None. If you are truly a good candidate, probably no significant disadvantages with experienced surgical team.
None. Small incision aortic valve surgery can be performed through a small sternotomy or a small thoracotomy. Patient selection is critical, when the proper technique is used, stroke rate is no different.
Few. A small incision may limit the options that the surgeon has to respond to something unexpected. An incision in the groin and cannulation of the femoral vessels can increase the risk of stroke. A thorough work up preoperatively should minimize these risks.
How is a small aortic annulus or root handled when doing aortic valve replacement? Do the 19mm or 17mm valves flow badly? More risks?
Cardiac surgeon. Small aortic annulus is identified by echocardiography. Your cardiac surgeon will plan to enlarge the annulus to accommodate the largest valve practical. Sometimes even cutting into the heart like a ross/konno is required. All surgery has risks but your surgeon will be everything possible to help you, remember they have dedicated themselves to this job. Hope this helps.
Enlargement. In an average sized person, the smaller the implanted vale, the higher the residual flow gradient across the valve. This translates into higher cardiac work. The way around this is to enlarge the aortic root. There are multiple techniques for this, which are very effective. All of the valves work well, but the smaller the valve, the higher the gradient.
Aortic valve sx. The native aortic valve is surgically removed and replaced with a mechanical valve or a bioprosthetic valve. Mechanical valves last a life time but need anticoagulation with coumadin (warfarin).
Valve replacement. The surgery replaces the valve with either a mechanical or animal tissue valve. This is done on a heart lung machine. The valve takes the place of the damaged valve and the patient lives their life with a new disease 'artificial valve' with its own set of problems. The obstruction or valve leak of the diseased valve is corrected by the artificial valve. Sometimes blood thinners are needed.
Replacing valve. The patients aortic valve leaflets are cut out and a prosthetic valve is sewn to the patients aortic valve annulus. It is done using cardiopulmonary bypass. Choices of valve are mechanical or bio prosthetic.
Straight forward. The aortic valve is replaced by instituting cardiopulmonary bypass and cardioplegic arrest. The aorta is cut open after stopping the heart, the diseased valve and calcium is removed, the aortic anulus is sized and a tissue valve or a mechanical valve is sewn in place, co2 flush used to aid deairing, aorta closed, heart restarted, cpb discontinued, hemostasis accomplished and wound closed.
Surgery. Severe dysfunction of the aortic valve can sometimes require surgery as therapy. Valve replacement consists of removing the diseased valve and placing either a mechanical or biological device. Choice of valve depends on multiple factirs, and requires a detailed discussion with your surgeon.