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Aortic Valve Replacement (AVR): What is it and How is it Done?

Aortic Valve Replacement (AVR): What is it and How is it Done?

An aortic valve replacement (AVR) is a type of open-heart surgery that treats the problem related to the heart’s aortic valve. The aortic valve is responsible to regulate the flow of blood pumped by the heart to the entire body. Cardiologists explain the aortic valve contains three tissue flaps called cusps; hence it is a tricuspid valve.

A person is required to undergo an aortic valve replacement if his or her aortic valve is not working properly. Experts explain aortic valve regurgitation and aortic valve stenosis are two different types of problems that might require a valve replacement.

  • In aortic regurgitation, the valve is leaky. Some blood flows back to the heart instead of flowing to other parts of the body.
  • In aortic stenosis, the valve is unable to open fully. This results in less blood flowing to other parts of the body.

In both cases, a person is required to undergo aortic valve replacement surgery.

A person with poor aortic valve function may experience the following symptoms:

  • Chest pain
  • Leg swelling
  • Passing out
  • Dizziness
  • Fatigue
  • Breathing difficulties

If a person experiences these symptoms or they get worse, he or she may need to undergo the surgery.

A health expert can suggest undergoing aortic valve replacement surgery only after conducting an echocardiogram or heart ultrasound.

Aging is one of the common factors that result in aortic regurgitation and aortic stenosis. The other factors include:

  • Certain genetic conditions like Marfan syndrome
  • Birth defects
  • Heart valve bacterial infection

Risks of aortic valve replacement

Aortic valve replacement is a major surgery. There are certain risks involved like:

  • Infection
  • Heart rhythm problems
  • Valve dysfunction in replacement valves
  • Bleeding
  • Blood clots
  • Stroke
  • Death, although rare

Understand the risks and precautions of this surgery from the doctor or surgeon before undergoing aortic valve replacement.

How to Prepare for AVR

Before undergoing the surgery, you should get all the details about aortic valve replacement from the doctor.

The patient is required to sign a permission form that permits the surgeon to perform the surgery. Read the form carefully and fill all necessary details. In case of doubt ask a doctor or any healthcare professional.

A doctor may ask for a complete medical history, perform a few physical examinations and blood tests to ensure good health for the surgery.

The patient will be instructed to avoid consuming any food and fluids for 8 hours before the surgery. Generally, the patient is asked to stop eating or drinking after midnight.

If a woman is pregnant or think she is pregnant, should inform the health expert before the surgery.

A person should inform the doctor if he or she is allergic to anaesthetic agents, medicines, tape, latex, and iodine. Also, a doctor should know the patient’s medicine, drug, supplement, or herbal intake to prevent any possible interactions or side effects.

A patient having a history of a bleeding disorder or using any anticoagulant medicines (blood-thinning drugs), aspirin, or any medicine should inform the surgeon as these drugs may affect blood clotting. The surgeon may instruct to stop certain medicines until surgery or post-surgery recovery.

A few doctors may perform a blood test before surgery to examine the person’s blood clotting procedure and healing.

A patient who smokes should avoid smoking as soon as possible. Health experts believe avoiding cigarette smoking improves the chances for a successful post-surgery. Overall, stopping smoking cigarettes is beneficial for health and well-being.

aortic valve replacement

What Happens During AVR?

General anesthesia is used to perform an aortic valve replacement surgery. General anesthesia makes the patient unconscious throughout the procedure and he/she does not feel pain while the surgeon performs aortic valve replacement.

During the procedure, a surgeon makes a large incision approximately 25 cm long in the middle of the breastbone. This helps the doctor to access the heart properly and perform the surgery.

Next, the tubes are inserted in the heart and major blood vessels which are attached to the heart-lung machine (a bypass machine). This machine acts like the heart throughout the procedure.

The surgeon will inject a drug into the heart which will stop the heart. This also helps the main artery, Aorta, to stop working. This allows the surgeon to operate properly while the heart-lung machine takes care of the patient’s body.

The surgeon will open the aorta and remove the damaged aortic valve and place a new valve with the help of stitches.

Once done, the surgeon uses electric shocks to start the heart to pump again. As the heart starts to pump, the tubes and wires attached to the heart and major blood vessels are removed which were connected to the bypass machine.

After that, the surgeon joins the breastbone and the wounds on the chest are closed with the help of dissolvable stitches. The surgical site is then covered by bandages.

Recovery Period

Majority of patients who underwent heart valve replacement or repair surgery are advised to be under observation for a week. The medical care professionals will examine and monitor the patient’s heart functioning, breathing, blood pressure, and offer pain relief medicines accordingly.

A patient should know that a full recovery will take several months, depending on the age, healing rate, health condition, and the type of surgery.

Ensure the incisions are clean and dry. In case of infection or any health issue, contact the surgeon immediately. Also, contact the surgeon if the patient experiences the following:

  • Increased drainage from the incision area
  • Swelling or tenderness at the incision area
  • Fever
  • Chills

Ensure, before getting discharged from the hospital, the patient understands the ways to care and manage incision.

Post-Surgical Care

After the discharge, ensure someone drives the patient safely to his or her home.

  • A patient may feel exhausted post-surgery. Therefore, the patient needs to rest and regain his or her strength. It may take a few weeks to regain strength.
  • Once at home, the patient needs to check his or her body temperature and weight daily. If the body temperature is above 100.4 degrees Fahrenheit (38 degrees Celsius) or there is a change in body weight, contact the health expert immediately.
  • Do not lift heavy weighted objects for a few weeks. Consult a doctor before trying to lift heavy objects or while performing normal activities.
  • Follow the diet, exercises, medicines, and wound care instructed by the health expert.
  • Avoid performing stressful workouts until the doctor suggests.

A surgeon will set an appointment for stitches or staple removal post-surgery. Till that time, ensure healthy wound and incision care and safety.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources
Aortic valve replacement/https://www.nhs.uk/conditions/aortic-valve-replacement/Accessed on 26/02/2020 Aortic Valve Surgery: Procedure Details/https://my.clevelandclinic.org/health/treatments/16745-aortic-valve-surgery/procedure-details/Accessed on 26/02/2020 Aortic Valve Surgery/https://my.clevelandclinic.org/health/treatments/16745-aortic-valve-surgery/Accessed on 26/02/2020 Options for Heart Valve Replacement/https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options/options-for-heart-valve-replacement/Accessed on 26/02/2020 Heart Valve Repair or Replacement Surgery/https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/heart-valve-repair-or-replacement-surgery/Accessed on 26/02/2020 Valve Replacement Surgery/https://www.healthline.com/health/heart-disease/valve-replacement-surgery/Accessed on 26/02/2020 Aortic valve surgery - minimally invasive/https://medlineplus.gov/ency/article/007407.htm/Accessed on 26/02/2020 Aortic Valve Replacement/https://www.ncbi.nlm.nih.gov/books/NBK537136/Accessed on 26/02/2020 Aortic valve repair and aortic valve replacement/https://www.mayoclinic.org/tests-procedures/aortic-valve-repair-aortic-valve-replacement/about/pac-20385093/Accessed on 26/02/2020
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Written by Nikita Bhalla Updated Apr 05
Fact Checked by Hello Doctor Medical Panel