Aortic valve replacement

Aortic valve replacement is a type of open heart surgery to treat problems affecting the aortic valve in the heart.

During surgery, an incision (cut) is made in the chest to access the heart. The heart is then stopped and a heart-lung (bypass) machine is used to take over the circulation during surgery. The aortic valve is removed and replaced with a prosthesis (a man-made valve). The heart is then started again and the incision in the chest is closed.

The heart

The heart has four chambers. There are two small chambers at the top of the heart called atria, and two larger chambers at the bottom which are called ventricles. Each ventricle has two one-way valves:

• one valve controls the blood flowing into the ventricle, and
• the other valve controls the blood flowing out of the ventricle.

Each valve is made up of flaps (also called leaflets, or cusps) that open and close, acting as one-way gates for the blood to flow through.

What is the aortic valve?

The aortic valve is the valve that controls the flow of blood out of the left ventricle of the heart, to the aorta (the body’s main artery). From the aorta, the blood flows to the rest of the body.

The aortic valve opens to allow blood to flow from the heart out to the rest of your body. It then closes to stop any blood leaking back into the heart.

Aortic valve replacement

There are two reasons that the aortic valve may need to be replaced:

• stenosis (narrowing) - if the aortic valve becomes narrowed and obstructs the blood flowing through it, or
• regurgitation (leaking) -  if the aortic valve leaks and blood flows back through the it into the left ventricle. This is also known as incompetence or a leaking valve.

If the aortic valve is no longer working properly, an aortic valve replacement is the usual method of treatment.

Each year, over 200,000 aortic valve replacements are carried out worldwide. In the UK, during 2007, the survival rate for the procedure was approximately 98%. This was as good as, or better than, the survival rates in the USA and Europe.

Incision
An incision is a cut made in the body with a surgical instrument during an operation.

Bypass
A bypass is when the flow of blood or other fluid is redirected, permanently because of a blockage in the body, or temporarily during an operation.