aortic stenosis

[haggie]

I am an 82 year old male with aortic stenosis (the valve remains open),a mitral valve problem, and congestive heart failure who has had a triple bypass and several stents. Is an aortic valve replacement a viable option for me?

[kenkeith]

Minimum invasive surgery for aortic valve repacement.  It is 6-10 cm in length and through a smaller incision allows the surgeon to open the upper part of the sternum only, which gives free access to the ascending aorta as it arises from the heart and hence the aortic valve.

Advantages of this incision are a more cosmetic result, faster healing, less blood loss and need for transfusion, and potentially shorter hospital stay. It is an option for almost anyone receiving isolated aortic valve replacement. Note that coronary artery bypass grafting can not be accomplished with minimally invasive incision options. It is an excellent option for someone who has had previous coronary artery bypass grafting and has an open internal mammary artery graft!!!!?

Surgery is usually not performed (fuill sternotomy) if one is in heart failure mode (EF below 29%)...too rsiky unless it is life your death situation.

Contrary to what the other poster stated, valve disorders do not improve.  An exception is ischemiac left ventrical enlargement.  The enlargement deforms the valve opening, and sometimes when the heart has reversed remodeling (size returns to normal) and MVR is correected. There was some expectation my mitral valve regurg could be corrected.  My left ventricle has returned to normal size, but MVR remains unabated!

A major valve sugeon at the Mayo Clinic commented too many people wait too long before deciding on surgery.  The porblem is if one waits too long there is a danger that left wentricle systole cannot be preserved...your systole function is already impaired as evidence by CHF, by a minimum invasion treatment may be beneficial.  That would be a decision of a surgeon to weigh the benefit vs. risk.  

[Encephalomalcia]

How bad is your aortic valve?  How out of breath are you?  This is a big surgery.  Valve replacement is very complex.  This surgery has a much more recovery time than a bypass surgery.  There is risk involved.  Sometimes valves get better, so do not rush into surgery unless you very much need it.