Aortic valve repair

The heart consists of four chambers, two atria (upper chambers) and two ventricles (lower chambers). There is a valve through which blood passes before leaving each chamber of the heart. The valves prevent the backward flow of blood. They act as one-way inlets of blood on one side of a ventricle and one-way outlets of blood on the other side of a ventricle. The four heart valves include the following:

1. Tricuspid valve: located between the right atrium and the right ventricle
2. Pulmonary valve: located between the right ventricle and the pulmonary artery
3. Mitral valve: located between the left atrium and the left ventricle
4. Aortic valve: located between the left ventricle and the aorta

There are two malfunctions of heart valves:

• When the valve does not close completely, causing the blood to flow backwards instead of forward through the valve, these malfunction known as regurgitation.
• Other condition when, valve opening becomes narrowed or does not form properly (congenital malformation), inhibiting the flow of blood out of the ventricle or atria. The heart is extra forced to pump blood in order to move blood through the stiff valve, this malfunction known as valve stenosis.

Sometimes the heart valves can have both malfunctions at the same time (regurgitation and stenosis).

Valve repair surgery most commonly done for congenital valve defects. The following procedure could be done by the cardiac surgeon to repair a valve:

• Decalcification removes calcium buildup from the leaflets. Once the calcium is removed, the leaflets can close properly.
• Patching Inserting tissue to patch holes or tears in the flaps (perforated cusps) that close off the valve.
• Reshaping is done when the surgeon cuts out a section of a leaflet. Once the leaflet is sewn back together, the valve can close properly.
• Commissurotomy is used for narrowed valves, where the leaflets are thickened and perhaps stuck together. The surgeon opens the valve by cutting the points where the leaflets meet.
• Annuloplasty is tightening or reinforcing the ring around a valve (annulus) by implanting an artificial ring.
• Repair of structural support replaces or shortens the cords support (chordae tendineae and the papillary muscles) that gives the valves support. When the cords are the right length, the valve can close properly.

Yes, the aortic valve can be repaired in mild to moderate cases.

 The surgery can take anywhere from 2 to 4 hours or more, depending on the number of valves that need to be repaired.