Aortic Valve Replacement

What You Should Know:

• Aortic valve replacement is surgery to fix the aortic valve in your heart. The heart has two upper chambers or rooms called atria, and two lower chambers called ventricles. The atria get blood from the body. Blood in the atria goes through valves (doors) into the ventricles. The job of the valves is to keep the blood flowing in one direction through the heart. Your aortic valve is between your left ventricle and aorta. The aorta is the large blood vessel that carries blood from the heart to the body. In most people, the aortic valve is made up of three smaller doors or cusps attached to the aortic ring. The cusps come from each side and the top of the aortic ring and meet in the middle.
  
  
• The two reasons for an aortic valve replacement are aortic regurgitation and aortic stenosis.
  
  
  • Aortic regurgitation means that one or more of the cusps in the aortic valve do not close completely. The cusps may bulge into the ventricles when the ventricles are filling with blood during a heart beat. When this happens, blood leaks backward.
    
  • Stenosis means narrow or tight. When the aortic valve has a stenosis, it cannot let all the blood in the atrium get into the ventricle.
    
    
• Both aortic regurgitation and aortic stenosis cause blood to stay in the atrium. Over time, blood will back up into the lungs and your heart may begin to weaken and fail. Your body needs a certain amount of blood, with the right amount of things like oxygen, in it. If you have heart failure, your heart cannot send the right amount or type of blood to your body. During surgery, your aortic valve is removed and replaced with a human, animal, or man-made mechanical valve.

Getting Ready:

• The week before your surgery: 

  • You may need a blood transfusion if you lose a large amount of blood during surgery. Some people are worried about getting AIDS, hepatitis, or the West Nile virus from a blood transfusion. The risk of this happening is very low. Blood banks test all donated blood for AIDS, hepatitis, and the West Nile virus. You may be able to donate your own blood before surgery. This is called autologous blood donation. This must be done no later than three days before surgery. You may also ask a family member or friend with the same blood type to donate blood for you. This is called directed blood donation.
    
  • ICU:You may be given a tour of the intensive care unit (ICU) before your surgery to help you become familiar with where you will go after surgery.
    
  • Medicine:
    
    • Talk to your caregiver if you use aspirin or ibuprofen.
      
    • Ask your caregiver before taking any over-the-counter medicine, vitamins, herbs, food supplements, or laxatives.
      
  • Tests:You may need to have blood drawn for tests. Ask your caregiver for more information about these and other tests that you may need.Write down the date, time, and location of each test. 

  The night before your surgery: 

  • You may be offered medicine to help you sleep.
    
  • Ask caregivers about directions for eating and drinking.

The day of your surgery: 

• Write down the correct date, time, and location of your surgery.
  
• Ask your caregiver before taking any medicine on the day of your surgery. These medicines include insulin, diabetic pills, blood pressure pills, and heart pills. Bring a list of your medicines or the pill bottles with you to the hospital.
  
• Do not wear contact lenses on the day of surgery. You may wear glasses.
  
• Bring necessary personal belongings, such as a toothbrush, to the hospital with you.
  
• An anesthesiologist will talk to you before your surgery. This caregiver will give you medicine to make you sleep during surgery.
  
• You or a close family member may be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do surgery. It also explains the possible problems that can happen with surgery and your choices. Be sure all of your questions have been answered before you sign this form.
  
• Ask a family member or friend to drive you home when you leave the hospital. Do not drive yourself home.

Treatment:

What will happen: 

• You will be asked to change into a hospital gown. You may be given medicine in your IV to help you relax or make you drowsy. You will be taken on a bed to the operating room. You will get medicine called general anesthesia to prevent pain and keep you asleep during surgery.
  
• An incision (cut) is made in your chest. Caregivers will use tubes to connect your heart to a bypass machine. This machine keeps blood out of the heart during surgery. After surgery, the blood is able to flow through your heart again.
  
• Your aortic valve will be removed and replaced with a human, animal, or man-made mechanical valve. Your heart will also be checked to make sure there is no bleeding. Any air inside your heart will be removed. The heart-lung machine is stopped and your own heart and lungs will start working again. The incision in your chest is closed with wire and stitches or staples.

After surgery: You are taken to the recovery room or an intensive care unit (ICU). Caregivers will watch you very closely. A bandage is used to cover your stitches or staples. This bandage keeps the area clean and dry to help prevent infection. A caregiver may remove the bandage shortly after surgery to check the incision. Do not get out of bed until your caregiver says it is OK. Additional instructions will be provided by your caregivers to lead you to recovery.  Your family may be allowed to visit you in the ICU for a short visit several times a day.

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