Aortic Valve Replacement Surgery...?
My fiance needs his aortic valve replaced. He is 40 yrs old otherwise in good health. I am wondering how long he will be in surgery, how long he be in the hospital and any other info about have this surgery.
Answers:
There are two basic types of artificial heart valve: mechanical valve and tissue valves.
Tissue valves:
Tissue heart valves are usually made from animal tissues, any animal heart valve tissue or animal pericardial tissue. The tissue is treated to prevent rejection and calcification.
There are alternatives to animal tissue valves. In some cases a homograft - a human aortic valve -- can be implanted. Homograft valve are donated by patients and harvested after the patient dies. The durability of homograft valves is probably indistinguishable for porcine tissue valves. Another procedure for aortic valve replacement is the Ross procedure (or pulmonary autograft). In a Ross procedure, the aortic valve is removed and replaced near the patient's own pulmonary valve. A pulmonary homograft (pulmonary valve taken from a cadaver)is then used to replace the patient's own pulmonary spigot. This procedure was first used in 1967 and is used primarily in children.
Mechanical valve:
Mechanical valves are designed to outlast the patient, and have typically be stress-tested to last several hundred years. Although mechanical valves are long-lasting and mostly only one surgery is needed, there is an increased risk of blood clots forming with power-driven valves. As a result, mechanical valve recipient must generally take anti-coagulant (blood thinning) drugs such as warfarin for the rest of their lives, which makes the long-suffering more prone to bleeding.
Valve selection:
Tissue valves tend to wear out faster with increased flow demands - such as near a more active (typically younger) person. Tissue valves typically concluding 10-15 years in less active (typically elderly) patients, but wear out faster within younger patients. When a tissue valve wears out and needs replacement, the character must undergo another valve replacement surgery. For this reason, younger patients are regularly recommended mechanical valves to prevent the increased risk (and inconvenience) of another valve replacement.
Surgical Procedure:
Aortic spigot replacement is most frequently done through a median sternotomy, meaning the chestbone is sawed in half. Once the pericardium have been opened, the patient is placed on cardiopulmonary bypass device, also referred to as the heart-lung machine. This machine takes over the charge of breathing for the patient and pumping their blood around while the surgeon replaces the heart valve.
Once the patient is on bypass, an incision is made within the aorta. The surgeon then removes the patient's diseased aortic valve and a mechanical or tissue spigot is put in its place. Once the valve is in place and the aorta have been closed, the patient is taken off the heart-lung appliance. Transesophageal echocardiogram (TEE, an ultra-sound of the heart done through the esophagus) can be used to verify that the new valve is functioning properly. Pacing wires are usually put in place, so that the heart can be manually pace should any complications arise after surgery. Drainage tubes are also inserted to drain fluids from the chest and pericardium following surgery. These are usually removed within 36 hours while the pacing wires are generally not here in place until right before the patient is discharged from the hospital.
Hospital Stay and Recovery Time:
Immediately after aortic spigot replacement, the patient will frequently stay in a cardiac surgery intensive care component for 12-36 hours. After this, the patient is often moved to a lower-dependency unit and afterwards to a cardiac surgery ward. Total time spent in hospital following surgery is usually between 4 and 10 days, unless complications arise.
Recovery from aortic valve replacement will take 1-3 months if the long-suffering is in good health. Patients are advise not to do any heavy lifting for 6-8 weeks following surgery to avoid damaging the sternum (breast bone) while it heals.
Surgical Outcome and Risk of Procedure:
The risk of departure or serious complications from aortic valve replacement is typically quoted as being between 1-5%, depending on the health and age of the tolerant, as well as the skill of the surgeon. Older patients, as well as more fragile ones, are sometimes ineligible for surgery because of elevated risks.
Future Developments:
Percutaneous aortic valve replacement, which allows the implantation of valve using a catheter without open heart surgery is still being evaluated within clinical trials and appears to be promising in patients who are at high risk to undergo undo heart surgery. The Edwards SAPIEN valve is being evaluated in a multi-center clinical trial, near Cedars-Sinai Medical Center being the leading test site.
This is main heart surgery that is done on "bypass" (cardiopulmonary bypass, meaning the heart and lung machine.
This is terrifically serious.
He may be in the hospital for a week or more. He may need cardiac rehab to gradually be capable of do simple things.
He is at risk for many complications.
Here is a video:
http://my.clevelandclinic.org/heart/diso… Source(s): http://www.sts.org/sections/patientinfor…
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Answers:
There are two basic types of artificial heart valve: mechanical valve and tissue valves.
Tissue valves:
Tissue heart valves are usually made from animal tissues, any animal heart valve tissue or animal pericardial tissue. The tissue is treated to prevent rejection and calcification.
There are alternatives to animal tissue valves. In some cases a homograft - a human aortic valve -- can be implanted. Homograft valve are donated by patients and harvested after the patient dies. The durability of homograft valves is probably indistinguishable for porcine tissue valves. Another procedure for aortic valve replacement is the Ross procedure (or pulmonary autograft). In a Ross procedure, the aortic valve is removed and replaced near the patient's own pulmonary valve. A pulmonary homograft (pulmonary valve taken from a cadaver)is then used to replace the patient's own pulmonary spigot. This procedure was first used in 1967 and is used primarily in children.
Mechanical valve:
Mechanical valves are designed to outlast the patient, and have typically be stress-tested to last several hundred years. Although mechanical valves are long-lasting and mostly only one surgery is needed, there is an increased risk of blood clots forming with power-driven valves. As a result, mechanical valve recipient must generally take anti-coagulant (blood thinning) drugs such as warfarin for the rest of their lives, which makes the long-suffering more prone to bleeding.
Valve selection:
Tissue valves tend to wear out faster with increased flow demands - such as near a more active (typically younger) person. Tissue valves typically concluding 10-15 years in less active (typically elderly) patients, but wear out faster within younger patients. When a tissue valve wears out and needs replacement, the character must undergo another valve replacement surgery. For this reason, younger patients are regularly recommended mechanical valves to prevent the increased risk (and inconvenience) of another valve replacement.
Surgical Procedure:
Aortic spigot replacement is most frequently done through a median sternotomy, meaning the chestbone is sawed in half. Once the pericardium have been opened, the patient is placed on cardiopulmonary bypass device, also referred to as the heart-lung machine. This machine takes over the charge of breathing for the patient and pumping their blood around while the surgeon replaces the heart valve.
Once the patient is on bypass, an incision is made within the aorta. The surgeon then removes the patient's diseased aortic valve and a mechanical or tissue spigot is put in its place. Once the valve is in place and the aorta have been closed, the patient is taken off the heart-lung appliance. Transesophageal echocardiogram (TEE, an ultra-sound of the heart done through the esophagus) can be used to verify that the new valve is functioning properly. Pacing wires are usually put in place, so that the heart can be manually pace should any complications arise after surgery. Drainage tubes are also inserted to drain fluids from the chest and pericardium following surgery. These are usually removed within 36 hours while the pacing wires are generally not here in place until right before the patient is discharged from the hospital.
Hospital Stay and Recovery Time:
Immediately after aortic spigot replacement, the patient will frequently stay in a cardiac surgery intensive care component for 12-36 hours. After this, the patient is often moved to a lower-dependency unit and afterwards to a cardiac surgery ward. Total time spent in hospital following surgery is usually between 4 and 10 days, unless complications arise.
Recovery from aortic valve replacement will take 1-3 months if the long-suffering is in good health. Patients are advise not to do any heavy lifting for 6-8 weeks following surgery to avoid damaging the sternum (breast bone) while it heals.
Surgical Outcome and Risk of Procedure:
The risk of departure or serious complications from aortic valve replacement is typically quoted as being between 1-5%, depending on the health and age of the tolerant, as well as the skill of the surgeon. Older patients, as well as more fragile ones, are sometimes ineligible for surgery because of elevated risks.
Future Developments:
Percutaneous aortic valve replacement, which allows the implantation of valve using a catheter without open heart surgery is still being evaluated within clinical trials and appears to be promising in patients who are at high risk to undergo undo heart surgery. The Edwards SAPIEN valve is being evaluated in a multi-center clinical trial, near Cedars-Sinai Medical Center being the leading test site.
This is main heart surgery that is done on "bypass" (cardiopulmonary bypass, meaning the heart and lung machine.
This is terrifically serious.
He may be in the hospital for a week or more. He may need cardiac rehab to gradually be capable of do simple things.
He is at risk for many complications.
Here is a video:
http://my.clevelandclinic.org/heart/diso… Source(s): http://www.sts.org/sections/patientinfor…
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