The results of the aortic valve repair procedure depend on the skill and experience of the medical staff. Therefore, Bimaristan Medical Center works to direct the patient to the best specialized cardiac hospitals in Turkey.
Overview of the aortic valve
The aortic valve (aortic valve) consists of three leaflets (cusps) that rest on the annulus of the valve and separate the left ventricle of the heart from the ascending aorta.
The aortic valve opens in the systolic phase due to higher pressure within the left ventricle than in the aortic phase, and closes in the diastolic phase due to lower left ventricular pressure and higher pressure in the aorta.
The aortic valve allows oxygen-rich blood to pass from the heart to the aorta, which carries it to all the arteries of the body, and prevents it from returning to the heart when the pressure in the left ventricle drops in each heart cycle.
If the aortic valve does not work well, this will affect the blood flow and reduce the amount of blood reaching the body, forcing the heart to pump harder to deliver blood to all parts of the body.
Types of aortic valve disease
There are two main types of aortic valve disease:
- Aortic valve insufficiency (or aortic valve regurgitation): In this condition, the aortic valve does not close completely, allowing blood to return to the heart.
- Aortic valve stenosis: In this condition, the aortic valve is narrow and does not open enough to allow blood to leave the heart and circulate throughout the body.
The problem of the aortic valve may be congenital, or the valve may become diseased with age.
Bicuspid aortic valve is the most common congenital aortic valve disease, occurring in 1-2% in humans; Having two leaflets instead of three leaves the valve from fully opening and closing, and although the problem is present from birth, symptoms may not appear until adulthood.
Acquired aortic valve disease occurs when the valve is constantly damaged. Calcium builds up on the valve and makes the leaflets hard and narrow, limiting movement.
Aortic valve repair or replacement?
If the aortic valve problem is mild, it can be treated with medications, or it may not need treatment at all, but in some cases it is necessary to perform a repair or replacement of the aortic valve.
Aortic valve repair is now considered an alternative to valve replacement. It aims to restore normal aortic valve shape and function, and is most commonly used in patients with aortic valve insufficiency, proximal aortic aneurysm, or congenital aortic stenosis.
although Aortic valve replacement surgery It is the routine treatment in cases of severe aortic valve insufficiency. However, aortic valve repair, although not common, has many advantages that make it preferable to replacement in some suitable patients.
Aortic valve repair is preferred when aortic valve insufficiency occurs because it reduces the risk of blood clots, septic endocarditis and other infections associated with the use of replacement valves. Repairing a damaged valve is easier than replacing it and healing after the operation is faster.
Surgeons also prefer to repair the aortic valve rather than replace it when aortic valve insufficiency is associated with a nearby aortic aneurysm, which may lead to impaired aortic valve function.
It has proven studies If the aortic valve repair surgery is performed accurately and by experienced doctors, the results will be better than Aortic valve replacement surgery With a low mortality rate, the incidence of complications on the aortic valve after valve repair is lower than when it is replaced.
as that studies Others indicated that the survival rate after aortic valve repair was 96% after 1 year, 92% after 5 years, and 83% after 10 years.
Methods used in aortic valve repair in Turkey
The method of repairing the aortic valve varies according to the type of injury. Aortic valve repair aims to restore the normal anatomical structure of the aortic valve, and this leads to an almost complete restoration of valve function for a relatively long time.
The chest is usually opened and a procedure open heart surgery To repair the aortic valve in order to get a clearer view to accommodate the complex geometry of the valve, while Minimally Invasive Techniques Limits the ability to accurately judge the shape of the aortic valve.
as in Aortic valve replacement surgery The patient is placed under general anesthesia and connected to a cardiopulmonary bypass machine during aortic valve repair, and then the heart is stopped to analyze the exact shape of the aortic valve.
There are many techniques used to perform aortic valve repair, depending on the type and location of the aortic valve injury or disease, and research is still ongoing to discover more techniques that extend the life expectancy of the patient and improve the quality of life.
It is necessary to choose a medical team that specializes in performing aortic valve repair surgery because the results of the operation will depend on the skill and experience of this medical team. Bimaristan Medical Center Guide you and help you choose the right place, so that you get the best possible service and the best result.
Some of the techniques currently being performed for aortic valve repair:
Changing the shape of the leaflets of the aortic valve
The valve leafs are controlled and the appendages removed to make them fit together tightly when the valve is closed.
The two leaflets of the tricuspid aortic valve can also be sutured together and the valve changes shape and becomes like a bicuspid valve. This method is used to repair aortic valve insufficiency and cannot be used in case of aortic valve stenosis or in the case of congenital bicuspid aortic valve.
Repair of aortic valve lacerations and perforations
If the leaflets of the aortic valve have lacerations or holes, the surgeon can repair them with tissue grafts.
aortic ring annuloplasty
This technique is used when there is a widening of the aortic valve ring, which leads to the separation of the leaflets from each other and the occurrence of aortic valve insufficiency.
A special prosthetic ring is placed around the aortic valve to reinforce, stiffen and restore the aortic valve ring to increase valve sealing.
According to a studies The long-term results of this technique are satisfactory in treating this condition.
Valve-retaining aortic root replacement David Procedure
This procedure is specialized in treating aneurysms of the aortic root without replacing the aortic valve, and it replaced the Bentall operation, which was based on replacing the aneurysm with the aortic valve, whether the valve was damaged or healthy.
In this procedure, the aortic valve is removed extensively from its place, and then re-implanted with the replacement aneurysm graft, so this procedure is also called “aortic valve reimplantation.”
Balloon valvuloplasty توسيع
It is a minimally invasive technique commonly used toMitral valve stenosis repair Rarely, it is used to repair aortic valve stenosis, in which a small catheter carrying an expandable balloon is inserted into the heart, and when the balloon reaches the place of the narrowed aortic valve, it is inflated to dilate the valve and separate the leaflets from each other.
What after aortic valve repair?
A careful assessment of the aortic valve shape should be done after aortic valve repair; If one of the leaflets is too dilated, aortic valve prolapse may result, which, if left untreated, progresses to aortic valve insufficiency.
After the operation, the patient is transferred to the intensive care unit to spend at least one day there, and then he is transferred to a normal room in the hospital to stay there for several days. The length of stay in the hospital varies according to the technique used in the aortic valve repair.
During the patient's stay in the hospital, the medical staff will monitor his vital signs, ensure that there is no infection at the incision site, and manage post-operative pain.
The patient will also be helped to get out of bed and walk gradually, the recovery time depends on the type of procedure used to repair the valve, the patient's health condition before the operation, and the occurrence of any complications during or after surgery.
After discharge from the hospital, the patient may need to take some medications and will have to visit the doctor's office regularly for examinations, monitoring and evaluation of the aortic valve.
It is not necessary to take blood-thinning medications after aortic valve repair surgery as in Aortic valve replacement surgery with prosthetic valves, but thinners may be necessary if the patient has atrial fibrillation This is to prevent blood clots from forming in the left atrium.
The patient must make changes in his life to reach a healthy lifestyle, such as exercising, eating a healthy balanced diet, avoiding physical and psychological stress, and quitting smoking, all of which will help the patient recover faster and reduce the risks and complications that may occur in the future.
and indicate studies Only 1 out of 10 patients who had aortic valve repair surgery would need to repeat the operation within the first 10 years after the operation, and the durability of the aortic valve repair was excellent, especially in patients who had aortic valve annulus stenting.