Aortic Valve Repair - GO.CARE Blog
Aortic Valve Repair
Author: Hào Nghiêm
Review Date: August 6, 2018 | Last Modified: January 10, 2019
Aortic Valve Repair

Definition

1. What is Aortic Valve Repair?

Aortic Valve Repair and Aortic Valve Replacement are procedures that treat diseases affecting the aortic valve.

The aortic valve is one of four valves that regulate blood flow through the heart, separating the heart’s main pumping chamber (left ventricle) and the main artery. These valves keep blood flowing in the correct direction through the heart.

With each contraction of the ventricle, the aortic valve opens and allows blood to flow from the left ventricle into the aorta. When the ventricle relaxes, the aortic valve closes to prevent blood from flowing backward into the ventricle.

Therefore, when the aortic valve isn’t working properly, it can interfere with blood flow as well as force the heart to work harder to supply the necessary blood to the rest of your body.

2. What is the purpose of Aortic Valve Repair?

Aortic Valve Repair or Aortic Valve Replacement can treat aortic valve disease and help restore normal blood flow, reduce symptoms, prolong life and help preserve the function of your heart muscle.

Candidates

1. When is Aortic Valve Repair needed?

Aortic valve disease treatment depends on the severity of your condition, whether or not you’re experiencing signs and symptoms, and if your condition is getting worse.

Types of aortic valve disease that may require treatment with aortic valve repair or replacement include:

  • Aortic valve regurgitation

This occurs when blood flows backward through the aortic valve into the left ventricle each time the ventricle relaxes rather than in the normal, one-way direction from the ventricle to the aorta.

  • Back flow

Back flow may be caused by a dysfunctional or leaky valve. This may be due to deterioration of the valve, an abnormal valve shape present at birth (congenital heart disease) or by a bacterial infection.

  • Aortic valve stenosis

This disease causes the aortic valve to become narrowed or obstructed, which makes it harder for the heart pump blood into the aorta. This may be caused by congenital heart disease, thickening of the valve’s closure flaps (cusps) or post-inflammatory changes, such as those associated with rheumatic heart disease.

  • Congenital heart disease

This may contribute to aortic valve regurgitation or stenosis as well as result in other problems that prevent the aortic valve from working properly. For example, a person may be born with an aortic valve that doesn’t have enough tissue flaps (cusps), the valve may be the wrong size or shape, or there may not be an opening to allow blood to flow normally (atresia).

There are a number of ways to repair or replace a damaged or defective aortic valve. The two primary matters your surgeon will consider are whether your valve can be repaired or must be replaced, and which surgical approach will work best.

In certain limited circumstances, especially if your valve is leaky rather than blocked, it may be possible to repair it using small tissue patches on the flaps of the valve.

2. Who are eligible for Aortic Valve Repair?

If you are diagnosed with a damaged aortic valve, your surgeon will evaluate the specifics of your situation and help you weigh the risks of cardiac surgery against the risks of continuing to manage the disorder with medication and other nonsurgical treatments.

In some circumstances, especially if your symptoms are not severe, they can be managed with lifestyle changes and/or medication. However, a disorder of the aortic valve that is severe or causes symptoms can only be fixed surgically; nonsurgical options will at best just delay the need for surgery.

The decision to repair or replace a damaged aortic valve depends on many factors, including:

  • The severity of your aortic valve disease
  • Your age and overall health
  • Whether you need heart surgery to correct another heart problem in addition to aortic valve disease, such as heart bypass surgery to treat coronary artery disease, so both conditions can be treated at once.

In general, heart valve repair is usually the first choice because it’s associated with a lower risk of infection, preserves valve strength and function, and reduces the need to take blood-thinning medications for the rest of your life as necessary with certain types of valve replacement.

Not all valves can be repaired, however, and heart valve repair surgery is often harder to do than valve replacement. Your best option will depend on your individual situation as well as the expertise and experience of your multidisciplinary heart team.

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Cost

In Vietnam, the cost of Aortic valve repair is between 20 to 42 millions VND. This cost will change based on the procedure, health condition and all the additional service in different healthcare centers.

In the U.S, for patients not covered by health insurance, valve replacement surgery typically costs from about $80,000-$200,000 or more with an average, according to an American Heart Association report, of $164,238, not including the doctor fee. A surgeon fee can add $5,000 or more to the final bill.

Patients typically require one or more sessions of physical therapy to learn how to move without harming the incision and to learn exercises to assist recovery. This typically costs $50-$350 per session.

Patients who have a mechanical (man-made) valve inserted must take a blood thinning medication such as warfarin (brand name Coumadin), or possibly Plavix, for life. At Drugstore.com, Warfarin typically costs about $15-$25 per month, depending on dose, for the generic or $50-$70 for the brand name, and Plavix costs about $200 or more per month.

Preparation

1. What should I do before Aortic Valve Repair?

Food and medications

Talk to your doctor about:

  • When you can take your regular medications and whether you can take them before your surgery
  • When you should stop eating or drinking the night before the surgery

Clothing and personal items

Your treatment team may recommend that you bring several items to the hospital including:

  • A list of your medications
  • Eyeglasses, hearing aids or dentures
  • Personal care items, such as a brush, comb, shaving equipment and toothbrush
  • Loosefitting, comfortable clothing
  • A copy of your advance directive or living will
  • Items that may help you relax, such as portable music players or books
  • Any prescribed medical devices or equipment

During surgery, avoid wearing:

  • Jewelry
  • Eyeglasses
  • Contact lenses
  • Dentures
  • Nail polish

Moreover, your body hair will be shaved off at the location where the procedure will take place.

2. What should I do after Aortic Valve Repair?

After Aortic Valve Repair or Aortic Valve Replacement surgery, you may eventually be able to return to daily activities, such as working, driving and exercise.

You’ll still need to take certain medications and attend regular follow-up appointments with your doctor. You may have several tests to evaluate and monitor your condition.

Next, your doctor and health care team may instruct you to incorporate healthy lifestyle changes — such as physical activity, a healthy diet, stress management and avoiding tobacco use — into your life to reduce the risk of future complications and promote a healthy heart.

Your doctor may recommend that you participate in cardiac rehabilitation — a program of education and exercise designed to help you improve your health and help you recover after heart surgery.

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Procedure

1. How long does Aortic Valve Repair last?

Typically, an Aortic Valve Repair open-heart procedure takes from four to six hours, in some cases up to eight hours;

2. How is the procedure of Aortic Valve Repair?

Aortic Valve Repair is usually performed through traditional open-heart surgery and opening of the chest bone (sternotomy). Doctors wire the bone back together after the procedure to prevent movement and aid in healing.

More specifically, Aortic Valve Repair procedures may involve several different types of repair, including:

  • Inserting tissue to patch holes or tears in the flaps (perforated cusps) that close off the valve
  • Adding support at the base or roots of the valve
  • Separating fused valve cusps
  • Reshaping or removing tissue to allow the valve to close more tightly
  • Tightening or reinforcing the ring around a valve (annulus) by implanting an artificial ring (annuloplasty)

Aortic valves that can’t open fully due to aortic valve stenosis may be repaired with surgery or with a less invasive procedure called balloon valvuloplasty — which uses an approach called cardiac catheterization. You’re usually awake during cardiac catheterization, and it requires a much shorter hospital stay than traditional heart surgery.

Balloon valvuloplasty is often used to treat infants and children with aortic valve stenosis. However, the valve tends to narrow again in adults who have had the procedure, so it’s usually only performed in adults who are too ill for surgery or who are waiting for a valve replacement. You may need additional procedures to treat the narrowed valve over time.

Moreover, doctors may also use a catheter procedure to perform aortic valve repair by inserting a plug or device to fix a leaking replacement heart valve.

3. What happens after the procedure?

Afterwards, patients are then maintained under general anesthesia for an additional four to six hours. If their heart is performing well and there is no excess bleeding, they can emerge from anesthesia and have their breathing tube removed. Most patients stay in the ICU until midday of the day after their procedure.

The medical team will give patients oxygen, fluids, nutrition and medications through intravenous (IV) lines. Other tubes will drain urine from their bladder and drain fluid and blood from their chest; if they continue to do well, the drainage tubes in their chest can then be removed and they can be moved to a regular hospital bed later that day.

Normally, your hospital stay ranges from four to seven days.

More specifically, during your hospital stay, the treatment team will likely:

  • Watch for signs of infection in the incision sites
  • Periodically check the patients’ blood pressure, breathing and heart rate
  • Work with the patients to manage any pain they experience after surgery
  • Instruct the patients to walk regularly to gradually increase their activity and do breathing exercises as they recover

At that point, the vast majority of patients are able to go home, with support from the visiting nurse service, though about 15% to 20% may need to spend some time in a rehab facility for more extensive rehabilitation.

Your doctor may give you instructions to follow during your recovery, such as watching for signs of infection in your incisions, properly caring for incisions, taking medications, and managing pain and other side effects after your surgery.

Recovery time depends on your procedure, overall health before the procedure and any complications.

Furthermore, your doctor may advise you to avoid driving a car or lifting anything more than 4.5 kg for several weeks. Your doctor will discuss with you when you can return to normal activities.

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Complications & Side Effects

1. What complications could arise from Aortic Valve Repair?

Complications associated with Aortic Valve Repair surgery may include:

  • Myocardial infarction (heart attack)
  • Lung problems
  • Stroke
  • Death

2. What are the possible side effects of Aortic Valve Repair?

Potential side effects of Aortic Valve Repair include:

  • Post-surgical bleeding
  • Blood clots
  • Incision site infection
  • Pneumonia
  • Problems breathing
  • Arrhythmias (abnormal heart rhythm)

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Please choose the {best hospitals and clinics that provide Aortic Valve Repair} in Asia to get the most suitable healthcare for your condition.

GO.CARE  does not provide medical advice, diagnosis or treatment.