Aortic Valve Surgery: Aortic Valve Repair and Replacement
Aortic valve stenosis (narrowing) and aortic valve regurgitation are two types of aortic valve disease that affect the function of the aortic valve. Stenosis causes a buildup of calcium deposits, which limits the mobility of the aortic valve and restricts blood flow. During regurgitation, the valve does not close properly and blood that has been ejected from the heart leaks back into the heart. Your heart pumps harder to compensate for these disorders, which can result in inadequate blood circulation to the rest of your body.
What is Aortic Valve Surgery?
Aortic valve disease may be treated medically in its initial stages, but surgery becomes necessary when a patient develops heart failure or significant heart damage. The damaged valve can be either replaced or repaired.
Aortic Valve Surgery at Brigham and Women’s Hospital
Open heart surgery, which involves opening the chest with a nine-inch incision and cutting through the sternum, has long been the standard approach for aortic valve replacement. However, specialists at the Brigham Cardiac Valve Center also offer two minimally invasive aortic valve replacement procedures that are designed to result in less trauma, less blood loss, less pain, and a shorter hospital stay.
Upper mini-sternotomy – A small (three-inch) incision is made in the chest, and much of the sternum remains intact.
Transcatheter Aortic Valve Replacement (TAVR) – A heart valve is placed on a catheter and inserted through an artery in the upper leg and guided into the heart chambers, where a balloon is inflated to open up the diseased aortic valve. After positioning the catheter, the surgeon inflates the balloon to expand the new valve and secure it into place.
The replacement valves for these surgeries may be either mechanical or biological (made from animal tissue or donated human tissue).
Although replacement is the more common surgical approach for treating aortic valve issues, the valve is sometimes repaired. Examples of these surgical techniques for aortic valve repair are:
Commissurotomy – removal of a valve leaflet (section) that is too wide.
Valvuloplasty – installation of a ringed device that helps support a weak valve.
Decalcification – removal of calcium to prevent leakage.
Repair of structural support – reshaping of fibrous strings that support the valves.
Patching holes to stop leakage.
Reshaping a misshapen valve.
Cardiovascular Care at Brigham and Women’s Hospital
The Carl J. and Ruth Shapiro Cardiovascular Center at BWH is one of the most advanced centers of its kind in the New England region. Bringing together the full range of cardiovascular services in one building, the Center provides the technology and infrastructure to enable seamless and coordinated care for all cardiovascular patients.
Patient- and Family-focused Care
BWH has long been committed to not only the care of our patients seeking aortic valve replacement surgery, but also the many other needs that they and their families have. This philosophy of patient- and family-focused care – involving systems and services that emphasize healing in a comfortable, relaxed environment – is a guiding force behind the care we provide at the Center.
Quality of Patient Care
BWH is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our Inpatient Satisfaction Survey, sent to patients’ to assess their total care experience, helps us to monitor what we are doing well and where we could improve. We pride ourselves in the Quality of Patient Care we provide and how we compare with other hospitals.