Dallas County Living Well Magazine Summer 2014 | Page 31

Q&A with Todd M. Dewey, M.D.
Southwest Cardiothoracic Surgeons
Aortic Valve Replacement
As a pioneer in the field of aortic
valve replacement using a catheterbased system that does not require the
use of a heart lung machine, stopping
the heart or opening the chest, Dr.
Dewey has the distinction of performing the first transapical aortic valve replacement utilizing this breakthrough
technology in the United States. He is
recognized as one of the most experienced surgeons in the world with this
technique. Internationally known as
a leader in the field of valvular heart
disease, he has trained surgeons in Europe, Canada, Australia and the United
States in both catheter-based aortic
valve replacement and minimally invasive surgical techniques.

Q: What is the aortic valve?
A: The aortic valve is one of the four valves

of the heart. There are two valves that
separate the upper and lower chambers of
the heart (the mitral and tricuspid valves)
and two valves that separate the heart from
the rest of the body (the aortic and the pulmonary valves). The aortic valve normally
has three leaflets, although 1 to 2% of the
population is born with only two leaflets. A
normally functioning aortic valve opens easily and does not let blood leak back into the
heart when it closes.

severely narrowed valves have an opening
the size of a dime. Approximately 2% of
people older than 65 years of age, 3% of
people 75 and older, and 4% of people older
than 85 have aortic valve stenosis. However,
the prevalence is increasing with the aging
population in North America and Europe.

Q: What are the symptoms
of aortic stenosis?
A: Initial symptoms are mild fatigue or

shortness of breath with exertion. As the stenosis progresses and worsens, patients may
develop fainting with rapid standing, lower
extremity edema, chest pain, shortness of
breath while at rest, and ultimately death
unless it is treated.

Q: How is aortic stenosis
treated?
A: Typically aortic stenosis is treated with
open-heart surgery to completely replace
the narrowed valve. The most common type
of valves used to replace abnormal aortic
valves are either bovine or porcine in origin.
These types of valves do not require the use
of blood thinners. In medical centers with
extensive experience in aortic valve surgery,
most patients are treated with a minimally
invasive approach that decreases patient
discomfort and promotes early return to
activity.

Q: Are there any new
minimally invasive techniques
to treat aortic stenosis?
Q: What is the most common A: Percutaneous aortic valve replacement
problem with the aortic valve? is being performed at the leading cardiac
surgical centers around the world—includA: Aortic stenosis is the most common
ing advanced centers located here in North

proble