Aortic valve replacement is a type of open-heart surgery. It is used to treat problems with the aortic valve in the heart.
The aortic valve
The heart has four chambers. There are two small chambers at the top of the heart called atria, and two larger chambers at the bottom called 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, also called 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 left ventricle of the heart to the body’s main artery (the aorta). From the aorta, the blood flows to the rest of the body.
The aortic valve opens to allow blood to flow from the heart out to the rest of your 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 it into the left ventricle
If the aortic valve is no longer working properly, surgery is usually used 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 incision in the chest 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 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. Each case is carefully selected and 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 currently the most effective treatment for aortic stenosis and aortic regurgitation. Alternative treatment options are usually used only if a person is too frail for open-heart surgery.
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
How common is aortic valve replacement surgery?
Just under 5,000 aortic valve replacements were carried out on the NHS in England from April 2010 to April 2011.
Aortic valve replacement requires both specialised training and equipment. Therefore, depending on where you live, your local hospital may not be able to provide this treatment.
If this is the case, you will need to be transferred to a hospital that does.
Read more about waiting times and choice in the NHS.
