Aortic Valve Replacement Surgery - Medical Negligence Solicitors Claims


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Aortic Valve Replacement Surgery

The aortic valve is the valve in the heart that opens up to let blood flow out to the body. It normally opens completely and closes completely so blood does not go backwards into the heart when the heart is beating. You may need to have an aortic valvular surgery if the aortic valve doesn’t open all the way and the heart has to pump extra hard to get blood out. This is known as aortic stenosis. You may also need to have aortic valvular surgery if the aortic valve doesn’t close fully so blood leaks back into the heart. This is known as aortic regurgitation.

There are two ways of replacing the aortic valve. These include an open aortic valve surgery, in which a large chest incision is made and a minimally invasive aortic valve surgery, which is done by making several small cuts in the chest wall. There is always the risk that the minimally invasive surgery will fail so that an open aortic valve surgery must be performed on the same day.

Both types of surgery require general anaesthesia. In minimally invasive surgery, there are several ways to do it. These include doing a thoracoscopy, also called endoscopy, robotic-assisted surgery, and percutaneous surgery. The surgeon might make a 2-3 inch cut on the right side of your chest very near the sternum. The muscle is separated so the surgeon can reach the aortic valve. In the endoscopic approach, the surgeon will make up to 4 holes in the chest, one of which is for a lighted camera and the rest are used for surgical tools.

If the surgery is done robotically, the surgeon makes 2-4 small cuts in the chest wall. Each cut is less than an inch long. A special computer is used by the surgeon to control small robotic arms that manipulate the aortic valve while the doctor looks on in a 3 dimensional view of the heart and valve. For all procedures, a heart-lung machine will need to be utilized.

If the doctor determines that your aortic valve is too damaged to be fixed, it will have to be replaced. The old aortic valve will be cut out and a new aortic valve will be put in its place. There are two types of aortic valves:

  • Biologic, in which it is a valve made of human tissue or animal tissue.
  • Mechanical, which is usually a titanium or carbon-made valve. These last longer than biologic valves.

Surgery generally takes three to six hours, depending on the type of surgery and on any complications you might have. There is one aortic valvular surgery that has no incisions. A catheter is inserted into the femoral artery in the groin. It is passed up to the aortic valve. A balloon at the end of the catheter is inflated so that the opening to the aortic valve is greater. This is known as a percutaneous valvuloplasty.

There are complications to all of these procedures. There are anaesthesia risks such as breathing problems and cardiac arrest. There are bleeding complications from all procedures. You can get a deep vein thrombosis or pulmonary embolus from clotting problems in surgery. You can have reactions to medications given in surgery. Infection of the heart valves, lungs, kidneys, chest or bladder can happen.

There are risks that increase with age, including having a heart attack, stroke or sudden death. You can have damage to nerves, bones or other organs. The new valve can become infected. You can have kidney failure, poor incisional healing, or an irregular heartbeat. You may need to use a pacemaker after the procedure.

While mechanical valves rarely fail, it is more common for them to have blood clots develop on them that may become embolic and lead to a stroke. You can have bleeding from this surgery, but it is uncommon.

Biological valves have a lesser degree of blood clots but they have a higher failure rate. Minimally invasive heart valve surgery can be risky if the surgeon does not have the skill to do the procedure without complications.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here