Laparoscopic heart valve replacement surgery, especially laparoscopic aortic valve replacement surgery, is one of the possible options for performing aortic valve replacement in case of its damage and inability to work and control blood flow correctly.
Perhaps the use of modern techniques such as the laparoscope has significantly contributed to increasing the safety rate for complex cardiac operations and accelerating the patient’s recovery period and helping them return to practicing their life normally within a short period after the operation.
Professor Dr. Mohamed El-Ghannam is the most famous specialist in this field, and has long experience and high efficiency in performing open-heart surgeries and laparoscopic minimally invasive surgeries.
How is Laparoscopic Aortic Valve Replacement Surgery Performed?
Laparoscopic aortic valve replacement surgery is performed through a small opening only 5 cm long without fully opening the chest. The doctor inserts the laparoscopic tube through the aorta until reaching the damaged valve and replacing it with a new valve (mechanical or tissue). The operation takes 3 to 4 hours, and its success rate reaches 98%, with faster recovery and less pain compared to traditional open-heart surgery.
What is Laparoscopic Aortic Valve Replacement Surgery?
The laparoscope can be used for the purpose of repairing or changing heart valves. The doctor inserts the laparoscope through a small incision in the chest, and the laparoscopic tube is guided into the aorta until reaching the damaged valve, at which point it is replaced with the new valve.
Laparoscopic minimally invasive aortic valve replacement surgery is characterized by saving the patient from the pain and danger they are exposed to during open-heart surgeries. Also, the patient returns to practicing their normal life quickly after the operation and does not need a long period for recovery and healing.
How is Laparoscopic Heart Valve Replacement Surgery Performed?
Laparoscopic heart valve replacement surgery is performed after the patient undergoes general anesthesia. Then, the doctor makes a small opening only 5 cm long, then the laparoscopic tube is inserted through this opening without making a chest incision like open-heart surgeries.
Depending on the laparoscopic imaging technique, the doctor guides the laparoscope in the aorta stream reaching the place of the damaged aortic valve, then performs a repair or replacement process for the valve and planting and fixing a new valve (heart valve operation), which is either a mechanical valve or a biological tissue valve, and the specialist doctor is the one who decides the most appropriate type of valve to treat the patient.
The operation takes approximately 3 to 4 hours. After the operation, the patient needs to stay in the intensive care unit to monitor their health status for a day or more depending on their health situation. Then they move to a regular room for several days, after which they can leave the hospital and recover quickly at home.
What is the Success Rate of Laparoscopic Heart Valve Replacement Surgery?
Laparoscopic minimally invasive aortic valve replacement surgery is considered the safest compared to traditional open-heart surgeries, due to the small surgical opening through which it is performed, providing the patient with a greater chance for rapid recovery and less susceptibility to infection.
Also, the pain the patient feels after the operation is less, and the amount of blood lost is small, which is one of the most important features of this minimally invasive procedure, in addition to the possibility of the patient returning to practice their life after the operation quickly.
Professor Dr. Mohamed Ali El-Ghannam, Consultant of Heart and Chest Surgery, explains that laparoscopic aortic valve replacement operations are performed by an experienced medical team that has sufficient experience for this type of surgery, and its success rate reaches 98%. It is very suitable for the elderly as it reaches the highest success rate for heart valve replacement surgery for the elderly and patients who suffer from other health problems.
What is the Aortic Valve? And What is its Shape?
The heart contains four valves: the aortic valve, the mitral valve, the pulmonary valve, and the tricuspid valve. These valves are what regulate the movement of blood in the correct direction, by closing and opening with regular and coordinated mechanical movements with the contraction and relaxation of the heart muscle.
The aortic valve is the gate that separates the left ventricle of the heart and the aorta responsible for transporting blood from the heart and nourishing the body’s organs.
Shape of the Aortic Valve
From an anatomical point of view, the shape of the aortic valve takes the form of three thin crescent-shaped leaflets (known as semilunar leaflets) that meet in the middle to close the valve opening tightly during heart relaxation, and open fully to allow blood to pass from the left ventricle to the aorta during contraction. Some people are born with an aortic valve containing only two leaflets instead of three (known as a bicuspid valve), which is one of the common congenital defects that may make the valve more susceptible to stenosis or regurgitation in the future.
Aortic Valve Diseases
Some individuals may suffer from a problem in the aortic valve such as:
Aortic Valve Stenosis
In this case, the aortic valve loses its flexibility and becomes stiff and narrow, as a result of several factors, the most famous of which are calcium, fat, and cholesterol deposits on it. This results in narrowing of the blood stream through the aorta, which requires more effort from the heart muscle to pump blood through that narrow valve.
Aortic Valve Regurgitation
In this case, relaxation of the valve occurs, and therefore it is unable to close completely, which allows blood to flow back into the heart.
Congenital Defects in the Aortic Valve
These include a change in the form and size of the valve, and this is reflected in the function of the valve.
Causes of Aortic Valve Stenosis
There are causes that may lead to aortic valve disease. Some may occur with advancing age and aging, but hereditary factors are also one of the important causes of valve disease. We can explain the causes in points as follows:
- Infection with a bacterial infection.
- Congenital heart defect.
- Hereditary factors.
- Dilation of the aortic wall, and this is what makes many patients wonder about the success rate of abdominal aortic artery surgery.
Symptoms of Aortic Valve Disease
Owners of simple cases of aortic valve disease may not feel symptoms initially, but advanced cases suffer from fatigue and shortness of breath, which prompts them to search for the cause and undergo medical examination. Symptoms of aortic valve disease include:
- The patient complains of shortness of breath.
- Swelling in the legs.
- Aortic valve stenosis causes shortness of breath with the least effort.
- Advanced cases may suffer from loss of consciousness or coma.
Symptoms of Aortic Valve Regurgitation Specifically
Aortic valve regurgitation symptoms vary slightly depending on the degree of regurgitation. In mild cases, no symptoms may appear at all, while aortic valve regurgitation symptoms start to appear as the condition worsens, including: shortness of breath when exerting effort or when lying down, feeling of palpitations or irregular heartbeat, unusual fatigue and exhaustion, and swelling of the feet and ankles in advanced cases. Monitoring aortic valve regurgitation symptoms early helps determine the appropriate time for medical intervention before the heart muscle is affected.
Degrees of Aortic Valve Regurgitation
Before making the decision to undergo this procedure, the doctor determines the degree of severity of the valve regurgitation, as aortic valve regurgitation is classified into several degrees based on the amount of blood leaking backward.
The degree of regurgitation is determined through the evaluation of Echo X-rays into the following:
- Mild Aortic Valve Regurgitation: The amount of blood leaking backward is small and usually no symptoms appear on the patient. It is discovered during periodic examination and its treatment is through periodic follow-up and continuous examination.
- Moderate Aortic Valve Regurgitation: The amount of leaking blood is slightly larger, leading to the appearance of some mild symptoms on the patient. Treating this degree of regurgitation requires commitment to taking some medications prescribed by the doctor with a lifestyle change.
- Severe Aortic Valve Regurgitation: Where a large amount of blood leaks backward, leading to the appearance of clear and severe symptoms on the patient, necessitating surgical intervention to replace the aortic valve.
Aortic Valve Replacement: When is it Necessary?
Professor Dr. Mohamed El-Ghannam, Consultant of Open-Heart Surgery and Minimally Invasive Surgical Intervention, explains that simple cases can coexist with aortic valve stenosis through medical treatment concurrent with periodic examination and follow-up.
But advanced cases need surgical intervention in order to protect the patient from complications that are likely to occur such as heart failure. Also, the patient becomes more susceptible to stroke or heart attack.
Therefore, the decision to undergo surgery and replace the valve is determined by the doctor according to a number of factors, including:
- The patient’s age and health status and whether they suffer from other diseases.
- Whether the patient suffers from any other heart problems.
- Also the degree of regurgitation or stenosis in the aortic valve.
Knowing when the patient wakes up after heart valve surgery.
Mostly, aortic valve repair is possible in cases of aortic valve regurgitation, but cases of valve stenosis may need aortic valve replacement (heart valve replacement operations). During surgical intervention, the damaged valve is replaced with another biological or artificial one according to what the doctor determines and finds appropriate for the patient’s condition.
The difference between an artificial and a biological valve is as follows:
- Biological or Tissue Valve: Obtained from pig, cow, or horse tissues. This type of biological valve has a lifespan of approximately 10 to 15 years.
- Mechanical or Artificial Valve: This type of valve is made of carbon or titanium material and the patient in this case needs to take anticoagulant medications regularly.
Aortic Valve Replacement Surgery: Available Options
In case of the decision to undergo aortic valve replacement surgery, the patient undergoes some routine tests to evaluate their condition, including blood analyses, ECG, and heart ultrasound. Then the doctor determines the appropriate technique for the patient, which is one of the following options:
Open-Heart Surgeries
These are operations performed by specialized and experienced consultants, where some bones of the front rib cage are incised, then reaching the heart, and dealing with the damaged aortic valve directly by repairing or replacing the valve.
Traditional open-heart surgery is considered one of the serious operations that require skill and experience from the heart surgeon. After the operation, the patient needs to stay in the hospital under observation to ensure the regularity of their vital rates for a period of up to a week. After that, they can return home and spend a recovery period that may last 6 to 8 weeks for the wound to heal according to their health situation, age, and extent of commitment to treatment.
Aortic Valve Replacement Operations with Catheterization
Heart valve replacement with catheterization is a simple procedure performed using a catheter that extends from one of the large blood vessels reaching the aortic valve, and then replacing it and planting the new valve.
Is Aortic Valve Replacement Surgery Dangerous?
There is no doubt that modern medical techniques such as cardiac catheterization and surgical laparoscope saved the patient from many risk factors they are exposed to during traditional open-heart surgeries, and helped the patient recover faster. As we mentioned, the success rate of aortic valve replacement surgery with minimally invasive surgical intervention techniques reaches 98%, with care to choose the doctor with experience and efficiency.
Best Open-Heart Surgery Doctor in Egypt
Professor Dr. Mohamed El-Ghannam, Consultant of Heart and Chest Surgery at the Faculty of Medicine, Ain Shams University, Doctorate in Heart and Chest Surgery, holder of a fellowship from the British College of Heart and Chest Surgery, and fellow of the University of Liverpool and James Cook University in England, and a member of the European Association of Thoracic Surgeons, an international member of the American Association for Thoracic Surgery, and a member of the Egyptian Society of Critical Care.
Cases Cured of Aortic Valve Regurgitation
There are many cases that have been cured of aortic valve regurgitation permanently thanks to the accurate diagnosis and appropriate treatments prescribed by Professor Dr. Mohamed El-Ghannam, Consultant of Open-Heart Surgery and Minimally Invasive Surgical Intervention.
Professor Dr. Mohamed El-Ghannam, the best heart and chest surgery doctor at Shifa Hospital, treats cases of aortic valve regurgitation based on the degree of regurgitation. If the patient suffers from moderate aortic valve regurgitation, after accurate diagnosis, the doctor prescribes a group of medications, and with commitment to treatment and follow-up, the condition improves significantly.
As for advanced cases of aortic valve regurgitation, surgical intervention such as laparoscopic intervention or through traditional surgery may be required based on the doctor’s evaluation of the case.
Despite recovery from valve regurgitation, the doctor advises the patient with some instructions and guidelines for life to maintain their heart health, including the following guidelines:
- Follow a healthy and balanced diet rich in fruits, vegetables, proteins, and whole grains.
- Take sufficient rest and sleep at a daily rate ranging from 6 to 8 hours.
- Avoid activities that increase pressure on the heart muscle.
- Practice sports regularly, especially walking, as it improves blood circulation in the body.
- Commit to follow-up with the doctor to check on heart health from time to time.
- Avoid foods that contain high percentages of sodium salts and saturated fats, as well as sugars.
- Do not smoke because it negatively affects heart and cardiovascular health.
- Avoid stress and continuous psychological pressure.
Cost of Aortic Valve Replacement Surgery
There is a big difference in the price of heart valve replacement surgery, due to the presence of several factors affecting the cost, including:
- Type of artificial valve: The cost of artificial valves varies according to the mechanical or biological type and the manufacturer.
- Type of surgical technique used: The cost of undergoing open-heart surgery differs from laparoscopic minimally invasive surgical intervention.
- Exposure to any complications during or after surgery.
- Hospital cost and the availability of capabilities and devices.
- Experience and skill of the surgeon and their fees.
- Experience of the assisting team from anesthesia, nursing, and care.
Laparoscopic Mitral Valve Replacement Surgery: Is it Performed in the Same Way?
In addition to the aortic valve, Professor Dr. Mohamed El-Ghannam also performs laparoscopic mitral valve replacement surgery for patients with mitral valve stenosis or regurgitation, using the same principle of minimally invasive surgical intervention; a small opening instead of fully opening the chest, which similarly reduces pain and accelerates recovery. The mitral valve differs from the aortic valve in its location (between the left atrium and ventricle) and in the nature of some complications, but the laparoscopic intervention method and high success rates are very similar between the two operations.
To know more details about this operation, you can read the article on Balloon Mitral Valve Dilation, which explains the steps and features of mitral valve treatment in detail.
Conclusion
In conclusion, the preference for performing laparoscopic aortic valve replacement surgery over undergoing traditional surgery is due to many factors. It is the safest due to the small surgical opening through which it is performed, and therefore a greater chance for rapid recovery and less susceptibility to infection.
Minimally invasive surgeries require a lot of skill and experience in this type of specialization, and this is what Dr. Mohamed El-Ghannam, Consultant of Open-Heart Surgery and Minimally Invasive Surgical Intervention, has gained as a distinguished reputation in the field of heart surgery, especially minimally invasive intervention.
Frequently Asked Questions
What is the shape of the aortic valve?
The aortic valve takes the form of three thin crescent-shaped leaflets that meet in the middle to close the opening tightly during heart relaxation and open fully during contraction to allow blood to pass. Some people may be born with a bicuspid valve (two leaflets only) instead of three as a common congenital defect.
What are the symptoms of aortic valve regurgitation?
They include shortness of breath when exerting effort or lying down, palpitations or irregular heartbeat, unusual fatigue and exhaustion, and swelling of the feet and ankles in advanced cases. No symptoms may appear in mild cases.
What is the success rate of laparoscopic aortic valve replacement surgery?
The success rate of laparoscopic aortic valve replacement surgery reaches 98%, which is a high rate compared to traditional open-heart surgery, with faster recovery, less pain, and less susceptibility to infection, especially when performed with an experienced medical team.
Is laparoscopic mitral valve replacement surgery similar to laparoscopic aortic valve replacement surgery?
Yes, laparoscopic mitral valve replacement surgery depends on the same principle of minimally invasive surgical intervention used in laparoscopic aortic valve replacement surgery, through a small opening instead of fully opening the chest, with high success rates and faster recovery in both cases.
