Aortic valve disease, whether stenosis (narrowing) or regurgitation (leakage), can significantly impair heart function and quality of life. When medical therapy is inadequate, aortic valve surgery becomes necessary. Livasa Hospital provides expert aortic valve surgery, including both traditional open surgical techniques and, when appropriate, newer catheter-based approaches. Our experienced cardiothoracic surgeons perform aortic valve repair and replacement with excellent perioperative outcomes and long-term durability.

Understanding Aortic Valve Disease

The aortic valve controls blood flow from the left ventricle into the aorta. When diseased, two main pathological patterns emerge:

Aortic Stenosis:

• Progressive narrowing of the aortic valve opening

• Causes increased resistance to left ventricular ejection

• Results from degenerative calcification, rheumatic disease or bicuspid valve anatomy

• Leads to left ventricular hypertrophy and eventually dysfunction

Aortic Regurgitation:

• Failure of the valve to close properly, allowing backward blood flow into the left ventricle

• Causes progressive left ventricular dilatation

• Can result from valve prolapse, endocarditis, aortic root disease or prior valve surgery

Clinical Indications for Aortic Valve Surgery

Aortic valve surgery is considered when:

• Symptomatic severe aortic stenosis – With angina, dyspnoea or syncope

• Asymptomatic severe stenosis with markers of high risk – Reduced ejection fraction, abnormal stress test

• Severe aortic regurgitation – With symptoms or ventricular dysfunction

• Moderate disease requiring concurrent cardiac surgery – During CABG or other procedures

• Prosthetic valve dysfunction – Stenosis, regurgitation or thrombosis

• Infective endocarditis with valve destruction – Requiring emergency surgery

• Aortic root disease with aortic regurgitation – Including aortic aneurysm

Types of Aortic Valve Prostheses

The choice depends on patient age, comorbidities, lifestyle and preferences.

Valve Repair Versus Replacement

Valve repair is preferred when feasible:

• Preserves native valve anatomy

• Avoids prosthesis-related issues

• Generally provides superior long-term durability

• Limited by valve pathology and surgeon expertise

Valve replacement is necessary when:

• Damage is too extensive for repair

• Stenosis is irreversible

• Previous repair has failed

Pre-Operative Evaluation

Comprehensive assessment before aortic valve surgery includes:

• Detailed echocardiographic evaluation of valve morphology and function

• Coronary angiography to assess for CAD requiring concurrent bypass

• Assessment of aortic root and proximal aorta

• Left ventricular function and dimensions

• Pulmonary and renal function assessment

• Anaesthetic evaluation

The Aortic Valve Surgical Procedure

Key operative steps include:

1. Median sternotomy – Full-length chest incision

2. Cardiopulmonary bypass – Institution of heart-lung machine support

3. Aortic cross-clamping – Isolation of the surgical field

4. Aortotomy – Opening the aorta above the valve

5. Valve excision – Removal of diseased valve

6. Valve repair or replacement – Depending on pathology and feasibility

7. Aortotomy closure – Meticulous reconstruction

8. Weaning from bypass – Restoration of normal circulation

9. Closure – Multi-layer chest closure

The procedure typically takes 2–3 hours depending on complexity and need for concomitant procedures.

Post-Operative Management

ICU Care:

• Haemodynamic monitoring and organ function support

• Gradual weaning from mechanical ventilation

• Early mobilisation and physiotherapy

Hospital Recovery:

• Typical hospital stay is 5–7 days

• Wound care and drain removal

• Progressive activity escalation

• Medication optimisation

Long-Term Follow-Up:

• Regular echocardiographic surveillance

• Anticoagulation if mechanical valve (lifelong INR 2–3)

• Endocarditis prophylaxis guidance

• Activity recommendations

• Pregnancy counselling if relevant

Expected Outcomes

Modern aortic valve surgery achieves:

• Operative mortality <2% in most patients

• Significant symptom improvement

• Improved left ventricular function

• Excellent long-term survival

• Good quality of life and functional capacity

Why Choose Livasa Hospital?

• Experienced cardiac surgeons with aortic valve expertise

• State-of-the-art operating facilities

• Comprehensive post-operative critical care

• NABH accreditation and quality assurance

• Long-term follow-up and monitoring programs

NAP – Contact Details

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

Call +91-80788 80788 to schedule a consultation for aortic valve surgery at Livasa Hospital.