What Types of Valves Are Used for Aortic Valve Replacement and Which Methods Are Used for Surgery?
Aortic valve replacement is a significant surgery performed when the aortic valve is not functioning properly. During this procedure, the malfunctioning aortic valve is replaced with a new one. The types of valves used and the surgical methods depend on factors such as the patient’s age, overall health, and lifestyle. This article provides information on the types of valves used for aortic valve replacement and the methods by which they are implanted.
Types of Valves Used
Mechanical Valves
- Characteristics: These are durable and usually preferred for younger patients. However, lifelong anticoagulant medication is necessary to prevent blood clotting.
- Advantages: They are long-lasting and generally do not require replacement during the patient’s lifetime.
- Disadvantages: Continuous use of blood thinners is required, which increases the risk of bleeding.
Bioprosthetic (Biological) Valves
- Characteristics: Made from animal or human tissues, these valves have a shorter lifespan than mechanical ones but do not require lifelong anticoagulant medication.
- Advantages: Since blood thinners are not needed, they are suitable for older patients and those with a high risk of bleeding. The risk of valve mismatch is lower compared to mechanical valves, and the infection risk is reduced.
- Disadvantages: These valves may need to be replaced after 10–20 years.
Ozaki Procedure
This method involves creating the aortic valve from the patient’s own heart tissue during surgery. It has been practiced globally for 16 years and for 6-7 years in some countries. This method is often referred to as “natural aortic valve surgery” since it closely mimics the function of a normal aortic valve. Patients typically do not need to restrict physical activity after the procedure, and there are even cases of patients returning to professional sports.
Surgical Methods
Open-Heart Surgery
- Characteristics: This is the most common method, where the chest is opened to access the heart, and the patient is connected to a heart-lung machine. After the valve is replaced, the chest is closed.
- Advantages: There are no special advantages beyond being the standard procedure.
- Disadvantages: It requires a long recovery time and a large surgical incision.
Minimally Invasive Surgery
- Characteristics: This surgery is performed through smaller incisions and also uses a heart-lung machine.
- Advantages: This method causes less pain, shorter recovery time, and smaller scars, making it more appealing to patients.
- Disadvantages: It requires a steeper learning curve and experience. The procedure is essentially the same as open-heart surgery.
Transcatheter Aortic Valve Implantation (TAVI)
- Characteristics: This method does not require opening the chest. Instead, a catheter is used to replace the valve, often through the groin, in a procedure usually performed in a catheterization lab rather than an operating room.
- Advantages: It is suitable for elderly patients and those with a high surgical risk. It offers faster recovery and is less invasive.
- Disadvantages: Long-term outcomes and durability are not as good as those with standard valve replacement. It may also lead to rhythm problems or require a pacemaker, and it is not suitable for every patient.
These are the primary valve types and surgical methods used for aortic valve replacement, with each option tailored to the individual patient’s needs.