Aortic Valve Replacement

[warkerk]

My 87 year old grandfather was just told he needs his aortic valve replaced.  They did a heart cathorization and everything else looked fantastic!  We were recently told about a non invasive replacement by the nurse.  The doctor has not told us about this option.  What is the criteria for this procedure?  It seems that this would be a lot easier.  Any ideas where I could get more information about this?

[kenkeith]

You didn't comment on the valve problem but usually the problem is regurgitation and once signs and symptoms of aortic valve regurgitation develop, you'll usually need surgery. However, if aortic valve regurgitation is weakening your heart, you may need surgery even if you feel well. While the heart is generally adept at counteracting deficiencies caused by a leaky aortic valve, the problem is that if the valve isn't fixed or replaced in time, the strength of your heart may decline so much that it's permanently weakened. You can avoid that by having surgery at the appropriate time.

Valve repair is less invassive  is surgery to preserve the valve and to improve its function. Occasionally, surgeons can modify the original valve (valvuloplasty) to eliminate backward blood flow.

Valve replacement. In many cases, the aortic valve has to be replaced to correct aortic valve regurgitation. In valve replacement surgery, the leaky aortic valve is replaced by an artificial (prosthetic) valve. The two types of artificial valves are mechanical and tissue. Mechanical valves are made from metal and are durable, but they carry the risk of blood clots forming on or near the valve. If you have a mechanical valve, you need to use blood-thinning (anticoagulant) medication for life to prevent blood clots from forming on the valve. Tissue valves generally come from a pig, cow or human-cadaver donor heart. These kinds of valves wear out over time, and you may need another operation to replace the valve. However, an advantage of the tissue valve is that you don't have to use long-term anticoagulation medication. Another type of tissue valve replacement, called an autograft, is sometimes possible. An autograft valve replacement uses your own pulmonary valve — another heart valve — to replace your damaged aortic valve.

Aortic valve surgery usually involves open-heart surgery performed with general anesthesia. Your heart is exposed and connected to a heart-lung machine that assumes your breathing and blood circulation during the procedure. Your surgeon then repairs or replaces your leaky aortic valve.

Aortic valve regurgitation can be eliminated with surgery, and you can usually resume normal activities within a few months. The prognosis following surgery is generally good.

Valve repair. Mitral valve repair is a surgery to preserve your own valve. The surgeon can modify the original valve (valvuloplasty) to eliminate backward blood flow. Surgeons can repair the valve by reconnecting valve leaflets or by removing excess valve tissue so that the leaflets can close tightly. Sometimes repairing the valve includes tightening or replacing the ring of tissue around the valve (annulus). This is called an annuloplasty. Valve repair is usually the preferred surgical choice because you avoid the complications of an artificial heart valve and because heart function is usually better if your own valve can be repaired instead of replaced.

LESS INVASIVE TECHNIQUES: As I have moderate to severe mitral valve regurgitation I am interesting in the progress of this procedure and try to get abreast. The following may be what your nurse refers:
"Doctors are developing less invasive techniques to treat valve disorders, such as repairing or replacing mitral valves using heart catheterization techniques. This type of less invasive mitral valve surgery is being studied in clinical trials".  Hope this is of some help!