Overview

The human heart is a complex organ. There are different valves in the heart, which help in controlling the flow of blood to and from the heart. Problems with the valve can hamper the proper functioning of the heart, leading to various kinds of health problems.

Aortic stenosis is one common problem which is seen in many cardiac patients. In this ailment, the aortic valve narrows down considerably, mainly due to calcification. This valve helps in separating the main pumping chamber of the heart from the system which circulates blood all throughout the body. With a narrowed aortic valve, blood flow out of the heart is reduced. This can lead to various kinds of cardiac complications. The aortic valve needs to be repaired or replaced as per the need of the patient.

Most common symptoms of aortic stenosis include shortness of breath, chest pains and fainting. The most dangerous thing is that the ailment remains asymptomatic for a long time. But when symptoms start showing, it progresses really fast. If surgery is not done within a short span of time, the chances of the patient’s survival are doubtful.

Surgical aortic valve replacement is the conventional treatment, which should be provided to patient with severe symptomatic aortic stenosis. However, there might be many other medical factors which might make this kind of surgery difficult for the surgeon as well as for the patient. Usually medications are provided to such patients to provide the maximum amount of support that is possible.

The process and procedure of sutureless valve surgery

When you are looking for alternatives for conventional aortic valve replacement or even transcatheter aortic valve implantation, the only alternative left is sutureless valve surgery. The problematic and damaged valve is removed in the process and problems of the coronary arteries and aortic valves can be treated at the same time in this kind of surgery. Moreover, the time taken for this surgery is not very long as the new valve does not need to be sewn. As a result, aortic cross-clamp times and cardiopulmonary times are minimized considerably.

The patient is mainly put under general anesthesia for such a surgery. The heart is accessed through a mini or full sternotomy. Once cardioplegia and cardiopulmonary bypass machine is set up, the damaged aortic valve is replaced and removed through the incision in the aorta. Calcifications around the native aortic annulus are removed for better and smooth valve implantation. The valve prosthesis, which will be implanted in place of the damaged valve, is placed on a delivery device and inserted into the native annulus with 1 or more stitches. Once the valve is released, the stitches are removed. The functioning and the positioning of the new valve is checked again and again post-surgery with the help of transoesphageal echocardiography.

Stay in the hospital and recovery

A patient who has undergone sutureless valve surgery will need to be at the hospital for couple of days under observation in case any kinds of complications and problems rise. All the vitals are monitored from time to time and strict monitoring is done on the heart function to understand that the newly implanted valve is working well.

At the time of discharge, the patient is given a set of instructions and guidelines which need to be followed strictly. There will be some restrictions initially, which have to be followed. Various kinds of medications are also prescribed which should be taken timely. The doctor will provide a follow up date and that appointment shouldn’t be missed.