cardiac surgeon may need to trim, reshape or rebuild your diseased valve. During valve repair surgery, a ring is placed at the base of the heart valve to provide added support to the repaired valve. This procedure is referred to as an annuloplasty. For a period of time after aortic valve repair, patients may be required to take a blood-thinning (anticoagulation) medication.

Aortic Valve Replacement

If the heart valve is too damaged to repair, heart valve replacement is needed. During aortic valve replacement the cardiac surgeon removes the diseased valve and replaces the diseased valve with either a mechanical valve or a tissue (bioprosthetic) valve.

Mechanical valves are made of special carbon compounds and titanium. The valves are sturdy and designed to last a lifetime. Due to the metal parts of mechanical valves, patients need to take blood-thinning medicine known as anticoagulants for the rest of their lives. The anticoagulants prevent blood clots from forming on the metal valve. Routine blood tests are needed to make sure the anticoagulation medicine dose is right for you.

Bioprosthetic valves are made from animal (bovine/cow) or human tissue. Unlike mechanical valves, patients that receive bioprosthetic valves do not have to take anticoagulants. Because these valves are made from natural tissue, bioprosthetic valves do not last as long as mechanical valves. The cardiac surgeons at the Center for Heart Valve Disease use bioprosthetic valves made from cow tissues when possible because research has shown that these tissue valves are the most durable and last upwards of 15 years in most patients.

Aortic Root Replacement

The aortic root is the first part of the aorta. An aortic root aneurysm is a bulging or weak spot that occurs at the beginning of the aorta. You may need aortic root replacement surgery to replace the diseased aortic root. The aortic valve may need to be repaired or replaced depending on the extent of disease to the aortic valve.

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Northwestern Medicine Bluhm Cardiovascular Institute is a nationally recognized destination for those who require highly specialized cardiovascular care.

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