Aortic Valve Repair in Children and Teens

This video explains aortic regurgitation and provides an overview of methods to treat damaged and diseased aortic valves.


Aortic Valve Repair in Children and Teens

Jonathan Chen, MD: Just like each child is different, so is each heart valve. I'm Jonathan Chen, a surgeon at the Pediatric Heart Valve Center at Children's Hospital of Philadelphia. My team is one of the most experienced in the country in valve repair and replacement. This video will help you understand the kinds of repairs we perform.

To better understand aortic valve repair, let's first take a look at the anatomy of the heart. This is your heart. It has four chambers and four valves. Blood passes through a valve before entering or leaving each chamber of the heart. The heart's lower chambers are called ventricles. The left ventricle pumps oxygen-rich blood through the aortic valve and into the aorta, the largest artery in the body.

Blood travels from the aorta to blood vessels throughout the body, delivering oxygen and nutrients.

Heart valves are made of flaps of tissue called leaflets. These leaflets work like one way doors, opening to let blood move forward, and closing to keep blood from flowing backward. Watch how the leaflets move from another angle, opening to let blood move forward and closing to keep blood from flowing backward.

To work properly, all three leaflets must meet when they close. If the valve doesn't completely close, blood leaks back into the heart. This is called regurgitation. Aortic regurgitation develops when the aortic valve leaflets become retracted, prolapsed, or distorted in some other way. A retracted valve is drawn in and the leaflets don't meet when they close. To repair a retracted valve, a surgeon usually performs a valve extension.

This means the surgeon takes a small amount of the strong tissue covering the heart, called the pericardium, and uses it to lengthen the leaflets. This does not affect the function of the pericardium. A prolapse valve has leaflets that droop. A surgeon will adjust or remove parts of the valve until all the leaflets meet.

In some cases, a surgeon may replace entire leaflets with tissue from the pericardium. This is called the Ozaki Procedure. Another cause of valve damage is infection. Infection may cause a perforation or small hole in the valve leaflets. A surgeon will use tissue from the pericardium to patch the hole.

Aortic valve repair is highly individualized. At the Valve Center at Children's Hospital of Philadelphia, our team uses cutting edge imaging to view each patient's heart before surgery. This allows us to develop a personalized surgical plan based on your child's unique anatomy. We work together and with you, to make the best decisions for your child before, during, and after surgery.

Related Centers and Programs: Topolewski Pediatric Heart Valve Center