Aortic Valve Replacement
The aortic and mitral valves replacement are most demanded procedures for treatment of valvular heart disease. The aortic valve is the hardest working of four heart valves that help blood to circulate inside the heart in a certain order. The aortic valve is located where the aorta enters into the left ventricle and it allows blood to flow from the heart to the lungs. As blood pressure in the left ventricle is always high, the aortic valve that carries out a function to open the blood way to the aorta and to prevent its moving back tends to degenerate overtime and may need repair or replacement. Heart Surgery Department of the Clinic of Braunschweig in Germany provides surgical intervention of different complexity to restore the function of the heart valves.
Problems of the Aortic Valve
There are two common types of the problem with valves:
- Stenosis is hardening of valve tissues which is normally caused by calcium deposits appearing on the walls with aging. The valve becomes stiff, narrow and hard to open. When the aortic valve is obstructed the pressure in the left ventricle is increased and it could lead to serious disorders including the heart failure. The symptoms of aortic stenosis are chest pain, dizziness, breath shortage, swelling of the limbs but sometimes there are no symptoms and you could know you have stenotic valve only on higher degree of disease.
- Regurgitation is insufficiency or leakage of the heart valve. When aortic valve becomes regurgitant it does not close completely and blood goes backward from the aorta making the heart work harder to push it out. This condition rarely can be improved with repair and means that you need valve replacement.
Aortic Valve Replacement
There are few types of surgery for valve replacement:
- Open chest surgery
- Percutaneous surgery
- Robotic surgery
Open Chest Valve Replacement
Open chest surgery is a traditional procedure for complex heart operations. If you also need coronary artery bypass or a few of your valves need to be replaced, you probably will be advised to have open surgery. It is performed through a large incision in the beast bone and takes 4-6 hours. As a rule, cardiopulmonary bypass is used which takes a function of the heart and the lungs in supplying the brain and the tissues with oxygen during the surgery while the heart is stopped.
Though there are many contraindications and a row of patients become illegible for open chest surgery because weak overall health and age but the procedure gives durable result and lengthen the life expectancy. That is why many cardiac surgeons still prefer the traditional approach to valves repair and replacement.
Percutaneous surgery is a non invasive or minimally invasive (depending on technique) procedure when approach to the heart is performed via catheter inserted through the needle puncture in patient’s skin. The other name for it is Transcatheter aortic valve replacement (TAVR).
The main reason to consider TAVR is decreasing risks related to surgery. Industrialization, higher life standard and development of medicine lead to increasing a life expectancy and a number of older people. But elderly need more sparing methods of interventions and percutaneous surgery opens to them new possibilities.
During transcatheter aortic valve replacement a valve implant is transported to its location by means of specially designed delivery system via one of possible sites:
- Via femoral artery in the groin in the similar way as stent to diseased artery or vein
- Via incision between ribs and a puncture in the heart
- Via the right upper breast bone and a puncture in the aorta
Once the implant is placed inside of diseased aortic valve, the system is removed and inserted device push the degenerative aortic valve out of the way of blood flowing.
There are some contradictions regarding the efficiency of the procedure. Though TAVR is obviously more sparing technique and it also has such benefits as faster recovery and cost saving options that follows from shorter stay in a hospital it is high probability of need in repeated procedure. For younger people with higher life expectancy the surgery is more recommended option.
The multidisciplinary team of the Clinic of Braunschweig always evaluates and weighs the all pro and contra choosing invasive method. Every individual case is decided based on the diagnostics results, age, related diseases and risks of complications. The main goal of Heart Surgery Department is durability and increasing of a lifetime.
If you wish to know more about aortic valve surgery or apply for personal consultation please use our callback service. Our specialists give you detailed information on treatments and costs.