Frequently Asked Questions About Aortic Valve Surgery

Below are answers to frequently asked questions about aortic valve surgery. Click on any of the questions below, or scroll down to read all the quesions and answers.

For more information about whether you're a candidate for one of our minimally invasive aortic valve procedures or to schedule a consult, please call 410-328-5842.

What is aortic valve surgery (AVS)? What are the most common procedures related to it?

Aortic valve surgery can be any procedure that involves replacing a patient's aortic valve, any procedure that involves the aorta or occurs near the aortic valve, and any procedure that aims to repair or re-implant a patient's aortic valve. By definition, because each of these types of procedures involves the aortic valve critical support structure, they can be classified as aortic valve surgery.

Approximately how many people undergo AVS each year?

Approximately 70,000 patients undergo AVS every year in this country. However, according to published statistics regarding disease incidence and population estimates, there may be twice as many patients who could benefit from, but have not yet undergone, aortic valve replacement surgery.

What specific medical conditions can cause a person to undergo aortic valve surgery?

Generally speaking, the American Heart Association recommends that doctors perform AVS on patients who suffer from severe aortic stenosis or severe aortic insufficiency. However, my experience has shown that patients who experienced higher levels of health before undergoing AVS often performed better throughout the surgical process.

Who are the best candidates for aortic valve surgery (ages, conditions, etc.)?

Younger patients, most notably those under the age of 70, handle AVS very well. In the same sense, however, the procedure can also be safely performed on patients as old as 80, and even 90, who are in relatively good health. Such older patients have been able to return to a quality of life comparable to that of members of the same age group who have not undergone the procedure.

Does the procedure have a high success rate?

Yes. According to the national database of the Society of Thoracic Surgeons, the risk of patients under the age of 70 experiencing fatal complications during AVS is approximately 1%. In fact, the mortality rate for AVS has consistently fallen over the past 10 years.

Are most aortic valve surgeries performed using minimally invasively surgical techniques? What about those performed at the University of Maryland Heart Center?

The majority of isolated aortic valve procedures are performed using a standard heart surgery incision. However, in the Maryland Heart Center, we now perform about 40% of these procedures using minimally invasively surgical techniques.

What type of recovery process follows this procedure, and how does this process vary depending upon how the procedure is performed?

Generally speaking, patients undergoing AVS require a hospital stay lasting from 4 to 5 days, and patients are usually able to walk by the time they leave the hospital. After leaving the hospital, patients are able to drive after 4 weeks, and return to deskwork after 4-6 weeks. For high activity work, such as jobs that require the lifting heavy objects, return to work is recommended after 10-12 weeks. At the University of Maryland Heart Center, our minimally invasive approach has significantly decreased the amount of recovery time needed for our older patients.

What impact does aortic valve surgery typically have on a patient's quality of life?

After undergoing AVS, patients' quality of life is expected to return to normal; it is expected to be comparable to that of other members of their respective age groups who have not undergone the procedure.

How would you describe the University of Maryland's aortic valve surgery program?

The aortic valve surgery program at the University of Maryland is state-of-the-art. The program has an extremely high volume of patients because patients know they are going to receive the best possible care while undergoing this procedure at the UM Heart Center.

What are some reasons why people should consider coming to the University of Maryland for aortic valve surgery?

There are four very important reasons patients should consider choosing University of Maryland Heart Center as their AVS hospital:

  • The University of Maryland Heart Center is a top-quality program whose reputation is nearly unprecedented in the medical community.
  • Patients will experience excellent care in the hands of our highly trained and qualified surgeons, doctors, and nurses.
  • The surgeons in the University of Maryland Heart Center have demonstrated programmatic excellence across all aspects of AVS.
  • The University of Maryland Heart Center already performs a high volume of aortic valve procedures with a high rate of success, so patients know they can trust their health in the hands of our surgeons.

Am I too old to have aortic valve surgery?

We have operated successfully on patients in their 80s and 90s. Each patient is evaluated individually to determine if they are eligible for the procedure.

How do I know if I am a candidate for the minimal access aortic valve procedure? 

Most patients are eligible for one of our minimal access surgical approaches. The decision for this is made based on the problem with your valve, your medical condition, your surgeon's opinion, and your wishes.

How will I know when I need surgery for aortic stenosis or aortic insufficiency (regurgitation)?

Your cardiologist should evaluate you with echocardiograms. He/she will guide you in determining when surgical intervention is appropriate.
 

Is it possible for you to fix my aortic valve rather than replace it?

If you have aortic stenosis, you have a narrowing of the valve, and at this time, this cannot be fixed surgically. You would need a valve replacement. If you have aortic insufficiency, you may be eligible for primary valve repair. Some patients have a condition where their aorta is dilated (enlarged) and in this case, you may be a candidate for a procedure which replaces the enlarged portion of your aorta and resuspends your valve (see valve sparing procedures). In either case, your own valve would be preserved.
 

Is is possible to have aortic stenosis or aortic insufficiency and not have symptoms?

Often times, the symptoms can be subtle. You should take the advice of your cardiologist and see a surgeon if that his his/her recommendation.
 

What information do you need to be able to evaluate me for aortic valve surgery? 

We would need your complete medical and surgical history. We would need to see the video of your most recent echocardiogram. If you are over 40, or have risk factors for coronary artery disease, you will need to have a cardiac catheterization to determine if you need coronary artery bypass in addition to your valve surgery.
 

My cardiologist is recommending a mechanical valve replacement for me, but I do not want to be on a blood thinner for life. Is a bioprosthetic (tissue) valve appropriate for me?

We are using bioprosthetic (tissue) valves in most of our aortic valve surgeries, even for younger patients. The decision about the valve type will be made by you and your surgeon when you are evaluated for the procedure. 

Can I have a catheter-based approach to replacing my aortic valve?

We offer transcatheter aortic valve replacement (TAVR) for patients who are too high risk to undergo traditional valve replacement surgery. Read more about TAVR.

For more information or to schedule a consult, please call 410-328-5842.

This page was last updated: August 19, 2014

         
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