Aortic Valve Replacement using Mini-Sternotomy

Aortic Valve Replacement using Mini-Sternotomy

Valve replacement surgery is an open-heart procedure in which the damaged valve is removed and replaced with a new valve.

A variety of replacement valves are available. Some valves are made of man-made substances. Others are made out of animal tissue, often from a pig.

During valve surgery, the doctor usually makes a large incision through the breastbone (sternum). Blood is circulated outside of the body through a machine to add oxygen to it (cardiopulmonary bypass or heart-lung machine). The heart may be cooled to slow or stop the heartbeat so the heart is protected from damage while surgery is done to replace the valve. The damaged aortic valve is removed and replaced with an artificial heart valve.

Dr. Shams Khwaja speciliazes in a less invasive aortic valve replacement surgery using mini-sternotomy. In minimally invasive heart surgery, the surgeon makes an incision in the chest that is less than one-third of the size of the incision used for conventional heart surgery [less than 4in.]. The aortic valve is located near the front of the chest. So surgeons have discovered that aortic valve replacement can be performed successfully through this smaller opening.

Rarely, a more complex operation is performed. The aortic valve may be replaced with one of the person's other heart valves (usually the pulmonic valve between the lower right heart chamber and the opening to the artery that goes to the lungs). Since the pulmonic valve is used in the heart to replace the aortic valve, an artificial valve is implanted to replace the pulmonary valve. This type of valve surgery may be used in people younger than 25 years of age who are more likely to benefit the most from this difficult surgery; the pulmonic valve is more durable, grows with the person, and has a lower risk of infection.

Valve replacement surgery is high-risk for people who have a failing left ventricle and who have had a heart attack.