The time taken for replacing an aortic valve is averagely 3 hours; which can be more or less depending on the condition of the valves and the number of valves which have to be changed. The patient has to be at the Intensive Care Unit (I.C.U) for at least 48 to 72 hours and needs a hospital stay of at least a week.
Anatomy of Aortic Valve
The heart pumps blood into the aorta, the largest artery of the body. The aortic valve is an opening or closure which separates the heart and aorta. When the heart pumps the blood the aortic valve opens so that the blood passes through it. After the blood passes, it closes so that the blood does not flow back. The aortic valve can become faulty in two ways:
- Firstly, it does not close properly so there is back flow or leakage of blood. This condition is known as Aortic Regurgitation.
- Secondly, it does not open completely or properly so the required amount of blood is not able to pass through the aorta. This condition is known as Aortic Stenosis.
In both the cases the replacement of aortic valve or an aortic valve surgery has to be done.
How The Aortic Replacement Surgery Is Performed?
The aortic valve surgery is performed under general anesthesia so that the patient does not feel pain and is deep asleep. A long incision of about 24 to 25 cm is made at the middle of the chest. The breastbone is divided so that the heart and aorta is clearly visible to the surgeon. The heart’s activity is stopped for some time, so that the surgery can take place smoothly. During this time the aorta is connected to a bypass pump. This machine works like the heart and ensures an uninterrupted blood supply to the body.
If the aortic valve is defective or not working properly, it has to be replaced by a new aortic valve. This is known as replacement surgery. The surgeon will replace the defective valve with a fresh and properly working valve. There are two types of valves, which are generally used for replacement. They are:
Mechanical Aortic Valves: These aortic valves are strong and long lasting. They are made up of plastic, titanium or carbon. The problem with these valves is that blood tends to adhere to it and may create a problem of blood clotting, so the patients have to take anticoagulant drugs like Warfarin or blood thinning agents throughout their life.
Biological Aortic Valves: These types of aortic valves are made up of human or animal tissues. If taken from animal, it is known as Xenograft. If these tissues are taken from human heart (donated) it is known as Homograft or Allograft. Sometimes the biological valve is made out of the patient’s own tissues, which is known as Autograft. The biological valves are not as strong as the mechanical valves and lasts up to 10 to 20 years, after which they have to be replaced. The patient need not take any anti-coagulants as in the case of mechanical valves. Biological valves are used more often in the elderly patients because in children and young, the patients there is a danger of breakage of the biological valve.
After the replacement of the aortic valve, the surgeon checks the proper activity of the aortic valve. The bypass machine is disconnected and the aorta is again connected with the heart and the heart is closed. The fluid which accumulates around the heart is cleaned up; the breastbones are connected back together with stainless steel wires. The skin of the chest is sutured. The surgery goes about for 3 to 5 hours and the recovery time is 2 to 3 months.