What Is a Surgical Aortic Valve Valvuloplasty (SAVV) Procedure?

Most aortic valves that have failed due to narrowing (aortic stenosis) need to be replaced.  However, there are certain circumstances when the valve is leaking (aortic regurgitation) when the valve may be repaired (aortic valvuloplasty) instead of replaced.  This is an advantage as the patient’s native valve is preserved.

Circumstances where this might be possible include:

  • aortic dilatation
  • a leaflet perforation

In these cases, it might be possible for the surgeon to achieve a good result without replacing the valve.  The patient must be prepared for a valve replacement if an adequate result is not achieved with the initial repair.

Surgical Aortic Valvuloplasty is often combined with other surgery such as Coronary Artery Bypass Graft Surgery (CABGS), or replacement of the beginning of the aorta if needed.

What Happens in Surgery?

The traditional way of repairing an aortic valve is with open chest surgery.

The patient is placed under general anaesthesia and the chest opened down the middle of the breast bone (sternum).  This gives excellent access to the heart and the bone heals well afterwards.  There other key-hole surgical approaches that might be suitable in certain circumstances.

The blood leaving the heart is diverted to a heart-lung machine and returned to the body full of oxygen to completely replace the heart function.  The heart is then cooled and stopped to give perfect surgical conditions.  The old valve is removed and a new valve is sewn in place.  Once that is complete the heart is warmed and restarted before returning to normal circulation and closing the chest.

What Happens After Surgery?

The patient is then taken to the intensive care unit where they usually remain for just one day.  Surgical drains and wires are removed over the next couple of days and the patient would usually leave the hospital at one week. Some patients benefit from a brief stay at inpatient rehabilitation afterwards.

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