Aortic Valve Replacement (AVR): Understanding the Procedure & Valve Types
AVR replaces a diseased aortic valve (stenosis/regurgitation) via open surgery or transcatheter (TAVR).
Valve Types
- Mechanical (Bileaflet Pyrolytic Carbon): Durable (lifetime); requires lifelong warfarin (INR 2.0–3.0); audible click.
- Bioprosthetic (Porcine/Bovine Pericardium): No long-term anticoagulation (aspirin only); limited durability (10–20 yrs); preferred >65–70 yrs.
- Ross Procedure: Autologous pulmonary valve → aortic position; pulmonary homograft → pulmonary. Growth potential in children; complex, avoids anticoagulation.
- TAVR: Bioprosthetic valve via femoral access; standard for high/intermediate surgical risk; expanding to low risk.
Post-Operative
- ICU monitoring, early mobilization.
- Anticoagulation per valve type.
- Endocarditis prophylaxis (dental).
- Lifelong cardiology follow-up (echo, INR if mechanical).
Shared decision-making incorporates age, lifestyle, comorbidities, patient preference.
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