January 22, 2013 in Features

Aortic valve surgery described

Anthony L. Komaroff Universal Uclick
 

DEAR DOCTOR K: I have aortic valve regurgitation and need to have my aortic valve replaced. What will happen during this procedure?

DEAR READER: When it’s working properly, your aortic valve opens to allow oxygen-rich blood to flow from your heart into your aorta and out to the rest of your body. The aorta is the body’s largest blood vessel.

Heart valves keep blood flowing in just one direction – the direction the heart wants to pump blood. Particularly when you’re sitting or standing up, gravity wants to pull blood back down into the heart from the aorta. A healthy aortic valve prevents gravity from pulling blood back down into the heart.

If it doesn’t close tightly, blood can re-enter the heart, causing aortic regurgitation. It can cause fatigue, shortness of breath, fainting and other symptoms.

If your symptoms are severe, or if the condition is weakening your heart, you may need to have your aortic valve replaced with a prosthetic valve.

The traditional surgery involves splitting the breast bone, exposing the heart and then replacing the valve.

After your heart is exposed, your heart will be cooled and stopped while the surgery is being performed. Since your heart has stopped, you need a machine – a heart-lung machine – to get oxygen in your blood and pump it around the body.

Once your heart is motionless, the surgeon will remove the malfunctioning heart valve, insert the prosthetic valve and stitch it into place.

Once your heart is pumping steadily without leaking blood, you will be disconnected from the heart-lung machine. The surgeon will reattach the halves of your breastbone and your chest incision will be closed.

For some patients, the heart surgeon can replace a heart valve through a smaller incision. New technologies allow artificial valves to be inserted into the heart without making even a small opening in the patient’s chest.

To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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