From the Guidelines
Cardiac surgeons with training and experience in valve repair techniques, typically at a Comprehensive Valve Center, are the most suitable professionals to repair aortic valves. These highly trained specialists perform procedures such as aortic valve replacement (AVR) or valve repair surgeries to address conditions like aortic stenosis, regurgitation, or other valve abnormalities, as suggested by the 2020 ACC/AHA guideline for the management of patients with valvular heart disease 1. The surgical approach may be traditional open-heart surgery or minimally invasive techniques depending on the patient's condition and surgeon's expertise.
Some key considerations for aortic valve repair include:
- Valve and aortic root anatomy and tissue characteristics, which can affect the feasibility of repair 1
- The complexity of patient selection and surgical techniques, which necessitate performance at a Comprehensive Valve Center 1
- The potential benefits and risks of transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR), particularly in patients with bicuspid aortic valves (BAV) 1
In terms of specific procedures, cardiac surgeons may perform:
- Aortic valve replacement (AVR) using mechanical or bioprosthetic valves
- Valve repair surgeries, such as valve sparing root replacement or valve reconstruction
- Minimally invasive techniques, such as transcatheter aortic valve replacement (TAVR) or sutureless valve replacement
Ultimately, the decision to repair or replace the aortic valve depends on the individual patient's condition, with repair being preferred when possible to preserve native tissue function, as noted in the 2020 ACC/AHA guideline 1. Patients typically require referral from their primary care physician or cardiologist to a cardiac surgeon, followed by comprehensive evaluation including echocardiograms and other cardiac imaging before determining the appropriate surgical intervention.