Aortic valve replacement is a procedure to replace a damaged valve that controls the flow of blood from the heart’s left ventricle (lower chamber) into the aorta, the body’s largest artery. The valve is comprised of three leaf-shaped flaps that open and close to let blood through. A valve is considered to be stenotic if it does not open fully because of stiffening or a defective formation of its flaps. When valve dysfunction causes blood to leak back into the ventricle, it is a condition called aortic regurgitation. In some cases, damaged valves can be repaired. When the damage is too severe for repair, replacement is necessary.
Biological replacement valves are made of human or animal donor tissue. Mechanical replacement valves use man-made materials, such as ceramic, stainless steel or titanium. With a biological valve, the patient may be able to avoid having to take blood thinners for life, but the valve will usually need to be replaced after 12 to 15 years. Mechanical valves last longer, but have a higher risk of blood clots so patients remain on blood thinners permanently.
Aortic Valve Replacement Procedures
In some cases, a pulmonary autograft will be performed. This procedure replaces the aortic valve with a section of the patient’s own pulmonary artery that includes the pulmonary valve. A transplanted valve from a human donor then replaces the pulmonary valve.
The traditional aortic valve replacement technique is an open heart procedure, performed after the sternum (breastbone) is cut through and separated to provide direct access to the heart.
Technological advances have resulted in less invasive procedures such as the Edwards SAPIEN Transcatheter Aortic Valve Replacement (TAVR). Reserved for cases of severe, inoperable heart valve disease, TAVR was only recently approved by the FDA. Florida Hospital is one of the first sites to perform this technique.