It's Topic Tuesday!
- keyanazahiri
- Feb 18
- 3 min read
Welcome back to Topic Tuesday! Today we will be covering Surgical Aortic Valve Replacements (SAVR). Before reading this post, make sure to look back at our previous posts from this month covering normal aortic valve anatomy, diseases of the aortic valve, different kinds of valves used for replacement, and more.
As a review, the aortic valve is the one-way valve that sits at the base of your aorta, allowing freshly oxygenated blood to flow from your heart into your aorta and towards the rest of your body. This valve is critical for your circulatory system and is consistently under high pressure from the heart squeezing blood towards it for movement towards the rest of the body. As you can imagine, being under constant pressure can cause this valve to weaken over time and can lead to malfunctioning of the valve. Aging, disease, or damage to the aortic valve can cause it to become stiff, narrow, or leaky, making it harder for your heart to pump blood effectively. In these cases, surgery may be needed to replace this valve with a mechanical or bioprosthetic valve, as discussed in our previous blog post. There are a number of factors that go into decision making for selecting a mechanical vs bioprosthetic valve, and this is an in-depth conversation you will have with your surgical team beforehand.
Now what actually goes into having a surgical aortic valve replacement (SAVR)? SAVR is an open-heart surgery procedure for mechanical or bioprosthetic/tissue valve replacements. To get to the heart for this procedure, the cardiac surgeon will begin by making an incision down the middle of your chest to separate the bone and gain access to the heart (called a sternotomy). Once the surgeon has access to the heart, the heart will temporarily be stopped to allow the surgeon to fix the valve without the heart moving. But how can the rest of your organs continue to get the blood and oxygen they need to function if your heart is stopped? This is where something called cardiopulmonary bypass (CPB) comes in.
CPB is a machine that essentially takes over the job of the heart and lungs during cardiac surgery. Tubes are placed in your heart and major blood vessels that function to redirect blood from the body to the machine rather than through the heart and lungs, allowing the blood to circulate and become oxygenated by the machine before being returned to the body. The CPB machine ensures that blood continues to flow throughout your body, so you still get the oxygen and nutrients needed while your heart is temporarily stopped. After being put on bypass, the cardiac surgeon will access the diseased aortic valve through the aorta, remove it, and hand sew the new valve in place of the old one. After this, the heart will be started again and bypass will be turned off, allowing blood to flow normally through the heart and new valve. After the surgical team makes sure the new valve is functioning properly, the chest and sternum will be put back together and the procedure will be complete. The procedure will typically take 4-6 hours to complete.
After surgery, you will be in the hospital, likely an intensive care unit, for about a week to allow your heart and functioning to be closely monitored. Finally, you will be discharged home on medications depending on which valve you received, and the full recovery will typically take 2-3 months. Physical therapy/cardiac rehab may be needed to help you regain your strength.
SAVR is a very commonly performed and highly effective procedure for treating severe aortic valve disease. These procedures can significantly improve the quality of life by allowing your heart to function more effectively. It is common to have anxiety and many questions about having this procedure, and your surgical team is there to help you understand your options and guide you through the process every step of the way. Many members of our Aortic Hope community have had these procedures as well and are here to support you and your loved ones in this experience.
Stay well,
Keyana Zahiri
Brown Medical Student
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