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What are the risks of aortic valve replacement surgery?

Traditional aortic valve replacement carries all the dangers of open-heart surgery; in TAVI (transcatheter aortic valve replacement), your chest isn't cracked, but this procedure isn't risk-free either. Check out this video with Dr. Craig Smith, a cardiothoracic surgeon, to learn why TAVI carries a small threat of stroke.

Dr. William M. Suh, MD
Internist

Aortic valve replacement surgery involves opening the chest, placing the patient on the heart-lung machine, stopping the heart, and replacing the diseased aortic valve. The risks of aortic valve replacement surgery include major bleeding, infection, heart attack, stroke, and even death. The risk of these complications happening is rare in low surgical risk patients but becomes more common if patient has high-risk features or major co-morbid conditions.

Dr. Timothy R. Malinowski, MD
Cardiologist (Heart Specialist)

Keeping in mind that aortic valve replacement with surgery is a potentially life-prolonging procedure, every surgery has risks. Aortic valve replacement surgery in general is performed at a low overall risk with very good outcomes. There is always a risk of not surviving an operation, but with aortic valve replacement, this risk is low, generally 2-5%, and around 1% in hospitals that perform this procedure frequently. There is a risk for stroke and decreased mental function after surgery related to being on a cardiopulmonary bypass machine, a machine that pumps blood while the heart is being operated on). This tends to occur in patients who already have some baseline cognitive dysfunction. Risks for pain, infection and bleeding exist with surgery in general. Abnormal heart rhythms can occur. They are usually successfully treated with medication. The IV catheters that need to be placed during surgery can cause injury to blood vessels or blood clots. Patients with underlying lung or kidney disease can potentially have worsening of their lung or kidney function and require supportive care specifically for that. 

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There are many, but the biggest risks of aortic valve replacement surgery are death, stroke, heart attack, heart failure, requiring a pacemaker or requiring some other emergency surgery from complications. That's a short list of the bad complications. However, the chances of complications happening are so dependent on the characteristics of the patient, such as their age, sometimes gender and if they have other health problems. There's actually an online calculator that a lot of physicians, including myself, will use to punch in all the characteristics of a patient to calculate the risks that may occur during aortic valve replacement surgery. That calculator is called the Society of Thoracic Surgery (STS) Risk.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.