Aortic Valve Replacement (AVR)

Background

The aortic valve controls blood flow between the left ventricle and the aorta, the large artery that delivers oxygen-rich blood to the body.

There are two main problems that can occur with the aortic valve: it can become hardened and narrowed (stenosis), or it can leak (regurgitation).

The most common problem in the elderly is called age-related calcific degeneration, where the gradual buildup of calcium causes the valve to narrow. In younger patients, a hereditary bicuspid valve (two leaflets instead of three) is a common cause. Other causes can include rheumatic heart disease or infection (endocarditis). Symptoms of aortic valve disease may include light-headedness, chest pain, shortness of breath and fatigue.

About the surgery

Aortic valve replacement is the most effective method of treating severe aortic valve disease. It involves removing the diseased valve and replacing it with an artificial valve. There are two types of artificial valves: biological (tissue) valves (commonly made out of pig tissue (porcine) or cow tissue (bovine)), and mechanical valves (made out of carbon fibre). Choosing whether to have a mechanical or tissue valve is a complex decision that every patient must make, and the patient should discuss the differences, and their own situation, with their surgeon. See our page on "Mechanical or Tissue Valve?" During the procedure, the sternum (breast) bone is divided to access the heart. The patient is then put on the heart-lung machine, the heart stopped, and the aortic valve is replaced. At this time the surgeon may also perform other procedures if needed, such as coronary artery bypass grafting, to avoid the patient needing another operation.

Recovery period

Patients usually stay in the intensive care unit for one to two days for monitoring, and then moved to the ward for four to five days. Two to three tubes stay in the chest to drain fluid from around the heart and are usually removed one to three days after the surgery. Full recovery usually takes about two months. Most patients are able to drive in about four to six weeks after surgery. Your surgeon will provide specific guidelines for your recovery and return to work.