Introduction 

Aortic valve replacement is a type of open-heart surgery and is used to treat problems with the heart's aortic valve.

The aortic valve

The heart has four chambers. There are two small chambers at the top of the heart (atria) and two larger chambers at the bottom (ventricles). 

Each ventricle has two valves:

  • one valve controls the blood flowing into the ventricle
  • the other valve controls the blood flowing out of the ventricle

Each valve is made up of flaps, which are also known as leaflets or cusps. These flaps open and close, acting as one-way gates for the blood to flow through.

The aortic valve controls the flow of blood out of the heart's left ventricle to the body’s main artery (the aorta). From here, the blood travels to the rest of the body.

First, the aortic valve opens to allow blood to flow from the heart to the rest of the body. It then closes, to stop any blood leaking back into the heart.

Why is it necessary to replace the aortic valve?

The aortic valve may need to be replaced for two reasons:

  • narrowing of the valve (aortic stenosis) – the aortic valve becomes narrowed and obstructs the blood flowing through it
  • leaking of the valve (aortic regurgitation) – the aortic valve leaks and blood flows back through into the left ventricle

If the aortic valve is no longer working properly, surgery is usually needed to replace it.

Read more about why you might need aortic valve replacement surgery.

How is aortic valve replacement carried out?

During surgery, a cut is made in the chest to access the heart. The heart is then stopped and a heart-lung bypass machine is used to take over the circulation during the operation.

The aortic valve is removed and replaced with an artificial valve (prosthesis). The heart is then started again and the chest incision is closed.

Read more about what happens during aortic valve replacement surgery.

Risks

An aortic valve replacement carries a risk of complications, some of which can be life-threatening. Around 1 in 50 people who undergo this type of surgery die from complications either during or shortly after surgery.

However, if aortic stenosis and aortic regurgitation are not treated, there is a much higher risk of dying from these conditions. However, the benefits of aortic valve replacement will usually far outweigh any associated risk of surgery.

Read more about the risks of aortic valve replacement.

Alternatives to aortic valve replacement

An aortic valve replacement is the most effective treatment for aortic stenosis and aortic regurgitation. Alternative treatment options are usually only used if a person is too frail for open-heart surgery, or using the standard method carries a high risk of complications.

Alternatives to aortic valve replacement include:

  • transcatheter aortic valve implantation – the replacement valve is guided into place through the blood vessels rather than through a large incision in the chest
  • aortic valve balloon valvuloplasty – the valve is widened using a balloon
  • sutureless aortic valve replacement – the valve is not secured using stitches (sutures), to minimise the time spent on a heart-lung machine

How common is aortic valve replacement surgery?

Almost 5,000 aortic valve replacements were carried out on the NHS in England between April 2011 and April 2012.

An aortic valve replacement requires both specialised training and equipment. However, your local hospital may not be able to provide this treatment.

If this is the case, you will be transferred to a hospital that does.

Read more about waiting times and choice in the NHS.

Illustration of aortic valve replacement

Aortic valve replacement

 

  1. Aorta
  2. Coronary artery
  3. Plastic repair of valve
  4. Mitral valve  

 

Having an operation

If your GP has suggested you may need surgery, this guide is for you

Page last reviewed: 03/04/2014

Next review due: 03/04/2016