Aortic valve surgery

Why it is done

The aortic valve lets blood out of the heart into the body. It can become narrowed and stiff (aortic stenosis) or leaky (aortic regurgitation). Severe valve disease can cause breathlessness, chest pain, dizziness or blackouts, and puts strain on the heart. Once symptoms develop in severe disease, treatment is usually recommended.

Options

• Surgical aortic valve replacement (AVR): the diseased valve is removed and replaced, using the heart–lung machine.
• Transcatheter aortic valve implantation (TAVI): a new valve is placed through a blood vessel, usually in the groin, without open surgery. This is often suitable for older patients or those at higher surgical risk. The heart team will discuss which option suits you.

Choice of valve

• Tissue (biological) valves do not need long-term blood thinners, but may wear out over time.
• Mechanical valves are designed to last a lifetime but require lifelong anticoagulation with warfarin.

The choice depends on your age, lifestyle and other medical conditions, and is made together with you.

Sutureless valves and minimally invasive surgery

In selected patients, a sutureless valve can be used. It is held in place without a full ring of stitches, which shortens the time on the heart–lung machine. Some patients are suitable for minimally invasive AVR through a small incision between the ribs on the right side of the chest (a right mini-thoracotomy) instead of dividing the breastbone. At Leeds General Infirmary, sutureless valves have been used since 2020 and minimally invasive AVR since 2025.

After the operation

Most patients spend a day or two in intensive care and go home after about a week. Recovery is broadly similar to other heart surgery, although people having minimally invasive surgery may return to some activities sooner. Anyone with a replacement valve should look after their teeth and seek prompt treatment for infections, because valves can become infected (endocarditis).

Risks

Risks include bleeding, infection, stroke, irregular heartbeat, the need for a permanent pacemaker, kidney problems and, rarely, death. Your surgeon will discuss your individual risk with you.

This guide is general information and does not replace advice from your own clinical team, who will explain the plan and risks for you individually. Last reviewed November 2026.