Heart valve disorders
Heart valves are flaps of tissue that ensure that blood entering or leaving the heart moves in the right direction, with no backflow. The aortic valve is the main heart valve that controls blood flow between the heart and the rest of the body.
A heart valve can become dysfunctional in two ways: stenosis or insufficiency.
Valve stenosis is due to the inability of the heart valve to open properly. As this tightening of the heart valve becomes increasingly severe, it prevents the heart from being able to pump enough blood through the valve.
This condition can occur in the aortic valve; this is called aortic stenosis.
Valve insufficiency, or regurgitation, is due to ineffective closure of the valve that leads to blood being pumped backwards instead of forward.
Aortic insufficiency is often caused by degeneration of the aortic valve tissue or damage to the valve from other causes. Patients with aortic aneurysms may have excessive stretching of the valve, which causes insufficiency.
Weill Cornell Medicine surgical expertise
At Weill Cornell Medicine, our cardiothoracic surgeons have exceptional experience and expertise in the surgical techniques for repairing and replacing aortic valves.
Minimally invasive aortic valve replacement: Our surgeons are experiences and successful in performing traditional, open-heart surgery to replace aortic valves. Our team has also led the development of less invasive techniques, including percutaneous transcatheter valve replacement technology (TAVR and TMVR). Our team plays a leading role in the clinical trials assessing the latest percutaneous mitral and aortic valve replacement approaches, giving us more experience than most centers in these emerging new techniques.
We have achieved superior outcomes using these innovative approaches, which make valve replacement possible for many patients who otherwise would not be good candidates for conventional heart surgery.
Our physicians participated as investigators in two pivotal clinical trials, which established the effectiveness of percutaneous (transcatheter) valve surgery:
1. The PARTNER Trial, which in 2011 demonstrated that transcatheter aortic valve implantation (TAVI) was as effective as conventional open-heart surgery for reducing mortality among high-risk patients with aortic stenosis. In 2010, PARTNER Trial investigators reported that patients who were not candidates for surgery fared much better with TAVI than patients who were treated medically. Currently, our team is conducting a new trial assessing the safety and efficacy of the SAPIEN 3 transcatheter heart valve in low-risk patients.
2. The EVEREST II trial, which evaluated the percutaneous implantation of a clip that grasps and approximates the edges of the mitral valve leaflets. The percutaneous approach was associated with superior safety and similar improvements in clinical outcomes compared with conventional surgery.
Our patients benefit from:
We recommend visiting the Weill Cornell Medicine Cardiothoracic Department website, as well as the American Heart Association.
Once you and your care team decide that surgery is the best treatment plan for your condition, you will schedule a pre-surgical appointment, which takes place at M404.
During your pre-surgical appointment:
Your nurse practitioner will explain what you can expect for your specific surgery and hospital stay
Your nurse practitioner will review your current medications
You will sign a consent form for the surgery and potential blood transfusion (Please note: Most patients do not receive blood transfusions during surgery, but we are required to have you sign this consent form, just in case you do need a transfusion and are not awake at the time to give your consent. ALL blood is stringently tested for HIV, hepatitis, and cytomegalovirus.)
You have the opportunity to ask questions
You will receive a small bottle of antibacterial soap
This process generally takes two to three hours.
You will be given instructions as to which medications you should stop taking to prepare for surgery.
On the night before your surgery, shower using half of the bottle of antibacterial soap. On the morning of the surgery, before you come to the hospital, shower using the rest of the soap.
Do not eat or drink after midnight the night before your surgery. You may take your medications that the nurse practitioner approved you to take the morning of surgery, with just a small sip of water.
Parking is available in front of the 68th Street circular entrance to the hospital. There are also several parking garages in the immediate area.
Parking is only validated on the day of your hospital discharge, not on the day of your pre-surgical appointment.
Please be sure to bring you:
Pajamas, robe, and slippers
Generally try not to bring too much to the hospital, because you probably won't use a lot of these things and will just have to carry them home.
Please do not bring any jewelry or expensive electronics with you for the first hospital day. Your family and friends are welcome to bring those items once you are awake and in your room.
Please check in at Greenberg 3-West (Same-Day Surgery Unit), which is on the third floor of the Greenberg Pavilion, using the "G" elevators.
If you are the first case, please check in at 6 AM. If you are the second case, please check in at 10 AM.
The usual length of the actual cardiac surgery is about three and a half to four hours. However, the total length of time your family member will spend in the operating room is longer. Much of that "extra time" is spent preparing you for surgery and getting you ready to go to the recovery room (PACU) or ICU following surgery.
During your surgery, your family and friends should wait in the Ronald O. Perelman Heart Institute Atrium. Please tell them to check in at the front desk so that they can be contacted when your surgeon calls.
If the Ronald O. Perelman Heart Institute Atrium is closed at the time of your surgery, your family and friends may wait in the smaller waiting area right outside the Cardiothoracic ICU (4-West).
There is also a café on the first floor of the hospital, directly opposite the information desk and down the hall from the front door on the left, which is open at all times. This café sells coffee, tea, and a variety of food.
Please download our extensive Guide to Surgery.
Please see Insurance Questionsor call (212) 746-5161.