Aortic Valve Replacement

About Aortic Valve Replacement

Surgical aortic valve replacement removes a diseased aortic valve and replaces it with a prosthetic valve. The most common indication is aortic stenosis, a narrowing of the valve that becomes more frequent with age and in people born with a bicuspid aortic valve, and the operation is also performed for severe aortic regurgitation and for valve infection. The traditional approach is a median sternotomy with cardiopulmonary bypass, during which the heart is stopped, the aorta is opened, the damaged leaflets and calcium are removed and the new valve is sewn into the annulus. Less invasive variants use a partial sternotomy or a small incision between the ribs. Replacement valves are either mechanical, made of durable materials and requiring lifelong anticoagulation, or biological, made from animal tissue and tending to wear out over time. The choice depends on age, other conditions and patient preference. Transcatheter aortic valve replacement has become an alternative for many patients, but open surgical replacement remains a standard operation, particularly for younger patients and when other cardiac surgery is needed at the same time.