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Aortic Valve Repair

Aortic valve repair is cardiac surgery performed to treat aortic regurgitation (leakage) of the aortic valve. The aortic valve connects the left ventricle of the heart with the aorta, the body's largest artery, from where oxygenated blood is pumped to the rest of the body

Conventionally, the surgery is performed with a "median sternotomy" or an incision in the middle of the chest to allow access to the heart. This is followed by a cut in the aorta to allow the surgeon better view of the valve, while the patient is attached to the heart-lung machine.

Depending on the cause for regurgitation, the surgeon may perform an annuloplasty, or use sutures or a graft in order to restore the valve into good working order.

Aortic valve repair is well understood and is generally safe. It is performed under general anaesthesia.

Aortic valve repair is a surgery mostly performed on the young, and on patients whose valves are regurgitant but not stenotic, and uncalcified. The decision is weighed against the fact that aortic valve repair avoids the need for a patient to take anticoagulation medicine, and the fact that they are likely to outlive any aortic valve replacement, requiring further surgery in later life.

Possible reasons for an aortic heart valve to become regurgitant are degeneration of the aortic valve , bacterial endocarditis, rheumatic fever and Marfan's syndrome.

Aortic valve regurgitation develops gradually, and your heart often compensates for the problem. You may have no signs or symptoms for years, and you may even be unaware that you have the condition.

The primary symptoms of aortic valve regurgitation are: fatigue and weakness (esp. during physical activity), shortness of breath, chest pain, swollen ankles, heart palpitations and dizziness.

There are a number of ways to diagnose a regurgitant aortic valve, including: an echocardiogram, exercise tests, an MRI scan of the heart, an electrocardiogram (ECG), and chest X-rays. If these non-invasive methods are inconclusive, you may also require cardiac catheterisation, in which a small catheter is threaded through blood vessels to the aorta and dye is injected in order to provide a very clear X-ray picture.

Even if the regurgitant valve is not yet a problem, most doctors may recommend surgery in order to minimise long-term risk. There are no currently known alternative treatment options other than surgery. The alternative to an aortic valve repair is an aortic valve replacement, and the use of either is subject to each particular patient.

Aortic valve repair is a relatively common and well understood type of cardiac surgery, and is therefore generally safe and rarely results in major complications. It is performed under general anaesthetic.

Success rates vary depending on the underlying complexity of each case, but around 90% of patients need no further surgery in the next 5 years, and the surgical mortality rate is 1% or less.

Recovery depends on the health and age of the individual, but a full recovery may take up to 4-6 weeks, with most people returning home one week after their operation. There will be a single scar on the chest area. There are limitations on heavily lifting and driving for up to six weeks after the operation.