What is aortic valve replacement?
Aortic valve replacement is an "open heart" procedure performed by cardiothoracic surgeons for treatment of narrowing (stenosis) or leakage (regurgitation) of the aortic valve.

Are there any warning signs for a failing aortic valve?
A failing aortic valve may cause a variety of symptoms including shortness of breath, chest pain (angina pectoris), and dizziness or loss of consciousness (passing out).

A narrow valve makes the heart work harder just to pump the blood through the valve to the body. A leaky valve lets blood back into the heart after it has been pumped out. The heart must therefore pump more blood forward to make up for the blood that is leaking backwards in. Either case, the extra work may cause symptoms of heart failure, such as shortness of breath. Early on the shortness of breath may be noticeable only with exercise. Later, with the progression of valve disease, a patient could experience shortness of breath with even light activity or at rest. Some individuals will be unable to sleep flat in bed or may awaken from sleep short of breath. Another sign of heart failure that may occasionally occur is swelling of the feet, particularly prominent later in the afternoon or evening although other conditions, such as varicose veins, can also cause this to occur.

The extra work the heart has to perform may also cause chest pain or angina pectoris similar to the symptoms of a heart attack. It may be difficult to tell the difference between heart valve disease and narrowing of the blood vessels to the heart itself (coronary arteries).

Aortic valve disease may also cause dizziness, light-headedness or even fainting spells. The decision to proceed with surgery should be made with your medical care team, which usually consists of a thoracic or cardiothoracic surgeon and a cardiologist. Your medical team will likely base their recommendations on your symptoms and the results of several tests, including an echocardiogram and sometimes cardiac catheterization. An echocardiogram may show enlargement of the heart, and can help to measure the degree of stenosis or regurgitation. A cardiac catheterization provides similar information, but can also identify any narrowings of the coronary arteries.

Valve replacement
In almost all cases, the aortic valve can only be corrected by valve replacement. Tissue valves from bovine pericardium or mechanical valves of pyrolite carbon have outstanding track records. We have carefully selected the valves that we use based on long standing clinical performances. Over one million of the St. Jude mechanical valves that we use at NorthShore University HealthSystem have been implanted world wide, and the tissue valves we use have a durability profile that far exceeds earlier generations, minimizing the need for re-operations.

What to expect
The night before surgery you will be allowed to eat dinner. Nothing to eat or drink after midnight except for small sips of water with medication. No aspirin products. Sleeping pills will be provided if needed. Fleets enema will be prescribed. Antibacterial soap should be used for last shower. You will be called by the ambulatory surgery unit and told what time to come to the hospital the next morning. The operating room has been specially prepared for your surgery. The anesthesiologist will give you medication shortly before your surgery begins which will make you drowsy. After you are asleep a breathing tube will be inserted and your breathing will be taken over by a ventilator (breathing machine). After surgery you will go to the Intensive Care Unit for 24 hours. The breathing tube will be discontinued when you are fully awake. From the intensive Care Unit you will be transferred to a private room on the cardiothoracic Surgery Unit. You will be in the hospital for 4 - 5 days.

In addition to the cardiothoracic surgeon the following personnel will help care for you: nurse practitioners, specially trained cardiac surgery nurses, pharmacists, music therapist, physical therapist, respiratory therapist, dietician, discharge planning nurses and cardiac rehabilitation nurses.

If you would like additional information or would like to make an appointment, call 847.570.2868.

Cardiothoracic Surgery
2650 Ridge Avenue
Evanston, IL 60201

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