Aortic valve replacement (AVDR) is an operation that replaces the aortic valve in patients who cannot withstand open heart surgery.
Also called transcatheter aortic valve implantation or percutaneous aortic valve implantation, this procedure allows the aortic valve to be replaced without open surgery, i.e. without opening the chest cavity but also without using a cardiopulmonary pump. This is an operation for patients with severe aortic valve narrowing who cannot benefit from conventional open-heart surgery. Indeed, this minimally invasive alternative makes it possible to save patients considered inoperable or at high risk for open-heart surgery.
The AVDR procedure is indicated for patients:
Having a very tight calcified aortic narrowing (stenosis), responsible for very disabling, even potentially fatal manifestations (shortness of breath, angina pain or syncope occurring during exercise)
Duration of hospital stay
5 to 10 days.
Monitoring required after the intervention.
Average length of stay
2 to 3 weeks.
The surgeon will have to agree that the patient can fly again.
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Before the procedure, the patient will meet with the surgeon to ensure that he or she is eligible for the procedure. The surgeon will perform a series of tests, such as a physical examination, blood test, chest X-ray, ultrasound, CT scan, and angiography.
The procedure is performed under general anesthesia. There are two different approaches to percutaneous aortic valve replacement.
Option 1: The surgeon makes an incision in the femoral artery, in the groin, and passes a catheter through the incision to the heart.
Option 2: The surgeon will make an incision on the left side of the chest and pass the catheter through the incision to the heart.
A balloon device containing the new valve is attached to the catheter and the new valve is implanted inside the existing aortic valve. Then the balloon is inflated, making it easier to replace the natural valve with the new one.
Once the new valve is in place and working properly, the catheter is then removed and the incision is closed with sutures.
The valve used can be a mechanical valve (handmade) or a biological valve (made from animal tissue).
The procedure can last from 1 to 2 hours.
Once the operation is completed, the patient is transferred to the intensive care unit for a 24 to 48-hour stay for increased heart monitoring.
Then, the patient is transferred to the surgical unit for a period of 4 to 5 days.
If the incision was made in the chest, a chest tube is placed after the procedure.
Infection, bleeding, kidney failure, valve failure, arrhythmia, heart attack, death.
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