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What Happens During The Aortic Valve Replacement?

Clip Number: 8 of 35
Presentation: Aortic Valve Replacement
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Reviewed By: Arthur Schoenstadt, MD
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Now let's discuss your procedure.
After your anesthesia takes effect, the surgical area will be scrubbed with a special disinfectant soap and may also be shaved.
Your surgeon will then make a 6-8 inch incision down the middle of your chest. Your breastbone is then separated, the heart sac is carefully pulled back, and your heart is examined.
At this point, you will be given a large dose of a blood-thinning medicine, called heparin, to make sure that your blood does not clot. Your surgeon will then connect your heart to the heart-lung bypass machine with a plastic tube. Blood from your heart is then sent to the bypass machine through this tube. The machine supplies your blood with oxygen, and then pumps it back to the rest of your body through the other tube. While connected, your blood simply bypasses your heart and your lungs, but still reaches the rest of your body.
After the heart-lung bypass is established, your heart will need to be cooled to keep it still. Then, the aortic valve replacement procedure can begin.
The aorta is gently opened to reveal your aortic valve. Your surgeon will then carefully remove the old aortic valve. At this time your doctor will then select a mechanical or tissue replacement valve and this be sewn into place with stitches. Once securely in place, the aorta will be closed with stitches.
After this is done and your heart regains strength, you will slowly be removed from the heart-lung bypass machine. You will be completely free of the machine when your heart resumes its normal function and can support your body with its own pumping ability. Because everyone's heart is different, the time it takes to be removed from the bypass machine varies.
If your heart is slow to return to its normal function, several options are available to help it regain strength. These include medication through your IV, or electrical stimulation from small thin wires called "pacing wires" to help your heart beat normally - until your own heart's electrical system has recovered. These wires are placed directly onto the surface of your heart and will be left inside your chest during your hospital recovery. Usually these are temporary, and should be removed prior to you going home, but in some patients, the wires may need to be replaced by a permanent pacemaker.
Several chest tubes will also be placed inside your chest to collect any fluid that drains into the spaces around your heart and lungs. These help to ensure that your lungs and heart are working properly.
Lastly, your breastbone is brought back together with thick steel wire. This helps your breastbone to heal and prevents movement as you become active again. Your skin incision is then closed with stitches and a sterile bandage is applied.

Aortic Valve Replacement


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