Definition of Aortic valve surgery - open:

Blood flows out of your heart and into the aorta through a valve. This valve is called the aortic valve. It opens up so blood can flow out. It then closes, keeping blood from flowing backwards.

Aortic valve surgery is done to either repair or replace the aortic valve in your heart.

• An aortic valve that does not close all the way allows blood to leak back into your heart. This is called aortic regurgitation.
• An aortic valve that does not open fully will restrict blood flow. This is called aortic stenosis.

In open surgery, the surgeon makes a large incision (cut) in your breastbone to reach the heart and aorta.

See also: Aortic valve surgery - minimally invasive

Description:

Before your surgery you will receive general anesthesia. This will make you unconscious and unable to feel pain.

• Your surgeon will make a 10-inch-long cut in the middle of your chest.
• Next, your surgeon will separate your breastbone to be able to see your heart and aorta (the main blood vessel leading from your heart to the rest of your body).
• Most people are connected to a heart-lung bypass machine or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart while your heart is stopped.

If your surgeon can repair your aortic valve, you may have:

• Ring annuloplasty -- The surgeon repairs the ring-like part around the valve by sewing a ring of metal, cloth, or tissue around the valve.
• Valve repair -- The surgeon trims, shapes, or rebuilds 1 or more of the 3 leaflets of the valve. The leaflets are flaps that open and close the valve.

If your aortic valve is too damaged, you will need a new valve. This is called replacement surgery. Your surgeon will remove your aortic valve and sew a new one into place. There are two main types of new valves:

• Mechanical -- made of man-made materials, such as cloth, metal, or ceramic. These valves last the longest, but you will need to take blood-thinning medicine, such as warfarin (Coumadin) or aspirin, for the rest of your life.
• Biological -- made of human or animal tissue. These valves last 12 to 15 years, but you may not need to take blood thinners for life.

Once the new or repaired valve is working, your surgeon will

• Close your heart and take you off the heart-lung machine.
• Place catheters (tubes) around your heart to drain fluids that build up.
• Close your breastbone with stainless steel wires. It will take about 6 weeks for the bone to heal. The wires will stay inside your body.

This surgery may take 3 to 6 hours.

Sometimes other procedures are done during open aortic about surgery. These include the Ross (or switch) procedure, the David procedure, and a graft of the ascending aorta.