Aortic Valve Repair
By repairing the patient's own valve, aortic valve repair is a surgical technique used to treat aortic valve disease. Aortic valve repair aims to conserve and restore the patient's natural valve, as opposed to aortic valve replacement, which substitutes a prosthetic valve for the injured one.
About Aortic Valve Repair
Repairing the aortic valve involves surgery to fix structural defects or malfunctions in the valve, which controls blood flow from the left ventricle of the heart to the aorta. The goals of aortic valve repair are to return the valve to its typical function, stop more damage, and keep a valve replacement from being necessary.
Aortic Valve Repair Techniques:
There are several techniques used in aortic valve repair, each tailored to the specific characteristics of the valve and the patient’s condition:
- Valvuloplasty: This technique entails altering the annulus and valve leaflets to enhance their functionality. It may involve procedures like annuloplasty (reinforcing the valve ring), decalcification (removing calcium deposits), and commissurotomy (cutting the fused valve leaflets).
- Leaflet Repair: By excising extra tissue, patching weak spots, or suturing tears, surgeons can fix damaged or prolapsed aortic valve leaflets.
- Valve Reimplantation: The valve may occasionally be taken out of the aorta and then put back in. This aortic valve repair method can preserve the valve’s native anatomy while assisting in the correction of annular dilatation.
- Valve-Sparing Root Replacement: This is a more complex procedure that involves replacing the aortic valve repair root while preserving the patient’s own aortic valve. It is typically used for patients with aortic root aneurysms.
- Minimally Invasive Techniques: Compared to open heart surgery, some aortic valve repairs can be carried out using minimally invasive techniques, which involve smaller incisions, quicker recovery periods, and less scarring.
Procedure of Aortic Valve Repair
Usually, aortic valve repair is carried out in the cardiac surgery suite of a hospital while the patient is sedated. Depending on the chosen repair approach, there may be variations in the processes involved in the surgical operation.
- Anesthesia and Incision: General anesthesia is used during aortic valve repair. To access the heart and aorta, the surgeon performs a chest incision, typically a median sternotomy.
- Examination and Assessment: To ascertain the degree of damage or malfunction, the surgeon thoroughly inspects the Aortic Valve Repair. The structure and function of the valve can be evaluated using diagnostic techniques like transesophageal echocardiography.
Repair Techniques: Several techniques can be employed to repair the aortic valve, depending on the specific issue present:
a. Valve Reshaping: In cases of valve prolapse or regurgitation, the surgeon may reshape the aortic valve repair leaflets to ensure proper coaptation (closure) and prevent leakage.
b. Annuloplasty: If the valve annulus (the ring-like structure that supports the valve) is dilated or distorted, annuloplasty may be performed. This involves reinforcing and reshaping the annulus using sutures or an annuloplasty ring.
c. Leaflet Repair or Reconstruction: Damaged or torn valve leaflets can be repaired or reconstructed to restore their normal structure and function. This may involve removing excess tissue, reinforcing weak areas, or using tissue patches.Testing and Adjustment: Following aortic valve surgery, the surgeon performs testing on the valve to verify that it is functioning properly. To evaluate the closure of the valve and ensure there are no leaks, this may entail injecting a dye or saline solution.
Closing Incisions: The patient is weaned off the heart-lung machine and the chest incisions are closed.
Recovery: After being taken out of anesthesia, the patient is moved to a recovery room where they are closely watched. Eventually, for closer observation, they will be transferred to the intensive care unit (ICU).
Closure and Recovery: The surgeon uses sutures or staples to close the incisions after determining that the Aortic Valve Repair was effective. After surgery, the patient is moved to the intensive care unit (ICU) for recuperation, postoperative treatment, and monitoring.