There are two surgical methods currently that can restore normal aortic valve functioning.
The first surgical procedure involves replacing the aortic valve. The three types of replacement valve options are mechanical, porcine, and bovine. The bovine valve generally has the longest warranty, if you will, functioning well for about 10 years, while the mechanical valve has the shortest guaranteed functionality.
Replacing the aortic valve involves open-heart surgery, which requires that the recipient being in otherwise fairly good cardiac and general health to minimize the risk of serious complications or death, either during the surgery or after the surgery.
However, for patients with existing serious cardiac and/or general health problems, a second aortic valve replacement option that does not require open-heart surgery is available.
This procedure is known as transcatheter aortic valve replacement (TAVR). The procedure consists of using a catheter – usually through the femoral artery – to insert a flexible ring into the aortic valve to restore correct opening and closing of the valve.
But, even though TAVR is a less risky surgical option than open-heart surgery to replace the aortic valve, it poses significant short-term and long-term post-surgical risks.
These risks include blood clot formation and subsequent strokes immediately after the surgery (this is a common risk with femoral artery catheterization) and a higher likelihood of developing long-term small vessel ischemia (TIAs) resulting in microbleeds in the brain.
Additionally, the older a recipient of TAVR is, the higher these risks are.
Because small vessel ischemia affects the vascular functioning of the brain, a concurrent higher risk for cognitive impairment, decline, and dementia are also associated with TAVR.
Proper aortic valve functioning is a vital part of cardiac health, so this post is not discouraging surgical procedures to correct this malfunction.
However, as Going Gentle Into That Good Night‘s purpose is, in part, to educate, this post presents the information we need to know when and if we are faced with choosing a procedure to repair the aortic valve.
It’s been my experience that a lot of medical professionals tend to either downplay or hide the real risks associated with surgical procedures especially and that leads to either faulty choices for care or devastation when things – and they often do – go wrong after receiving care.
We should all be able to go in armed with the facts so that we can make the best decisions possible because all the risks are already known and on the table. Without that, we cannot be competent medical advocates for our loved ones and we will not be prepared for possible negative outcomes.