An Overview of Aortic Stenosis Surgery

Medically Reviewed By Angela Ryan Lee, MD, FACC

If your aortic stenosis is severe or causing symptoms, doctors may advise surgery to treat the condition. This can include procedures such as surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR), and balloon valvuloplasty. TAVR is a less invasive procedure than SAVR and typically has a shorter recovery period.

Balloon valvuloplasty is not a permanent fix for aortic stenosis. Instead, it may be used as a temporary therapy before a valve replacement procedure.

This article discusses aortic stenosis surgery, including how to prepare and what to expect during recovery.

Surgical aortic valve replacement

A paper cutout of the human heart
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SAVR has historically been the stan Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source d Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source ard treatment Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source for aortic stenosis. It’s a type of open heart surgery performed under general anesthesia. This procedure may be a more favorable option for certain groups. These can include younger people and people with significant aortic stenosis Trusted Source AHA/ASA Journals Peer reviewed journal Go to source or coronary artery disease.

During SAVR, your surgeon will make a large incision in the center of your chest. This allows them to divide the breastbone, providing direct access to the heart. They will then remove the affected valve and replace it with a new one.

Learn more about heart valve repair.

Transcatheter aortic valve replacement

Transcatheter aortic valve replacement (TAVR) is a less invasive procedure than SAVR. It may be preferable for people with high surgical risk Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source .

TAVR is typically performed in a hospital, with or without general anesthesia.

To reach the aortic valve, your cardiologist will make a small incision in an artery. This is usually the femoral artery Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source , which they will access from your groin area. They will then insert a catheter carrying a replacement aortic valve into the artery. Once the catheter reaches the affected valve, the surgeon will place the new valve inside the old one.

Balloon valvuloplasty

This procedure is a short-term treatment for aortic stenosis. Similar to TAVR, it involves inserting a catheter through an artery to reach the affected valve. Once there, a balloon is inflated, widening the narrowed valve.

This type of treatment isn’t permanent. However, your doctor may perform Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source this procedure to give you more time before undergoing valve replacement.

Preparing for your procedure

Before your procedure, your care team will likely run a series of tests. These may include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source tests such as computed tomography angiography (CTA). CTA can help doctors determine how big the replacement valve will need to be.

Other tests can include:

Your doctor may ask you to discontinue certain medications before undergoing any type of aortic stenosis surgery. They may also have you stop eating or drinking for a short period of time.

Recovering from your procedure

An SAVR procedure typically takes a few hours. After surgery, you may need to remain in the hospital for a few days to a week. Recovery from SAVR may take 2–3 months.

People who undergo TAVR instead of SAVR typically have a shorter hospital stay. They may be able to resume their typical activities within a few weeks.

Balloon valvuloplasty also typically has a shorter recovery period than SAVR. During recovery, you may have a higher risk of developing blood clots. As a result, your doctor may prescribe Trusted Source AHA/ASA Journals Peer reviewed journal Go to source blood thinners.

Outcomes

SAVR is the standard treatment for people with aortic stenosis who have low surgical risk. However, TAVR is considered safer for older adults and has comparable outcomes.

Balloon valvuloplasty is a temporary treatment. People who undergo this procedure will eventually require one of the other procedures to definitively treat Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source their condition.

With any of these procedures, managing any coexisting conditions is critical to improving your outlook. These can include conditions such as high blood pressure and coronary artery disease.

After surgery, you will likely require long-term monitoring. This can help doctors ensure the replacement valve is working properly or evaluate your condition after balloon valvuloplasty.

Learn more about outlook and life expectancy for people with aortic stenosis.

Ask your doctor about lifestyle or dietary changes you may need to make after aortic stenosis surgery.

Learn more about 8 foods for heart health after TAVR.

Risks

As with most heart procedures, aortic stenosis surgery carries risks both during and after the procedure. 

According to the National Heart, Lung, and Blood Institute (NHLBI), risks associated with TAVR may include:

  • leaking from a replacement valve that doesn’t fit well
  • damage where the surgeons inserted the catheters
  • bleeding
  • heart damage that may lead to a need for a permanent pacemaker
  • stroke
  • kidney injury
  • infection
  • blood clots

Learn more about 8 symptoms to never ignore after surgery.

Frequently asked questions

Here are answers to a few other common questions about aortic stenosis surgery.

How serious is aortic stenosis surgery?

Depending on the procedure, aortic stenosis surgery can be serious. SAVR is much more invasive than TAVR. However, each procedure can cause complications, such as heart damage or bleeding.

How long does it take to recover from aortic stenosis surgery?

Recovery time after aortic stenosis surgery can depend on a few factors. These can include the type of procedure and your overall health. In general, SAVR recovery can take a few months, whereas TAVR and balloon valvuloplasty typically have shorter recovery periods.

Is surgery the only option for aortic stenosis?

Medications will not manage Trusted Source AHA/ASA Journals Peer reviewed journal Go to source aortic stenosis or slow its progression. If your condition is severe or causing symptoms, surgery will help improve your outlook.

Summary

Doctors may perform SAVR, TAVR, or balloon valvuloplasty to manage aortic stenosis. The procedure that is right for you will depend on your individual situation.

Talk with your doctor about the risks and benefits of each type of aortic stenosis surgery.

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Medical Reviewer: Angela Ryan Lee, MD, FACC
Last Review Date: 2023 Jun 18
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