Aortic Heart Valve Issues

My diagnosis is that the aneurysm is primary, and due to its expansion, my aortic valve cannot close properly and blood leaks back into my heart (the secondary effect of my condition). Both problems need to be fixed. The aneurysm needs to be repaired to avoid the possibility of rupture or aortic dissection. The valve needs repair because the leak causes the heart to work harder which can eventually lead to an enlarged heart. The aneurysm fix is fairly standard. The damaged portion is surgically replaced with a Dacron tube. The aortic valve must also be repaired or replaced.

Valve Replacement Options
There are two replacement options, each with advantages and disadvantages. The first option is replacement with an artificial valve made out of plastic and metal. Dr. I showed me one of these valves. The advantage of an artificial valve is that it lasts forever. The downside is that you must take blood thinners, such as Coumadin, for the rest of your life. The other option is a tissue based valve from a cow or a pig. This type of valve does not require blood thinning medication. However, in "younger" patients such as myself, the valve will only last 10 to 15 years. For me that would mean another surgery at about age 60.

Valve Repair
A final option is valve repair, or more formally, a valve sparing aortic root replacement. This surgery was developed by Dr. Tirone David (currently with Toronto General Hospital), and the procedure carries his name. It is a complicated operation that adds about an hour and half to the more standard valve replacement approach. The obvious advantage of this approach is avoiding the need for blood thinning medication and hopefully future valve replacement.