Aortic valve replacement is a cardiac surgery procedure in which a patient's aortic valve is replaced by a different valve. The aortic valve can be affected by a range of diseases; the valve can either become leaky (
aortic insufficiency / regurgitation) or partially blocked (
aortic stenosis). Aortic valve replacement currently requires open heart surgery.
Two Types of Valves can be used: Tissue or Mechanical
Surgical ProcedureAortic valve replacement is most frequently done through a median sternotomy, meaning the chestbone is sawed in half. Once the pericardium has been opened, the patient is placed on cardiopulmonary bypass machine, also referred to as the heart-lung machine. This machine takes over the task of breathing for the patient and pumping his blood around while the surgeon replaces the heart valve.
Once the patient is on bypass, an incision is made in the aorta. The surgeon then removes the patient's diseased aortic valve and a mechanical or tissue valve is put in its place. Once the valve is in place and the aorta has been closed, the patient is taken off the heart-lung machine.
Transesophageal echocardiogram (TEE, an ultra-sound of the heart done through the esophagus) can be used to verify that the new valve is functioning properly.
Bag of WormsAs the patient is warmed and brought back to normal 37 degrees Celsius and the heart begins to pump again, the heart can possibly go into
v-tach. This is because it has been "asleep" for around 4 hours and when it "wakes" back up, it may over compensate by pumping all of its muscles at once. It will look like a "
bag of worms" as all the muscles quiver and fire together. The patient can be "Charged" with electric shocks to stop the
v-tach and regulate the heartbeat.
Pacing Wires and Drainage TubesPacing wires are usually put in place, so that the heart can be manually paced should any complications arise after surgery. Drainage tubes are also inserted to drain fluids from the chest and pericardium following surgery. These are usually removed within 36 hours while the pacing wires are generally left in place until right before the patient is discharged from the hospital.
Source: http://en.wikipedia.org/wiki/Aortic_valve_replacementIn order to perform the procedure,
Cardioplegia must be performed. Cardioplegia is the intentional and temporary cessation of cardiac activity, primarily used in cardiac surgery.
Source: http://en.wikipedia.org/wiki/Cardioplegia