Aortic valve replacement
Key facts
- Aortic valve replacement is a type of heart surgery.
- A healthy aortic valve opens fully and closes fully with each heartbeat.
- The surgery is usually done under a general anaesthetic.
- Full recovery from aortic valve replacement can take several weeks to months.
What is an aortic valve replacement?
Aortic valve replacement is a type of heart surgery. The aortic valve is one of 4 valves in the heart. These valves all work together to keep blood flowing in the right direction.
Sometimes the aortic valve stops working properly. If this happens it may need to be replaced. This is done in hospital by a specialist surgeon.
When is aortic valve replacement needed?
A healthy aortic valve opens fully and closes fully with each heartbeat. This allows the heart to pump enough blood around the body.
If the valve does not open or close properly, your heart must work much harder. The heart can get overworked because it’s trying to send enough blood to your body.
When your aortic valve is not working properly you can feel short of breath or tired. Sometimes people can have oedema (a build-up of fluid in the body). This can cause swelling or puffiness in your arms or legs.
Sometimes the heart valves are faulty at birth. Sometimes the valves can become damaged due to illness. The most common reason for aortic valve replacement is aortic stenosis — when your valve opening is narrowed. This is usually caused by age.
A test can be done to find out if there is a problem with your heart valves. This is called an echocardiogram (sometimes called an ‘echo’). The doctor will organise an ultrasound of your heart.
How to prepare for an aortic valve replacement
If your doctor recommends an aortic valve replacement, more tests are needed. These tests give the doctor more information about the heart. They include:
- a blood test
- a chest x-ray
- an electrocardiogram (ECG)
The ECG is done to test the electrical properties of your heart.
If you are having these tests, your doctor or hospital staff will give you instructions on how to get ready for the surgery.
If you are a smoker, it’s a good idea to quit long before the procedure. This can help reduce your risks of side effects from the surgery.
What happens during the surgery to replace the aortic valve?
There are 2 ways that your aortic valve may be replaced:
- transcatheter aortic valve implantation (TAVI)
- open heart technique
TAVI can be performed with conscious sedation, whereas surgery is usually done under general anaesthetic. However, not all patients are suitable for TAVI.
With TAVI, the valve is replaced using a balloon catheter. The balloon catheter is guided to the right place in your heart. Once it’s inside the artery, the balloon is gently inflated to open the aortic valve. The doctor then puts in the new valve. The old valve is pushed out of the way.
With the open heart technique, the surgeon will cut through your breastbone to reach your heart. Then, a machine will take over your heart and lungs to keep them working properly during the surgery. The faulty valve will be replaced with a new valve. If this new valve is made of either human or animal tissue, it is called a biological valve. If the new valve is made of metal, it is called a mechanical valve.
During the surgery you may need a blood transfusion. All blood used for transfusions in Australia is strictly screened to protect you from viruses.
Your doctor will be able to discuss the risks and benefits of each procedure with you.
Recovering from aortic valve replacement
After the surgery, you will be taken to the intensive care unit (ICU). You will be carefully monitored. Then you will be taken to a ward until you are ready to leave hospital.
Full recovery from open aortic valve replacement can take several weeks to months. You may have pain and tiredness while you are recovering. However, recovery following TAVI is usually faster.
If you are given a mechanical valve, you will need anti-clotting medicine. You will need to take this medicine for the rest of your life to stop blood clots.
If you are given a biological valve you will need to take anti-clotting medicine for a few months after surgery.
What are the risks of aortic valve surgery?
All surgery carries some risk. Some of these risks include:
- bleeding
- infections
- poor healing of the wound
- arrhythmias (changes to your heart rhythm)
- damage to your heart
- problems with your kidneys or lungs. This could happen if you already have a health issue.
It’s important to ask your doctor any questions that you have before the surgery. The doctor may give you some fact sheets or information to read. You can discuss these with your doctor if you still have questions.
It’s your choice whether you have the surgery.
Resources and support
About aortic valve replacement
Talk to your doctor if you have questions about aortic valve replacement.
About surgical procedures
Learn more about surgical procedures in general, including:
You should talk to your health professional about the benefits and risks of getting a medical implant. Use the Therapeutic Goods Administration's guide on what to ask. The information is in English, Arabic, Croatian, Farsi, Greek, Italian, Korean, Mandarin, Spanish, Turkish and Vietnamese.
You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.
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Last reviewed: February 2024
