Purpose:
An aortic valve repair surgery may be needed in the following cases:
1. Aortic valve stenosis: 
When the aortic valve becomes narrowed or obstructed, the condition is known as aortic valve stenosis.
This leads to difficulty in pumping blood by the heart into the aorta.
The causes of aortic valve stenosis may include a congenital heart disorder (heart disorder present at birth), inflammatory changes due to rheumatic heart disease (a condition that leads to permanent heart valve damage), or thickening of the closure flaps of the valve.

2. Aortic valve regurgitation:
The blood flows backward through the aortic valve into the left ventricle every time the ventricle relaxes instead of blood flowing in a unidirectional manner from the ventricle to the aorta in case of regurgitation.
The backflow is caused due to a leaky or dysfunctional valve.
A leaky or dysfunctional valve may be caused due to a congenital (present at birth) defect, bacterial infection, or valve deterioration.

3. Other congenital heart diseases:
A congenital heart disease may lead to aortic valve stenosis, regurgitation, and other disorders that prevent the proper functioning of the aortic valve.

Symptoms:
Sometimes, a faulty or diseased aortic valve may show no symptoms. In some cases, the following symptoms may be seen:

• Loss of energy 
• Weakness
• Fatigue
• Ankle swelling
• Chest pain
• Palpitations (extra or skipped heartbeats)
• Shortness of breath
• Loss of consciousness 
• Dizziness 

The following diagnostic tests are performed before an aortic valve repair surgery:

1. Physical examination: The doctor checks for a heart murmur (a swishing sound heard due to abnormal blood flow across the heart valve) using a stethoscope. The presence of a murmur may indicate a possible heart condition.
2. Echocardiogram: Sound waves are used to obtain a clear image of the heart and its valves.
3. Transesophageal echocardiogram: A small wand-like device, called a transducer, is attached to the end of a tube and inserted through the mouth into the stomach. This enables the doctor to have a closer look at the valves of the heart.
4. Electrocardiogram: This test enables the doctor to measure the electrical activity of the heart. 
5. Chest x-ray: A chest x-ray helps to identify an enlarged heart, which could indicate the presence of a heart valve disease. 
6. Cardiac MRI: This test helps in obtaining a detailed image of the heart.
7. Stress tests or exercise tests: These tests help in monitoring the heart’s response to physical exertion.
8. Cardiac catheterization: A catheter (tube) is inserted through a blood vessel in the arm or groin region, and then guided to a heart artery. A dye is now injected through the catheter to make the heart arteries visible on an x-ray. This helps the doctor in checking how well the heart functions and measuring the pressure inside the heart chambers.

An aortic valve repair surgery is usually done under general anesthesia (the patient is made unconscious before the procedure). The procedure can be done using the following different ways:

1. Traditional open-heart surgery:
The surgeon makes a 6- to 8-inch-long incision or cut in the chest region.
This incision splits open the breastbone.
The heart function of the patient is stopped.
A heart-lung bypass machine is attached to the patient to take over the function of the heart and lungs.
The aortic valve is now repaired by the surgeon by reshaping the aortic valve flaps, tissue patches, or any other method, depending on the type of defect that may be present.
After the completion of the aortic valve repair, the heart function is restarted.
The incision is closed using sutures (stitches).

2. Minimally invasive aortic valve surgery:
Small 2-to-4-inch incisions are made to create a J-shaped incision in the chest area.
Aortic valve repair is carried out by inserting a tube with a camera on one end and other small surgical instruments through the incisions made.
A minimally-invasive surgery is less painful, has a quicker recovery, and has fewer complications than open-heart surgery.

3. Transcatheter Aortic Valve Repair (TAVR) procedure:
A thin tube (catheter) is inserted through a small opening in the leg or groin region. 
This catheter tube is now guided to the heart region using x-rays and the surgeon performs aortic valve repair.

Aortic valve repair surgery may be associated with the following complications:

• Infection
• Bleeding 
• Formation of blood clots
• Arrhythmia (irregular heart rhythm)
• Kidney disorders
• Stroke (a condition that occurs as a result of interrupted blood supply to the brain)
• Need for an aortic valve replacement 

• A patient undergoing minimally invasive surgery takes only a couple of days to recover completely. However, recovery after open-heart surgery may take substantial time.
• It is normal to have some pain, swelling, and redness after the surgery.
• The patient may have appetite loss, sleep disturbances, and weakness after the procedure. These symptoms usually improve with time.
• The breastbone may take about six to eight weeks to heal completely.
• The patient should avoid heavy lifting and strenuous activities for a few weeks after the surgery.
• It may take approximately three months after the surgery for the patient to resume his/her normal physical activities.
• Patients having desk jobs can normally go back to work after six to eight weeks.
• Cardiac rehab and an exercise regime are recommended to the patient after the surgery.