Aortic Valve Replacement (AVR)

Where is the Aortic Valve Located?

The aortic valve is a one-way valve that is located between the left ventricle and the aorta.

Aortic Valve Replacement (AVR)

When the left ventricle contracts, it pushes blood out of the ventricle, through the aortic valve, into the aorta and out to the rest of your body. Unlike a TAVR, the surgical AVR typically requires 3 to 5 days in the hospital afterwards but it is a "tried and true" surgery which has been practiced for over 50 years.

Conditions Treated

Aortic Stenosis: when the valve does not open all the way, limiting the blood flow coming out. Causes include bicuspid aortic valve, rheumatic valve disease and natural aging of the valve.

Aortic Regurgitation: when the valve does not close all the way and is "leaking" blood back into the heart. Causes include hypertension, infected valve, aneurysm in the aorta and congenital valve defects.

What to Expect

The patient receives a sedative medication through an IV and is in a deep sleep for the procedure. He or she has a breathing tube and is connected to a ventilator. Once all the tubes and monitors are in place, incisions are made in one or both legs or one of the wrists to access the blood vessels to be used for the grafts. The surgeon makes an incision down the center of the chest, separates the two halves of the breastbone and spreads them apart to expose the heart to replace the valve. Once completed, chest tubes and pacing wires are placed and the sternum is closed.

After surgery, the patient is typically taken to the recovery room before being taken to the cardiac intensive care unit (CICU) to be closely monitored. The patient has a breathing tube until they are stable enough to breathe on their own, usually the same day. A nurse will help the patient cough and take deep breaths every two hours to keep mucus from collecting in the lungs and possibly causing pneumonia. The patient will also start with a liquid diet and gradually advance to more solid foods as they are deemed fit to tolerate them. Patients will usually transfer to Open Heart Step Down (OHSD) on post-op day 1.

While on OHSD, if you continue to progress well, the chest tubes and pacing wires will be removed by post-op day 3. Once you are able to ambulate on room air, you are usually ready to go home.