The notion of having your chest opened and your heart exposed is enough to give you pause, even if you need a valve replacement. Check out this video with Dr. Craig Smith, a cardiothoracic surgeon, to learn what happens in aortic valve replacement.
During a conventional aortic valve replacement operation, the patient is put to sleep with a tube in their windpipe, lying on their back, the chest is opened usually through the center of the chest with some variations on that thing, but generally speaking, through the center of the chest, through the sternum.
The heart is exposed by pushing the halves of the sternum apart. The heart is connected to a heart lung machine with connections to the aorta and the venous system to return blood to and from a heart lung machine, so that the heart can be stopped. A clamp is put across the the aorta so the blood can't get to the coronaries, the heart arrests, it stops, and it's empty, and in empty arrested state, we open the aorta, remove the valve, clad all the calcium that's built up on the valve, as much as possible so that we can place sutures around it, then, sutures around where the valve used to be, the sutures are put through a valve. The valve is run down, the sutures in place, tied in position, and the aorta is closed.
Then gradually the work of circulation is passed back to the patient from the heart-lung machine and off we go.
Craig Smith, MD, a leading cardiac surgeon, is the chairman of surgery at Columbia University and chief of cardiothoracic sSurgery. He is double board-certified by the American Board of Thoracic Surgery and the American Board of Surgery.
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