Minimally invasive aortic valve replacement is performed in Turkey to treat aortic valve issues and improve quality of life with a minimally invasive surgical procedure.
Overview of the aortic valve
The aortic valve (also known as the aortic valve) consists of three leaflets and controls the flow of blood from the left ventricle of the heart to the aorta, which in turn carries oxygen-laden blood throughout the body. The valve opens to allow blood to pass from the heart to the aorta and then closes to prevent its return in the opposite direction—this happens with every heart cycle.
The aortic valve may develop a disease or injury that makes it hard and narrow, preventing proper opening and reducing the amount of blood leaving the heart—this is known as aortic valve stenosis. Alternatively, the valve may become unable to close properly, causing blood to leak backward into the heart—this is called aortic valve insufficiency.
These conditions increase the blood volume in the left ventricle, which may lead to mitral valve insufficiency and force the heart to work harder, eventually leading to heart failure if left untreated.
In elderly patients, the most common issue is degenerative valve stenosis, where the valve leaflets become fibrotic and calcified over time. In younger patients, a bicuspid aortic valve is the most common issue, also leading to stenosis.
Minimally invasive aortic valve replacement (MIAVR) is a procedure used to replace a malfunctioning aortic valve with a prosthetic one, without the need for full open-heart surgery. It’s called “minimally invasive” because it requires a much smaller incision than traditional approaches.
Studies show the one-year survival rate after minimally invasive aortic valve replacement is 98%, and the three-year survival rate is 94%, highlighting the effectiveness of this modern surgical option in treating aortic valve disorders.
Benefits of minimally invasive aortic valve replacement
Minimally invasive aortic valve replacement surgery in Turkey has developed significantly in recent years because it offers several advantages over traditional open surgery:
- Smaller incision and therefore smaller post-operative scar
- Less bleeding
- Lower risk of sepsis
- Less pain after the procedure
- Shorter hospital stay (usually 3 to 4 days)
- Faster healing and return to work
However, minimally invasive aortic valve replacement is not suitable for all patients. About 85% to 90% may qualify depending on heart function, chest anatomy, and other health conditions.
Doctors at Bimaristan Medical Center will help patients choose the procedure that is most appropriate for their condition.
Preparing for minimally invasive aortic valve replacement
When you decide to have a minimally invasive aortic valve replacement, you will be asked to follow a few important steps to prepare for surgery and reduce your risk factors, including the following instructions:
- Start eating a healthy, balanced diet and stop smoking weeks before the operation to prepare your body and lungs for anesthesia and surgery.
- Stop taking certain medications before the procedure. Therefore, it is essential for the patient to inform the doctor of all medications being taken—especially blood thinners, which can increase bleeding during the operation.
- Refrain from eating or drinking starting at midnight the night before surgery, as a full stomach raises the risk of vomiting and potential inhalation injuries during anesthesia.
You may need to undergo some tests before the procedure, such as blood tests, a chest X-ray, and an electrocardiogram (ECG), to ensure you’re ready for surgery.
Planning a minimally invasive aortic valve replacement?
At Bimaristan Medical Center in Turkey, we guide you through every step — from preparation to recovery — using the latest minimally invasive aortic valve replacement techniques.
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How to perform minimally invasive aortic valve replacement surgery in Turkey
When the aortic valve does not function properly, it is necessary to perform surgery to replace it, relieve symptoms, and prolong the patient’s life expectancy. The choice of the type of replacement valve (artificial or biological) before surgery is essential and depends on the age, comorbidities,s and the patient’s desire.
First, the patient is placed under general anesthesia before any interventions are performed, meaning the patient will be deeply asleep for the duration of the procedure and will not feel anything during the procedure.
The minimally invasive aortic valve replacement procedure takes about two hours, depending on the minimally invasive technique used to perform the procedure, and friends and family should stay in the waiting room until the procedure is complete, where the surgeon will brief them on the process.
There are several ways to perform a minimally invasive aortic valve replacement, all of which require the patient to be connected to a cardiopulmonary bypass machine to stop the heart during the procedure.
The surgeon will remove the old aortic valve and replace it with the new one, after which the heart will be allowed to restore its pumping function gradually, the cardiopulmonary bypass device will be removed, and the incision will be sutured.
Options for minimally invasive aortic valve replacement surgery in Turkey
Open surgical aortic valve replacement requires an incision of approximately 20 centimeters in the sternum and the use of a cardiopulmonary bypass device to stop the heart during surgery, while minimally invasive aortic valve replacement has several techniques available in Turkey:
- A small incision is made at the top of the sternum 5-8 cm (2-3 inches), all surgical steps are performed directly through this small incision with long surgical instruments, and the heart is routinely connected directly to the cardiopulmonary bypass machine.
- A small surgical incision (called a keyhole) between the second and third right ribs of the sternum, 5-8 cm (2-3 inches) long, through which the heart is accessed. A small incision in the omentum usually accompanies this procedure to connect the patient to the cardiopulmonary bypass machine.
- Robotic aortic valve replacement; In this technique, several very small surgical incisions are made and robotic arms are inserted through them, and the surgeon controls these arms remotely through a special computer in the operating room that shows a 3D image of the heart and the aortic valve, a small incision in the omentum also accompanies this technique to connect the patient to the cardiopulmonary bypass device.
- Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive technique because it does not require an open-heart surgery to perform, in which the replacement aortic valve is inserted through a catheter and placed over the old valve without the need to stop the heart and use a cardiopulmonary bypass device.
Risks that can occur during minimally invasive aortic valve replacement
There are always risks with any surgical procedure, and these risks vary from person to person depending on their age and health condition.
The minimally invasive procedure may not be available to all patients, as open-heart surgery can be performed to replace the aortic valve in the traditional way.
Although most people who have undergone minimally invasive aortic valve replacement surgery have had successful outcomes and improved overall health, there are risks and complications with this procedure, like any other:
- Sepsis
- Bleeding
- Renal damage
- Cerebral hemorrhage
- Heart attack
- Irregular heartbeat
- Complications from anesthesia
- Pneumonia
- Death (rare)
There are also risk factors that may increase the risk of surgery for an aortic valve patient:
- Chronic diseases such as diabetes, hypertension, and chronic kidney disease
- Other heart diseases; this includes coronary artery disease, for example
- Pulmonary issues and smoking
- Obesity
- Aging
- Infections
The doctor will take all these risks into consideration and discuss with the patient about the possibility and the best way to carry out the surgery.
Recovery after minimally invasive aortic valve replacement surgery
Immediately after minimally invasive aortic valve replacement, the patient will be transferred to the intensive care unit (ICU) for one day, during which they will be connected to several monitoring machines to track vital signs. Afterward, the patient is moved to a regular hospital room for a stay of several days.
The patient will be encouraged to get out of bed and sit in a chair soon after the operation. Within one or two days, the patient should be able to walk with assistance.
The recovery time following minimally invasive aortic valve replacement depends on several factors, including the surgical technique used, the patient’s general health prior to surgery, and whether any complications arise. The doctor may prescribe medications such as pain relievers.
Patients are advised not to drive or lift heavy objects for several weeks after the procedure. The doctor will inform the patient when it is safe to resume daily activities.
It is essential to follow all medical advice regarding medications, physical activity, nutrition, and wound care, and to attend follow-up appointments to monitor recovery and ensure the success of the procedure.
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