Director, Cardiothoracic Surgery
Vice Chair, Surgery
Aortic Valve Replacement
The normal function of the Aortic Valve can be affected by many conditions or diseases such as rheumatic fever, infections, congenital birth defects, build-up of calcium deposits and the degeneration of the normal aging process. The two most common abnormalities of the aortic valve that requires surgery are aortic stenosis and aortic regurgitation.
The Surgical Approach
The surgeons at Maimonides perform three types of approaches (incisions) to aortic valve replacement. There are very specific reasons for each that your surgeon will discuss with you during the planning stages of your surgery.
Conventional sternotomy – This incision involves dividing the entire breast bone down the middle of your chest and is frequently used when your surgeon must perform coronary artery bypass(es) at the time of your aortic valve replacement.
Minimally Invasive Surgery (two types)
- A three to four-inch incision made on the chest which extends from right to left just to the right of your breast bone
- A three to four-inch, up and down incision dividing only the upper breast bone in the middle of your chest
In general, aortic valve replacement surgery takes approximately four hours. Additional time is necessary if coronary artery bypass surgery is also required. The usual stay in the Cardiothoracic Intensive Care Unit (CTICU) is one to two days, with three or four more additional days of recuperation in a less intense hospital environment.
An entire team of dedicated heart surgery professionals will guide you every step of the way through your hospitalization and beyond. The team meets every day to monitor your progress and establish a daily care plan for you based on your progress. These dedicated professionals include surgeons, cardiologists, nurses, nurse practitioners, physician assistants, social service staff and patient care representatives, all working together seamlessly with compassion and expert clinical judgment from your preoperative experience to eventual discharge to home or an extended care facility for further rehabilitation.
Heart Valves Used for Aortic Valve Replacement
In general, there are three types of heart valves used for Aortic Valve replacement. The choice of which valve is right for you is a complex decision that your doctor will discuss, in detail, with you. The decision is made for each individual patient and is influenced by things such as patient age, ongoing medical conditions, the nature of the aortic valve disease, lifestyle and your ability to take life-long anticoagulation medicine.
- Bioprosthetic Valve – heart valve manufacturers use the valve (or other heart tissue) from an animal such as pig or a horse and mount the tissue on a frame to make the valve sturdy and durable. This valve requires no long term anticoagulation medicine (“blood thinners”) but does begin to deteriorate in twelve to fifteen years.
- Mechanical Valve – these valves are made of new, high-tech carbon metals which, unlike the Bioprosthetic Valve, may function normally for many, many years without deterioration, however, they do require that the patient be placed on anticoagulation medicine (“blood thinners”) permanently.
- Biologic Valve – similar to the Bioprosthetic Valve in that it does not require blood thinners but it does deteriorate with time. This valve is obtained from human donors, usually after accidental death.