The following surgery is not from our patient. It is shown to demonstrate some aspects of surgical valve replacement using a porcine heterograft. In general, this type of valve is used when anticoagulation is contraindicated or an older patient, where a lont-term durability is not a major issue.
Another patient's surgery
The following aortic valve replacement surgery is presented through the courtesy of Dr. Donald Doty, and was carried out at the University of Iowa Hospitals.
The patient has been placed on cardiopulmonary bypass and the cross-clamped aorta opened just above the aortic valve.
The surgeon has already partially excised one non-calcified, but perforated cusp. The removal of this cusp is rapidly completed, and then the other cusp, which is also fenestrated, is removed.
Next, the annulus is sized with a porcine valve sizer.
Once the valve annulus is sized, sutures are placed around the annulus and a porcine heterograft is brought into position and appropriately aligned, so that the valve struts do not obstruct the coronary ostia.
Next, the annular sutures are passed through the valve sewing ring, and the valve is lowered into its predetermined alignment.
The sutures are then tied and the valve secured in place. Following this, the aortotomy is closed with a running suture.