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Aortic Valve While Dr. Salenger favors mitral valve repair over replacement, aortic valve replacements tend to last longer and function better for most patients. Although research has not pinpointed the reasons for the functional differences between mitral and aortic valve replacement, Dr. Salenger surmises it���s because of less pressure levied upon the aortic valve throughout the cardiac cycle. The Society of Thoracic Surgeons (STS) identi���es the two most common causes of aortic valve malfunction to be congenital and senile calcification. The most common congenital problem is a bicuspid aortic valve. Some of these valves will start to leak or become too tight as a person ages, usually around the sixth decade. Senile calcific aortic stenosis occurs in some elderly patients. For unknown reasons, calcium deposits on the aortic valve lea���ets prevent effective opening of the valve. When this tightening of the valve occurs, patients develop aortic stenosis. Aortic stenosis classically presents with shortness of breath, chest pain or light-headedness. The presentation can sometimes be similar to a heart attack. Other patients may complain only of being increasingly tired or lacking energy. Patients with the above constellation of symptoms should be evaluated for aortic Dr. Salenger and Todd Mignone, a mitral valve repair and coronary artery bypass graft patient valve disease. If assessment reveals severe aortic valve disease, surgery is most likely necessary. Dr. Salenger and his team then take over. The patient is taken to the operating room and placed on the heart-lung machine. This machine will circulate and oxygenate the blood, keeping it away from the heart while surgeons operate. After opening the aorta, Dr. Lundy discusses with Dr. Salenger recent medical articles for peer discussions during upcoming journal club meetings with physicians. Dr. Salenger says, the malfunctioning valve is cut out and replaced with a new mechanical or biological valve. Mechanical valves, made of metal, are more durable, but have a tendency to cause blood clots, requiring patients to take anticoagulant medications for the remainder of their lives. Biological valves, made from animal or cadaveric heart tissues, reduce the risk of blood clots but are not as durable as mechanical valves. Patients and surgeons choose which valve to use based on patient preference, risks posed by age and comorbidities, and lifestyle. Patients may have other conditions involving the aortic valve, says Dr. Salenger, including aneurysmal dilation of the ascending aorta in close proximity to the aortic valve. The STS reports that an estimated 15,000 Americans die each year from ruptured aortic aneurysms, but early detection and surgical intervention can treat the condition before it turns lethal. Depending on location, surgeons at the Center for Valve Surgery may repair the aneurysm by replacing both the valve and aorta or simply replacing the aorta, leaving the valve in place. MDNEWS.COM I MD NEWS Mid Hudson |9