Aortic valve repair is a surgery that fixes damaged parts of your aortic valve. This helps your valve close normally so blood doesn’t leak backward. Repair of your aortic valve is less common than replacement, but experienced surgeons recommend it in some cases. Your surgeon will tell you more about the benefits and risks in your unique situation.
Aortic valve repair is a type of heart valve surgery that helps the “door” between your heart and your body’s main artery (aorta) work normally. This “door” (your aortic valve) opens and closes with every heartbeat to manage blood flow from your heart’s lower left chamber into your aorta. Damage to your valve can prevent it from opening and closing how it should.
For example, some people develop a leaky aortic valve (aortic regurgitation). This means your valve has trouble fully closing. This results in some blood leaking backward into your heart instead of moving forward into your aorta. This forces your heart to work harder to pump out enough blood, leading to heart damage over time. That’s why people with severe aortic regurgitation and/or symptoms typically need surgery to repair or replace their valves.
Surgeons usually replace your aortic valve to fix problems like regurgitation. However, some people can benefit from repair of their aortic valve. Surgeons carefully choose the people who can have repair surgery on a case-by-case basis. They take into account many factors, including the anatomy of your valve and the extent of damage. Your surgeon will recommend either repair or replacement based on your individual needs.
Pre-operative testing is a main part of your preparation. Your surgeon needs to make sure that your aortic valve is repairable. If parts of your valve are too damaged, then you may need a replacement valve instead of a repair. You might have a transesophageal echocardiogram (TEE) to give your surgeon a detailed, close-up look at your valve and other areas of your heart.
Other tests you may need include:
Your provider will give you detailed instructions for how you should prepare. Follow these closely and ask if there’s anything you don’t understand. The instructions will tell you:
Surgeons perform aortic valve repair through open-heart surgery or, in some cases, minimally invasive surgery. Open-heart surgery involves one large cut (incision) in the middle of your chest. Minimally invasive surgery uses smaller incisions to access your heart and repair your valve. Your surgeon will let you know which method is more suitable for you.
In general, aortic valve repair follows these steps:
You can expect to spend about three to seven days in the hospital. Your care team will keep a close eye on you and make sure you’re recovering normally. They’ll help you get moving slowly and safely.
Before you go home, you’ll learn about cardiac rehab and how it can help you continue your recovery.
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The main benefit of aortic valve repair is that it allows you to keep your natural (native) valve. This means you can avoid many of the risks associated with valve replacement, including the potential need for long-term blood thinners (anticoagulants). Your provider can tell you more about the benefits of repair over replacement in your specific situation.
Aortic valve repair is a serious operation that carries some risks. One possible complication is the need for another surgery. You may need another surgery for additional repairs or a valve replacement if:
Other possible complications of any aortic valve surgery include:
Everyone has different levels of risk. Your surgeon will talk to you about your risks before surgery. It’s important you understand all possible complications and how they may affect you. Ask if anything is unclear. People who have serious health issues prior to the surgery (for example, people with severe heart failure) may face higher risks.
You’ll likely need about four to eight weeks to recover from your surgery. You may need less time if you have minimally invasive surgery (smaller incisions).
It’s normal to feel tired for several weeks. Take it easy and don’t try to do too much, too fast. Your provider will tell you when it’s safe for you to return to your usual activities, including driving and going back to work. Participating in cardiac rehab can also help you safely get moving again while also making healthy lifestyle changes.
Call your healthcare provider right away if you have signs of complications after your surgery, including:
Aortic valve repair is much less common than aortic valve replacement. Researchers estimate that less than 5% of all aortic valve surgeries involve valve repair. This is largely because aortic valve repair is a highly specialized type of surgery. It’s not widespread among many hospitals and surgeons.
Aortic valve repair surgery treats aortic regurgitation (leaky valve).
Surgeons sometimes perform aortic valve repair as an isolated procedure. This means the only problem is a leaky valve, and the repair will address that problem.
Surgeons can also repair your aortic valve during valve-sparing aortic root replacement. This surgery treats an aneurysm (abnormal widening) in the part of your aorta that attaches to your heart. Your surgeon removes damaged parts of your aorta and also repairs your aortic valve. This approach allows you to keep your natural valve and avoid a valve replacement.
In both cases, your surgeon uses highly specialized techniques to give your valve the ability to work normally. It’s best to have aortic valve repair at a high-volume hospital with surgeons experienced in this technique.
A note from Cleveland Clinic
Aortic valve repair is a major surgery, so you may be nervous about the process and wonder how you’ll feel after. But in an experienced surgeon’s hands, your heart can get the care it needs to work better and stronger in the long run. As you prepare for your surgery, share all of your questions and concerns with your healthcare team. They’ll explain what you can expect and connect you with resources to learn more.
Last reviewed by a Cleveland Clinic medical professional on 08/10/2023.
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