Valve-sparing aortic root replacement is a highly specialised surgery which Dr Scott performs to repair a portion of the aorta nearest to the heart, the aortic root while preserving the aortic valve. By doing this surgery, long-term blood-thinning medications can be avoided as no valve replacement is needed and the risk of stroke or endocarditis can be decreased.

Why would surgical interventions for mitral and aortic valves be needed?

The aortic root is where the coronary artery attaches to the heart and includes the annulus and leaflets of the aortic valve. Valve-sparing aortic root replacement is done for conditions that damage the aortic root such as high blood pressure and Marfan syndrome, or when the aortic root has an aneurysm or is enlarged causing the aortic valve to leak. When left untreated, an aneurysm dissection can occur in which blood flows through a tear in the inner layer of the aorta, causing the layers to separate. When this occurs, the blood flow is disrupted, and the arterial wall may burst..

How is this procedure done?

Under general anaesthesia, you will be connected to a heart-lung bypass machine which will take over the duties of the heart and lungs in supplying the body with oxygenated blood. Medications are then given to stop the heart’s beating so that your cardiothoracic surgeon may work on a still heart. The diseased part of the aortic artery is removed and measured. This measurement is then used to make a graft to fit appropriately.

The graft is then sewn into place by connecting the graft to the aortic valve. The patients’ own preserved aortic valve is then re-suspended within the graft and sewn into place. Finally, he will ensure the valve opens and closes as it should without leaking after which he will reconnect the rest of the aorta to the heart

What can I expect after surgery?

Waking up from surgery, you can expect a chest tube to be placed in your chest to drain any blood or fluid that may build up in the chest. You should have a catheter placed for urine for the next few days before you can get up and move around. You will be kept in the ICU for close observation of your heart, blood flow and fluid drainage for about 2 days. On a daily basis, you will receive oxygen therapy and be given compression stockings to wear on your legs as well. You will be moved from ICU to your hospital room where you will be advised to stay for a further 3 to 5 days before you may go home.

Dr Scott will advise you on how to care for your incisions and how to treat the symptoms after surgery. Symptoms of swelling, muscle pain in the upper back and shoulders, fatigue, sleeping and appetite problems, constipation and chest pain near the chest bone are all normal after valve-sparing aortic root replacement surgery. It may take anything from 6-12 weeks for a full recovery, and your cardiothoracic surgeon will be able to tell you when you may begin physical activity. You will be instructed to walk regularly and slowly increase your activity, as well as how to do breathing exercises to aid recovery. Patients are usually able to return to work at 8 weeks post-operation depending on the physical demand of their type of work.