Overview

Chambers and valves of the heartEnlarge image

Aortic valve repair and aortic valve replacement are procedures to treat a damaged
or diseased aortic valve.

The aortic valve is one of four valves that control blood flow in the heart. It separates
the lower left heart chamber (left ventricle) and the body's main artery (aorta).

When the heart squeezes (contracts), the aortic valve opens and lets blood flow from
the left ventricle into the aorta. When the heart relaxes, the aortic valve closes to
prevent blood from moving backward.

A diseased or damaged aortic valve can interfere with blood flow and force the heart
to work harder to send blood to the rest of the body.

Aortic valve repair or aortic valve replacement can improve blood flow, reduce
symptoms of heart valve disease and prolong life.

Why it's done

Aortic valve regurgitationEnlarge image

Aortic valve stenosisEnlarge image

Aortic valve repair and aortic valve replacement are done to treat aortic valve
disease. Mild aortic valve disease without symptoms may only require frequent
health checkups. But most aortic valve conditions are mechanical problems that
eventually require surgery to reduce symptoms and the risk of complications, such
as heart failure, heart attack, stroke or death due to sudden cardiac arrest.

Types of aortic valve disease that may require treatment with aortic valve repair or
replacement include:

 Aortic valve regurgitation. Blood flows backward through the aortic valve into the
heart's main pumping chamber (left ventricle). Aortic valve regurgitation may result
from a leaky or dysfunctional valve. Any condition that damages the aortic valve can
cause regurgitation. Sometimes, a baby is born with an irregularly shaped aortic valve
(congenital heart defect) that leads to regurgitation.
 Aortic valve stenosis. The aortic valve is narrowed or blocked. It's hard for the valve
to open properly. The heart must work harder to pump blood into the aorta. Aortic valve
stenosis may be caused by a heart condition present at birth (congenital heart defect).
 An infection called rheumatic fever may lead to inflammation that damages the heart
valve (rheumatic heart disease).
 Other aortic valve problems present at birth (congenital heart defects). Some
babies may be born with an aortic valve that's missing a valve opening or that doesn't
have enough tissue flaps (cusps). A congenital heart defect can als

Treatment
Aortic stenosis can be treated either medically or surgically
depending on severity and/or symptoms. Surgical treatment may
consist of repair of the valve leaflets or replacement of the valve.
Surgery can be either an open repair or minimally invasive, based on
your individual case.

Open Surgical Aortic Valve Replacement

Open surgical aortic valve replacement (SAVR) is the treatment of

choice for aortic stenosis patients. During the procedure, the valve
leaflets are repaired or the damaged valve is removed and replaced
with a new valve. Visit our Surgical Aortic Valve Replacement
page to learn more about this open-heart procedure.

Minimally Invasive Transcatheter Aortic Valve

Replacement

For aortic stenosis patients who are not candidates for open-heart
surgery, we offer multiple minimally invasive, percutaneous
(through the skin) options for aortic valve replacement. Known as
transcatheter aortic valve replacement (TAVR), the procedures
involve the use of a catheter threaded through small incisions to
access the valve leaflets and repair them or to access the damaged
aortic valve and insert a new valve. Visit our Transcatheter Aortic
Valve Replacement page to learn more about minimally invasive
procedures.

Surgery to repair or replace an aortic valve is usually done through a cut (incision) in
the chest. Less invasive approaches may be available. Ask your health care provider
which type of procedure is best for you. Aortic valve surgery may be done at the
same time as other heart surgery.

Surgery options for aortic valve stenosis include:

 Balloon valvuloplasty. This procedure can treat aortic valve stenosis in infants
and children. In adults, the aortic valve tends to narrow again after the
procedure. So it's usually only done if you're too ill for surgery or you're waiting
for a valve replacement, because additional procedures are typically needed to
treat the narrowed valve over time.
In this procedure, a long, thin tube (catheter) with a balloon on the tip is inserted
into an artery in the arm or groin. It's guided to the aortic valve. Once in place,
the balloon is inflated, which widens the valve opening. The balloon is then
deflated, and the catheter and balloon are removed.
 Aortic valve replacement. Aortic valve replacement is often needed to treat
aortic valve stenosis. In aortic valve replacement, the surgeon removes the
damaged valve and replaces it with a mechanical valve or a valve made from
cow, pig or human heart tissue (biological tissue valve). Sometimes, the aortic
valve is replaced with the person's own lung (pulmonary) valve. The pulmonary
valve is replaced with a biological lung tissue valve from a deceased donor This
more complicated surgery is called the Ross procedure.
Biological tissue valves break down over time and may eventually need to be
replaced. People with mechanical valves will need to take blood-thinning
medications for life to prevent blood clots. Your health care provider will discuss
with you the benefits and risks of each type of valve.
 Transcatheter aortic valve replacement (TAVR). TAVR is an alternative to
open-heart aortic valve replacement surgery. This minimally invasive procedure
replaces a narrowed aortic valve with a valve made of cow or pig tissue. It may
be an option if you're at intermediate or high risk of complications from surgical
aortic valve replacement. Ask your health care provider about your options.
TAVR is done using smaller incisions and a thin, flexible tube (catheter) to
reach the heart. A flexible tube (catheter) is inserted into a blood vessel and
guided to the heart. A replacement valve made of cow or pig tissue is passed
through the catheter to the aortic valve area. A balloon on the catheter tip
inflates to press the new valve into place. Some valves can self-expand. The
surgeon removes the catheter once the new valve is securely in place.
Surgeons may also perform a catheter procedure to insert a replacement valve
into a biological tissue valve that is no longer working properly.

 Aortic valve repair. To repair an aortic valve, surgeons separate valve flaps
(cusps) that have fused. However, valve repair is rarely used to treat aortic
valve stenosis. Generally aortic valve stenosis requires aortic valve
replacement.