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Is Aortic Valve Repair A New Global Phenomenon?

By Adam Pick on November 7, 2017

Together, we’ve learned lots about the advantages of mitral valve repair procedures which include long-term durability and freedom from re-operation. In the process, I’ve attended wonderful mitral valve conferences and I’ve even gone inside live surgeon workshops dedicated to teaching best practices for mitral valve repair.

That said, you might be wondering, “What about aortic valve repair?” and “Why don’t I hear much about aortic valve repair?”. Unfortunately, our educational efforts specific to aortic valve repair have been minimal. In the past, I simply haven’t received many patient questions about aortic valve repair.

Well… It appears that is about to change. During the recent Heart Valve Summit, I sat down with Dr. Vinay Badhwar, the Professor and Executive Chair of Cardiovascular and Thoracic Surgery at West Virginia University Medicine, to get the latest updates on new aortic valve repair devices and techniques. Here are the exciting highlights from our discussion.

I hoped this educational video helped the patients and caregivers in our community learn more about aortic valve repair procedures for both aortic stenosis and aortic regurgitation. Needless to say, these are very exciting developments. Going forward, I will do my best to further expand our knowledge about aortic valve repair techniques.

On behalf of our community, I would like to extend a huge thanks to Dr. Badhwar for sharing his clinical experiences and research with me at the Heart Valve Summit!

Keep on tickin!
Adam

P.S. For the hearing impaired members of our community, please find below a written transcript of my interview with Dr. Badhwar.

Adam Pick: Hi, everybody. It’s Adam with HeartValveSurgery.com. Today we’re answering your questions at the Heart Valve Summit in Chicago, Illinois. I am thrilled to be with Dr. Vinay Badhwar, who is the Professor and Executive Chair of the Department of Cardiovascular and Thoracic Surgery at West Virginia University in Morgantown. Dr. Badhwar, thanks for being with us today.

Dr. Vinay Badhwar: Good to see you again.

Adam Pick: We were just looking over some questions that we got. One of the questions that didn’t come in was about a topic – we hear a lot about mitral valve repair; we don’t hear a lot about aortic valve repair. Can you maybe talk about some of the exciting things that you’re doing at West Virginia University?

Dr. Vinay Badhwar: Sure. I mean, it’s a global trend now, actually. Aortic valve repair, as opposed to replacing the valve, going back typically when patients present with either a blocked aorta valve or aortic valve stenosis, or a leaking aortic valve or what’s called aortic valve regurgitation, there’s really only one surgical option and that’s replacing the valve. All of your readers and bloggers discuss the merits of replacing with a mechanical valve or a tissue valve – I know, something that you know things about.

What’s changed, perhaps over the last five years or so, is that for certain patients there are techniques that have been developed to rebuild the valve or repair the valve. In blocked valves or stenotic valves, we now can use one’s own heart lining – or pericardium – to rebuild the leaflets. That’s a procedure called the Ozaki Operation, a name for a surgeon out of Japan that has experimented and now done that in over 1,000 patients in Japan and now in the United States.

Now patients that have a leaky valve, there’s been many techniques that have been developed, namely in Europe. All of those have been using leaflet techniques to try to repair a portion of the leaflets that have failed, or other issues like that, but that’s not always fully reproduceable. It’s not really been rapidly adapted in the United States. However, an exciting development that’s happened starting in Europe, and now in the United States, we now have FDA approved rings. Let me explain why that’s important. As I know all of your viewers have seen, is that in the mitral operations, we always support all the good things we do to repair the mitral valves with a ring because we’ve shown that late recurrence occurs when we don’t support the annulus, or the door frame of the valve. In the aortic valve, we now for the first time have that available. Those are aortic valve repair rings, or what’s called the HAART aortic annuloplasty rings for both valves that are three leaflets and two leaflets, or tri-leaflet valves and bi-cuspid valves.

Adam Pick: Definitely exciting for me to hear this news because we always hear about the mitral valve repair, that that is a potential fix for life, versus some of the replacement techniques. Dr. Badhwar, we can’t thank you enough for everything that you’re doing at the West Virginia University. Keep up all the great work, and thanks for being with us today!

Dr. Vinay Badhwar: Pleasure, as always.

Written by Adam Pick
- Patient & Website Founder

Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Jacqueline K. LaRock Benson says on November 7th, 2017 at 4:54 pm

Just wondering if this aortic valve repair would work for me as I also have an aortic aneursym that would be repaired at the same time. I am getting it checked every 6 months and it is currently stable. I just wonder if I can have an easier surgery without having to cut open my chest which entails a longer recovery. Thanks!
Jackie

Dayna Wiggins Oldenburg says on November 7th, 2017 at 6:09 pm

Have they performed this on any Ross procedure patients? My son had the ross procedure at 4 years old in 2007 and a year ago Nov 10th he had his pulmonary replaced with a porcine valve. Just curious as they watch his Aortic Valve closely.

Adam says on November 7th, 2017 at 6:49 pm

Great question Dayna! I had a Ross Procedure too. Let me ask around and I’ll do my best to get an answer for you and our community. Thanks so much for asking! Also, for those who are unfamiliar with the Ross Procedure, click https://www.heart-valve-surgery.com/ross-procedure.php. https://uploads.disquscdn.com/images/a636c18e05eda8dc3e884c6c788696a75773244c8b0a1c28d66bc89ef3b509ce.gif

Adam says on November 7th, 2017 at 6:51 pm

Another great question Jacqueline! Thanks for asking! Let me see if I can track down an answer for you. Also, here’s a great new post about aortic aneurysms for our community. https://www.heart-valve-surgery.com/heart-surgery-blog/2017/09/28/top-facts-aortic-aneurysms-eric-weiss-dr/ https://uploads.disquscdn.com/images/70b1d303967745e6b8d5836b0402537be3b00f5d94adc821a2880e9db1669e86.jpg

Alexander says on November 8th, 2017 at 2:09 pm

Hi, I had an Aortic valve transplant (Bovine tissue) performed just over 3 years ago plus 2 coronary arteries. Was wondering, how long can I expect to get from this replacement valve before it needs seeing to again? And secondly, what symptoms is one likely to feel if and when it gets close to that time?

Stephanie N James Hickman says on November 8th, 2017 at 6:31 pm

If you have already had an AVR for a bicuspid valve could you have this device and/or have the area reconstructed? I was wondering because of the money spent on meds and the inr reading expense.

Gary Knowlton says on November 9th, 2017 at 10:02 am

I had the same thing plus a bicuspid aortic valve where most people have a tricuspid I had the valve replaced and the aneurysm repaired 5 years ago at Clevend Clinic . It was 5 days in recovery then home and rehab at a wellness center for 3 months .