Aortic valve repair

Aortic valve repair or aortic valve reconstruction describes the reconstruction of both form and function of the native and dysfunctioning aortic valve. Most frequently it is applied for the treatment of aortic regurgitation. It can also become necessary for the treatment of aortic aneurysm, less frequently for congenital aortic stenosis.

An aortic valve repair will realistically be possible in the absence of relevant calcification or shrinking (retraction) of the aortic valve. Thus, congenital aortic stenosis may be treated by aortic valve repair. In acquired aortic stenosis valve replacement will be the only realistic option. In most instances aortic valve repair will be performed for aortic regurgitation (insufficiency). Aortic valve repair may also be performed in the treatment of aortic aneurysm or aortic dissection if either aneurysm or dissection involve the aorta close to the valve. The need for surgery on the aortic valve (including repair procedures) is indicated through objective criteria and the presence of symptoms.

Indication for aortic valve repair:

The goal of the operation is the improvement of life expectancy and treatment of heart failure as the consequence of dysfunction of the aortic valve. The goal may also be to avert complications of the aorta (rupture or dissection) in the treatment of aneurysm. Repair is a more recent alternative to replacement; in many instances replacement will be the only realistic option because of severe destruction of the valve.

While replacement of the aortic valve is a safe and reproducible procedure it may still be associated with the long-term occurrence of so-called valve-related complications. The probability of these complications depends on the age of the patient and the type of operation, but they have to be expected. Typical complications are blood clot formation (thrombus) on the valve or dislodgment of thrombus (embolism); bleeding complications are commonly a consequence of “blood-thinning” medication (anticoagulation). All biologic replacement devices have a tendency to degenerate, and there is also in increased risk of infections of valve prosthesis (prosthetic valve endocarditis). Compared to the results of valve replacement there will be a minimal tendency towards clot formation after aortic valve repair, and anticoagulation is commonly not necessary, thus minimizing the possibility of bleeding complications. The likelihood of infection of the repaired aortic valve is much lower compared to what is seen after aortic valve replacement. A repair procedure may not last forever, but in many instances the durability of an aortic valve repair will markedly exceed that of a biological prosthesis.

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Wikipedia