Our Summary

This study looked at why a certain heart surgery, called aortic root remodeling, might not work in some cases. This surgery is done to repair a part of the heart called the aorta. The researchers studied over a thousand patients who had this surgery between 1995 and 2019. Of these patients, 54 had to have another operation because their aorta wasn’t working properly. The reasons for this included a leaky aorta, a narrowed aorta, an infection, or a hole in the wall of the heart. They found that the main reasons for the failure were problems with the ‘cusp’ (a part of the aorta), or an infection. These patients were treated either by replacing the valve or repairing the cusp. No patient died in the hospital, but 12 patients died later on. Of the patients who had their cusp repaired again, half of them are still alive with a stable aorta. The researchers conclude that problems with the cusp are the main reasons for failure of this surgery. However, having another operation can be done safely and with low risk. In some patients, repairing the cusp alone may be an option.

FAQs

  1. What is aortic root remodeling surgery and why is it performed?
  2. What are the main reasons for the failure of aortic root remodeling surgery?
  3. What treatment options are available for patients whose aortic root remodeling surgery has failed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about valve replacement is to follow up regularly with your healthcare provider to monitor the function of the valve and address any potential issues early on. It is important to report any new symptoms or changes in your health to your doctor promptly. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support the function of the replaced valve and overall heart health.

Suitable For

Patients who are typically recommended valve replacement include those with aortic root aneurysms, aortic valve stenosis, aortic valve regurgitation, and other conditions affecting the aortic valve and aorta. These patients may experience symptoms such as chest pain, shortness of breath, fatigue, and heart palpitations. Additionally, patients with a history of previous heart surgeries or congenital heart defects may also be candidates for valve replacement. Ultimately, the decision to undergo valve replacement surgery is based on the individual patient’s medical history, symptoms, and overall health.

Timeline

Before valve replacement:

  • Patient may experience symptoms such as shortness of breath, chest pain, fatigue, and dizziness
  • Patient is referred to a cardiologist for evaluation and diagnosis
  • Cardiologist determines that the patient needs a valve replacement surgery
  • Patient undergoes pre-operative tests and evaluations to assess their overall health and suitability for surgery

After valve replacement:

  • Patient undergoes valve replacement surgery, which can be done through open-heart surgery or minimally invasive techniques
  • Patient is monitored closely in the hospital for any complications or side effects
  • Patient undergoes rehabilitation and physical therapy to regain strength and mobility
  • Patient may need to take medications to prevent blood clots and manage any underlying heart conditions
  • Patient attends regular follow-up appointments with their cardiologist to monitor their heart function and overall health
  • Patient can resume normal activities and enjoy an improved quality of life with a functioning heart valve

What to Ask Your Doctor

  1. What are the potential risks and benefits of aortic root remodeling surgery for valve replacement?
  2. How likely is it that I may need another operation in the future due to complications?
  3. What symptoms should I watch out for that may indicate a problem with the valve replacement?
  4. What follow-up care will be needed after the surgery to monitor the function of the valve and aorta?
  5. Are there any lifestyle changes or medications I should consider to reduce the risk of complications?
  6. What is the success rate of repairing the cusp versus replacing the valve in cases of failure?
  7. How long is the recovery period after aortic root remodeling surgery, and what can I expect during this time?
  8. Are there any alternative treatment options for valve replacement that I should be aware of?
  9. What is the long-term outlook for patients who have had aortic root remodeling surgery for valve replacement?
  10. Are there any specific factors in my medical history or condition that may affect the success of this surgery?

Reference

Authors: Giebels C, Fister JC, Ehrlich T, Federspiel J, Schäfers HJ. Journal: Ann Thorac Surg. 2022 Jun;113(6):2000-2006. doi: 10.1016/j.athoracsur.2021.07.034. Epub 2021 Aug 13. PMID: 34400134