Traditional, invasive heart surgery still primary option for most patients

BY DR. KOMOROFF Universal Uclick
Tuesday, January 22, 2013
1/22/13 at 4:23 AM


Dear Doctor K: I need to have my aortic valve replaced. What will happen during this procedure?

Dear Reader: Your aortic valve opens to allow oxygen-rich blood to flow from your heart into your aorta and out to the rest of your body.

A healthy aortic valve prevents gravity from pulling blood back down into the heart. Aging and disease can damage the aortic valve. If it doesn't close tightly, blood can re-enter the heart, causing aortic regurgitation. It can cause fatigue, fainting and other symptoms.

If your symptoms are severe, you may need to have your aortic valve replaced with a prosthetic valve.

The traditional surgery involves splitting the breast bone, exposing the heart and then replacing the valve. An intravenous (IV) line is inserted into your arm to deliver fluids and medications. You will be given a general anesthetic.

After your heart is exposed, your heart will be cooled and stopped while the surgery is being performed. A heart-lung machine will get oxygen in your blood and pump it around the body.

Once your heart is motionless, the surgeon will cut through its muscular wall, remove the malfunctioning heart valve, insert the prosthetic valve and stitch it into place.

After closing the incision in your heart wall, the surgeon will warm your heart. Once your heart is pumping steadily, you will be disconnected from the heart-lung machine. The surgeon will reattach the halves of your breastbone and your chest incision will be closed.

For some patients, new technologies allow artificial valves to be inserted into the heart without making even a small opening in the patient's chest.

Heart specialists are still gaining experience with these approaches. Because they involve cutting into fewer tissues, patients heal more quickly. However, it's not yet clear if the long-term results of less-invasive surgery are as good as with traditional surgery.



Write Dr. K at www.AskDoctorK.com or c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106

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