Aortic Valve Repair and Replacement

If you have an aortic valve problem, surgery may be the best way correct it. Fortunately, Northwest Regional Heart & Vascular in Portland is home to some of this region’s most experienced cardiac surgeons, with particular expertise in the latest minimally invasive surgical techniques.

As a candidate for surgery, you are carefully evaluated by a multidisciplinary team to determine what technique is best for you: transcatheter aortic valve implantation, minimally invasive surgical aortic valve replacement, or, less commonly, conventional, open-chest surgical aortic valve replacement.

And you’ll be glad to know that the average hospital stay at Northwest Regional Heart and Vascular for patients undergoing aortic valve replacement is 4.48 days vs. a national average of 7.5 days, according to the Society of Thoracic Surgeons registry – a testament to the skill of our cardiac surgeons and our excellent nursing care.

What is aortic valve disease?

Aortic valve disease is a condition in which the valve between the left ventricle (the main pumping chamber of your heart) and the aorta (the main artery supplying blood to your body) doesn’t work properly.

Aortic valve disease may be congenital (the valve is defective at birth) and it worsens over time, or certain diseases can damage the valve.

  • Aortic valve stenosis (narrowing) occurs when the valve opening is smaller than normal, restricting blood flow
  • Aortic valve regurgitation, also referred to as a leaky valve, occurs when a valve doesn’t close tightly so blood leaks backwards (regurgitates)

Treating aortic valve disease

Valve replacement and valve repair are the two surgical options for treating aortic valve disease. Most patients with aortic valve disease will need valve replacement. Sometimes, part of the aorta may also need to be replaced.

  • When valve replacement is necessary, there are two kinds of prosthetic heart valves available today:
    • Mechanical valves are created from man-made materials and typically do not wear out. Patients with mechanical heart valves must take an anticoagulant (blood-thinning) medicine for the rest of their lives to prevent blood clots.
    • Biological valves are usually made from cow (bovine) or pig (porcine) tissue, and are less likely to cause clots. These valves are less durable, however, and younger patients may require another replacement later in life.

Homograft valves are obtained from a human heart donor, preserved and frozen. They are ideal valve replacement material in the presence of infection and in older patients when aortic root replacement is necessary.

  • For some patients, valve repair is the optimal treatment. With valve repair, the patient retains normal heart anatomy and function, and anticoagulation treatment isn’t required.

The most appropriate surgical treatment depends on your age, health, valve condition and personal preference. Working closely with you and your cardiologist, we can help you choose the most appropriate procedure for your specific situation.

How aortic valve replacement and repair are performed

  • Minimally invasive heart valve surgery – The majority of aortic valve replacements at Northwest Regional Heart and Vascular are performed through a small incision between the ribs on the right side of the chest. This minimally invasive approach results in shorter hospital stays, less pain and scarring, reduced need for blood transfusions, fewer restrictions and faster return to normal activities.
  • Traditional open-chest surgery – In patients who need cardiac interventions in addition to aortic valve replacement or repair, the surgeon may need direct access to the heart through an incision that divides the breastbone. A heart-lung bypass machine performs the work of the heart while the surgeon replaces or repairs the faulty valve.
  • Percutaneous aortic valve replacement – Also known as TAVI (transcatheter aortic valve implantation), this procedure is particularly advantageous for patients for whom surgery is too high risk. With TAVI, the replacement valve is delivered via a catheter that’s guided through an artery from the groin or the wrist to the heart.

Would you like to learn more about heart valve surgery in Portland? Please call us to schedule a consultation: (503) 257-0959.