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Aortic Valve
The aortic valve lies between the left ventricle and the major artery
in the body, the aorta. Disease of this valve may be caused by rheumatic
fever, atherosclerosis, endocarditis, myxomatous changes (floppiness of
valve structures), or congenital abnormalities. The valve may not open well
(aortic stenosis) or may be leaky (aortic regurgitation).
The
main valve replacement options are mechanical and tissue. Mechanical
valves are made of titanium and metal and last for a lifetime. However,
they require lifelong anticoagulation with a 1-2%/year risk of bleeding
or stroke. Tissue
valves are made of bovine pericardium (lining of a cows heart) or porcine
aortic valve tissue. They do not require anticoagulation but only last 10-15
years and therefore a second operation is necessary when the life of the
valve has worn out.
Other options for replacement include the Ross operation,
which is suitable for younger patients without associated aortic aneurysms
and the use of a homograft. These are selected procedures for special
circumstances.
Surgeons at St. Luke's-Roosevelt perform isolated
aortic valve operations through a minimally invasive approach using
a 6cm incision.