Aortic valve surgery - minimally invasive
Alternative Names: Balloon valvuloplasty; Mini-thoracotomy aortic valve replacement or repair; Cardiac valvular surgery; Mini-sternotomy; Robotically-assisted endoscopic aortic valve replacement
Aortic valve surgery is done to replace the aortic valve in your heart.
Blood flows out of your heart and into the aorta through a valve. This valve is called the aortic valve. It opens up so blood can flow out. It then closes, keeping blood from flowing backwards.
- An aortic valve that does not close all the way allows blood to leak back into your heart. This is called aortic regurgitation.
- An aortic valve that does not open fully will restrict blood flow. This is called aortic stenosis.
Minimally invasive aortic valve surgery is done through much smaller cuts than the large cut needed for open aortic valve surgery.
Description of Procedure
Before your surgery you will receive general anesthesia. This will make you fall into a pain-free sleep.
There are several different ways to do minimally invasive aortic valve surgery. Techniques include laparoscopy or endoscopy, robot-assisted surgery, and percutaneous surgery.
- Your surgeon may make a 2-inch to 3-inch cut in the right part of your chest near the sternum (breastbone). Muscles in the area will be divided. This allows the surgeon to reach your heart and aortic valve.
- For the endoscopic, or keyhole, approach, your surgeon makes one to four small holes in your chest. Then your surgeon uses special instruments and a camera to do the surgery.
- For robotically-assisted valve surgery, the surgeon makes two to four tiny cuts (about 1/2 to 3/4 inches) in your chest. The surgeon uses a special computer to control robotic arms during the surgery. The surgeon sees a three-dimensional view of the heart and aortic valve on the computer. This method is very precise.
You will need to be on a heart-lung machine for all of these surgeries.
If your aortic valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your aortic valve and sew a new one into place. There are two main types of new valves:
- Mechanical -- made of man-made materials, such as titanium or ceramic. These valves last the longest, but you will need to take blood-thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life.
- Biological -- made of human or animal tissue. These valves last 10 to 12 years, but you may not need to take blood thinners for life.
In some cases, you will have coronary artery bypass surgery, or surgery to replace the first part of the aorta (large blood vessel leaving the heart) at the same time.
Once the new valve is working, your surgeon will:
- Close the small cut to your heart or aorta
- Place catheters (flexible tubes) around your heart to drain fluids that build up
- Close the surgical cut in your muscles and skin
The surgery may take 3 to 6 hours.
Aortic valve surgery can also be done through a groin artery. No cuts are made on your chest. The doctor sends a catheter (tube) with a balloon attached on the end to the valve. The balloon stretches the opening of the valve. This procedure is called percutaneous valvuloplasty.
Risks of Aortic valve surgery - minimally invasive
Risks for any anesthesia are:
- Bleeding
- Blood clots in the legs that may travel to the lungs
- Breathing problems
- Infection, including in the lungs, kidneys, bladder, chest, or heart valves
- Reactions to medicines
Other risks vary by the patient's age. Some of these risks are:
- Damage to other organs, nerves, or bones
- Heart attack, stroke, or death
- Infection of the new valve
- Kidney failure
- Irregular heartbeat that must be treated with medicines or a pacemaker
- Poor healing of incision
Learn more about Aortic valve surgery - minimally invasive
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network (1/26/2011).
Copyright 2011 A.D.A.M., Inc.
