Aortic Valve Surgery


Aortic valve brought two famous people have been in the news recently. One just had aortic valve surgery and the other who will soon be having the surgery.

Former first lady Barbara Bush, 83, had her aortic valve replace with a pig’s valve on Wednesday March 4, 2009. Heart surgeon Dr Gerald Lawrie performed the surgery at Methodist DeBakey Heart & Vascular Center in Houston, TX. The surgery and recovery are going extremely well. She is expected to be discharged from the hospital 7-10 tens post-surgery.

Comedian Robin Williams, 57, needs aortic valve replacement surgery. He has had to cancel his one-man comedy tour after doctors diagnosed the cause of his shortness of breath as aortic valve disease.

There are four valves in the heart. Two ( tricuspid and mitral) valves control flow of blood within the heart, between atrial and ventral chambers. The other two (pulmonary and aortic) valves control blood flow either into or out of the heart.

The aortic valve is a tricuspid valve. It helps control the outflow of blood from the left ventricle to the body. It opens to allow blood to leave the heart and closes to prevent regurgitation or leaking back into the ventricle.

When the aortic valve malfunctions, the heart will be forced to pump harder to deliver blood to the body. Symptoms of poor aortic valve function include shortness of breath, dizziness, chest pain, light-headedness or fainting.


Aortic valve disease may be congenital (abnormal from birth) or acquired (comes with aging as with Bush and Williams). The most common congenital abnormality is a bicuspid aortic valve. It occurs in 1-2% of people. It is the second most common cause of aortic disease that requires surgery.

The most common cause of aortic valve disease requiring surgery is called "senile aortic calcification." The valve has worn out with age. For unknown reasons, the body deposits calcium on the valve leaflets. This calcium hardens the valve which restricts or limits the motion of the valve leaflets. The restricted motion may prevent the valve from opening (causing stenosis) or closing (causing leakage or regurgitation).

There are two types of replacement valves for the aortic valve – mechanical or biological. The advantage of a mechanical valve is their durability. They don’t wear out. The main disadvantage is the tendency for blood clots to forms on mechanical valves. Patients who have mechanical valves must take anticoagulants or “blood thinners” for the rest of their life.

Biological valves may be “xenograft” or “homograft”. Xenografts are made from animal tissues, most often pig aortic valves as Mrs. Bush received. Homografts (as called allografts) come from human cadavers. Biologic valves are less durable than mechanical valves, but have less risk of blood clot formation. Patients do not have to be on blood thinners for life, only for 6 weeks to 3 months after surgery.

After successful aortic valve replacement, patients can expect to return to their preoperative condition or better. A patient will require preventative or prophylactic antibiotics whenever having dental work, and should always tell a doctor about their valve surgery before any surgical procedure.

To keep up to date with Williams' progress, visit:

The Society of Thoracic Surgeons
University of Southern California Keck School of Medical


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