The aortic valve is the one-way outlet between the lower left heart chamber and the aorta, the large artery that carries oxygenated blood to the body. Malformations, infections and other disease processes can cause obstruction or leaking of the aortic valve. When valve malfunction significantly compromises delivery of blood to the body, doctors typically recommend an aortic valve replacement. Although most people who have the operation experience a good outcome, there are potentially serious or life-threatening risks associated with aortic valve replacement.
Bleeding
Aortic valve replacement surgery can cause significant bleeding. Despite the increasing use of minimally invasive surgical techniques, which use smaller incisions compared to standard surgical approaches, many patients undergoing an aortic valve replacement require blood transfusions.
In a 2008 article published in the European Journal of Cardio-thoracic Surgery, Dr. Minoru Tabata and colleagues report that of 1,005 patients undergoing minimally invasive aortic valve replacement, 53 percent required a blood transfusion. Among patients age 80 or older, 87 percent required a blood transfusion. The authors note that 2.5 percent of the patients in the study returned to the operating room after the initial procedure because of continued bleeding post-operatively.
Heart Attack
A small percentage of people undergoing an aortic valve replacement have a heart attack during or shortly after the surgery, according to Medline Plus. Because patients undergoing aortic valve replacement receive intensive monitoring and care, treatment for a surgery-related heart attack typically begins quickly. The rapid response reduces the risk for widespread, permanent heart muscle damage.
Stroke
Stroke remains an uncommon but serious risk of aortic valve replacement surgery. With a stroke, an area of the brain loses its blood supply because of a clot or a blood vessel rupture. The severity of a stroke depends on the location and volume of brain tissue affected. In a 2005 study published in the medical journal Circulation, Dr. Nyali Taylor and colleagues report that approximately 1.5 percent of 34,500 study patients undergoing an aortic valve replacement procedure experienced a stroke.
Infection
Infections remain a risk for patients undergoing aortic valve replacement surgery. Possible sites of infection include the surgical wound, heart valves, lungs, bladder and kidneys. Although uncommon, a deep infection of the surgical wound can be potentially life-threatening.
In a 2009 study published in the Journal of Cardiothoracic and Vascular Anesthesia, Dr. Farzan Filsoufi and colleagues report a death rate of approximately 14 percent among patients who develop a deep infection of breastbone and nearby tissues after heart surgery. Factors associated with an increased the risk for this complication include diabetes mellitus, obesity and chronic obstructive pulmonary disease.
References
- European Journal of Cardio-thoracic Surgery: Early and Late Outcomes of 1,000 Minimally Invasive Aortic Valve Operations
- Medline Plus: Aortic Valve Surgery, Open
- Medline Plus: Aortic Valve Surgery, Minimally Invasive
- Circulation: Relationship Between Race and Mortality and Morbidity After Valve Replacement Surgery
- "Journal of Cardiothoracic and Vascular Anesthesia"; Epidemiology of Deep Sternal Wound Infection in Cardiac Surgery; Farzan Filsoufi, M.D., et al.; August 2009
