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FREQUENTLY ASKED QUESTIONS
Everything you need to know about keyhole aortic valve replacement surgery, recovery, and consultations.
What Is Aortic Valve Disease and Why Does It Need Treatment?
Your heart has a valve called the aortic valve. Think of it like a door that opens and closes with every heartbeat, allowing blood to flow out to the rest of your body.
There are three main types of aortic valve disease:
Aortic stenosis is when the valve becomes stiff and narrow. The door cannot open properly, so your heart has to work much harder to push blood through. Over time, this extra effort causes symptoms such as breathlessness, tiredness, chest tightness, and dizziness. If left untreated, it can lead to heart failure and enlargement of the heart chambers.
Aortic regurgitation (sometimes called a leaky valve) is when the valve does not close properly and blood leaks back in the wrong direction. This condition is often missed until the heart has already begun to enlarge, which is why regular monitoring is so important.
Bicuspid aortic valve disease is a condition you are born with. Instead of three leaflets, the valve has only two. This can cause the valve to become stiff or leaky earlier in life than a normal valve would. It is also linked to swelling of the main blood vessel leaving the heart (the aorta), which requires specialist assessment. The good news is that bicuspid valve disease can be treated very effectively using keyhole surgery, even in complex cases.
Severe aortic stenosis is serious. Once symptoms appear, the outlook without treatment can deteriorate quickly. The good news is that aortic valve replacement surgery, and particularly the keyhole approach, can restore normal blood flow, relieve your symptoms, and give you your quality of life back.
What Is Keyhole Aortic Valve Replacement and What Does the Operation Involve?
Keyhole aortic valve replacement (also called minimally invasive aortic valve replacement or ARTAVR) is a way of replacing your faulty aortic valve without breaking open your breastbone.
Instead of a large cut down the middle of your chest, your surgeon makes a small incision of a few centimetres between the ribs on the right side. Through that small opening, the old damaged valve is removed and a new one is put in its place. During the operation, a heart-lung bypass machine temporarily takes over the work of your heart and lungs, in exactly the same way as in traditional surgery. The operation itself achieves the same result.
The difference is in how your body recovers afterwards. Because no bones are broken, the small wound heals in around 7 to 10 days. Most patients are back home within a few days of surgery, and back to normal everyday life within 3 to 4 weeks, rather than the 3 months or more that traditional open-heart surgery typically requires.
What Is the Difference Between Keyhole Aortic Valve Surgery and Traditional Open-Heart Surgery?
Traditional open-heart surgery for aortic valve replacement involves a large cut straight down the middle of your chest. The breastbone is split apart to reach the heart, then wired back together at the end. That bone takes around 12 weeks to heal, meaning recovery is long, often painful, and places significant restrictions on what you can do in the weeks that follow.
Keyhole aortic valve surgery uses a small incision between the ribs. No bone is broken at any point.
In practical terms, here is what this means for you:
• A much smaller scar, just a few centimetres at the side of the chest, rather than a long scar running the full length of your breastbone
• Less pain in the days and weeks after your operation
• Less blood loss during surgery
• A lower risk of wound infection
• Home within 3 to 5 days rather than a week or longer
• Back to driving, walking further, climbing stairs, and doing the things you enjoy within around 3 to 4 weeks, compared to roughly 12 weeks after a breastbone split
The result of the surgery is exactly the same: a new, working aortic valve. But the experience of getting there, and the recovery on the other side, is far gentler on your body..
Am I Suitable for Keyhole Aortic Valve Surgery?
The great news is that most people who need an aortic valve replacement are suitable for the keyhole approach, particularly when the surgery is performed by an experienced specialist team.
You are likely to be a good candidate if:
• You have been told you need an aortic valve replacement
• You are in reasonable general health
• The structure and shape of your heart and chest are suitable (this is assessed from your scans and imaging)
• You have had heart surgery before, as keyhole is often the safer option for patients having a second or re-do procedure
• You are older, as the gentler nature of keyhole surgery makes it particularly well suited to elderly patients
In a small number of cases, a different approach may need to be considered, for example if several procedures need to be carried out at the same time, or if your scans reveal something specific about the structure and shape of your heart and chest that makes keyhole surgery more challenging. Certain other health conditions may also be a factor.
If you have been told elsewhere that keyhole surgery is not an option for you, it is always worth asking for a second opinion. We have helped many patients who were initially turned away from the keyhole approach. The only way to know for certain is through a proper assessment.
Is Keyhole Aortic Valve Surgery Safe if I Am Older or Have Other Health Conditions?
Yes, and in many cases the keyhole approach is the preferred option for older patients and those managing other health conditions.
Traditional open-heart surgery involving a breastbone split is a physically demanding procedure. For older patients, the combination of a large wound, significant blood loss, a longer time in hospital, and a slow recovery can carry additional risks that are worth taking seriously.
Keyhole surgery is gentler on the whole body, and that matters enormously for patients who are older or who have other conditions such as diabetes, lung disease, or kidney problems:
• Less blood loss during surgery means less strain on your heart, kidneys, and other organs
• A shorter hospital stay reduces your exposure to hospital-acquired infections
• Getting up and moving around sooner after surgery, often the very next day, is far better for your overall health and recovery
• No broken breastbone means less pain and a faster return to independence, whether that means driving again, walking the dog, or simply getting up and down the stairs more comfortably
Mr Birdi has extensive experience operating on older patients and those with complex medical histories. Age alone is never a barrier to keyhole surgery. Your suitability will always be assessed individually, and we will give you an honest picture of what we recommend for your specific situation.
Is Keyhole Aortic Valve Surgery Better Than Traditional Open-Heart Surgery?
For most patients, the keyhole approach has real advantages when it comes to how you feel during and after your recovery. The surgical result is the same: a new, working aortic valve. But the experience of getting there is very different.
Here is what patients typically notice:
• A much smaller scar, just a few centimetres at the side of the chest, rather than a long scar down the front
• Less pain in the days after surgery
• Less bleeding during the procedure
• A lower risk of infection
• Home within 3 to 5 days
• Back to driving, light exercise, and everyday activities in around 3 to 4 weeks, compared to 12 weeks or more after a breastbone split
For older patients, or those who have had previous heart surgery, the benefits are particularly significant. The gentler nature of the keyhole approach means less physical stress on the body overall, which can make a meaningful difference to how quickly and comfortably you recover.
Is Keyhole Aortic Valve Surgery Officially Recommended?
Yes. NICE (the National Institute for Health and Care Excellence), which sets the standards for medical treatment across England and Wales, published official guidelines in 2021 recommending that patients who are suitable for minimally invasive aortic valve replacement, or who would prefer it, should be referred to a specialist centre if that expertise is not available at their local hospital.
The Keyhole Heart Clinic is one of those specialist centres. Mr Birdi and his team have been performing this type of surgery for over two decades and are widely recognised as leaders in the field.
If your local hospital has told you that keyhole surgery is not available to you, NICE guidelines support your right to ask for a referral to a centre that can provide it.
Will My Health Insurance Cover Keyhole Aortic Valve Surgery?
In most cases, yes. Keyhole aortic valve replacement is covered by all the major UK private health insurers, including BUPA, Vitality, Aviva, Cigna, and WPA.
We always recommend checking directly with your insurance provider before your consultation, as the exact cover depends on your individual policy. For example, your policy may have an excess, may require that surgery takes place at a specific hospital, or may need a referral letter from your GP before you can proceed.
Our team has extensive experience working with all the major insurers and can help guide you through the process. We make sure there are no surprises.
How Much Does a Consultation Cost and What Does It Include?
A face-to-face consultation with Mr Birdi is £450. An online consultation is £325. The consultation fee covers everything outlined below.
Your consultation includes a thorough review of your clinical history and diagnosis, a clear explanation of your condition in plain language, and an honest discussion of all your treatment options. If surgical treatment is appropriate, Mr Birdi will explain exactly what the procedure involves, what to expect during your recovery, and what outcomes you can realistically look forward to.
After your consultation, your case is reviewed by a team of experienced specialists, including cardiologists, imaging experts, and cardiac surgeons, to make sure the treatment recommendation is tailored specifically to your circumstances. You benefit from the collective expertise of several senior doctors, not just one.
We offer consultations in London, Nottingham, and online. If you are not sure which option is right for you, our team is happy to advise.
How Do I Book an Appointment?
To book an appointment for a keyhole aortic valve replacement consultation, simply fill in the form on this page or call our office directly.
One of our patient coordinators will be in touch to guide you through the next steps and answer any questions you have before your appointment.
What Should I Expect During My Aortic Valve Consultation?
At your consultation, Mr Birdi will take the time to fully understand your situation. He will review your clinical history and confirm your diagnosis. If he needs any additional imaging or test results from your local hospital, he will arrange to obtain them. If further investigations are needed, he will explain exactly what they are and why.
After your consultation, your case is reviewed by a team of experienced specialists, including cardiologists, imaging experts, and cardiac surgeons, to make sure the treatment recommendation is tailored specifically to your circumstances. This means the advice you receive is backed by the collective experience of several leading doctors, not just one.
What Happens at My First Consultation With Mr Birdi?
Your consultation is not a rushed five-minute appointment. Mr Birdi will take the time to properly understand your situation, answer every question you have, and make sure you leave feeling clear about your condition and your options.
Here is what you can expect:
• A thorough review of your medical history, along with any previous test results or scans
• A clear explanation of your diagnosis in plain language, with no medical jargon
• An honest conversation about whether keyhole aortic valve surgery is the right option for you, including timing, any risks relevant to your situation, and what alternatives exist
• As much time as you need to ask questions. There are no silly ones.
• A family member or someone close to you is welcome to come along
After your appointment, your case is reviewed by a team of experienced specialists, including cardiologists, imaging experts, and cardiac surgeons, to make sure the treatment recommendation is tailored specifically to your circumstances. The recommendation you receive has the backing of several experienced senior doctors.
What Happens After Aortic Valve Surgery?
After your aortic valve surgery, you will be discharged from hospital with detailed written information to help you recover safely at home. You will know what to expect day by day, what to watch out for, and who to contact if you have any concerns.
You will then be seen by Mr Birdi in clinic 6 weeks after you leave hospital, so he can check your recovery, review your progress, and answer any questions that have come up since your operation.
Mr Birdi and the whole team at The Keyhole Heart Clinic remain contactable at any point after your discharge. If anything concerns you or you feel you need to be seen sooner, we can always arrange an earlier appointment.
How Quickly Can I Have Aortic Valve Surgery?
We work hard to make sure there is no unnecessary waiting once a decision has been made. In most cases, we aim to schedule your aortic valve surgery within two weeks of completing your pre-operative assessment and having your case reviewed by our specialist team. For many patients, this is a significantly faster route to treatment than waiting through the NHS.
Ready to take the next step?
Speak directly with Mr Birdi and our specialist team to discuss your suitability for keyhole aortic valve replacement.
Contact Us
For general questions, please send us a message and we'll get right back to you. You can also call us directly to speak with a member of our service team or insurance expert.
Would you like more information?
For general questions, please send us a message and we'll get right back to you. You can also call us directly to speak with a member of our service team or insurance expert.
Contact Us
For general questions, please send us a message and we'll get right back to you. You can also call us directly to speak with a member of our service team or insurance expert.
Would you like more information?
For general questions, please send us a message and we'll get right back to you. You can also call us directly to speak with a member of our service team or insurance expert.
Mr Birdi and his world-class team at The Keyhole Heart Clinic have over 20 years of clinical experience in keyhole heart surgery. You can rest assured that you're in safe hands. Offering advice as well as treatment, from consultations to second opinions, we are here to help you when you need us the most.