Aortic Valve Replacement – A Cornerstone Within Cardiac Surgery
Aortic valve replacements are the most common heart valve operations performed by cardiac surgeons.
These procedures involve replacing the aortic valve, which is typically damaged due to conditions causing aortic stenosis or regurgitation. Either a mechanical or biological prosthesis is the most common choice of aortic valve used, and the primary objective is to restore optimal cardiac function and alleviate symptoms associated with valve dysfunction.
Traditionally, aortic valve replacement necessitated a median sternotomy, involving a sizable skin incision and a full vertical fracture of the breastbone. This conventional approach often results in post-operative discomfort and prolonged recovery periods, which have consequences not only for the sternal bone fracture but also for the significant disruption of the entire rib cage and surrounding structures.
In contrast, the approach Mr Casula offers through minimal access aortic valve surgery can be performed via a small skin incision (typically 2 inches). This approach minimises trauma to the chest wall while preserving the integrity of the rib cage. By utilising a smaller opening, specifically trained and skilled cardiac surgeons can effectively replace the aortic valve, thereby reducing post-operative pain and expediting recovery.
Mr Casula pioneered these minimal access aortic techniques in the UK over 20 years ago, and during this time, his surgical results have been second to none.
Transcatheter Aortic Valve Implantation (TAVI)
In select high-risk patients, transcatheter aortic valve implantation (TAVI) presents a less invasive alternative to traditional surgical intervention. This innovative procedure involves the percutaneous insertion of an aortic prosthesis, typically through a small vascular access, without the need for cardiopulmonary bypass (CPB) support. TAVI offers a viable option for patients deemed unsuitable for conventional surgical approaches, providing symptomatic relief and improved quality of life.
To arrange a consultation with Mr Roberto P. Casula, please contact Mr Casula’s medical secretary on 0203 423 7498, or Cardiac Bookings team on 0203 423 7500, or via email at rcasulamedsec@ccf.org.
Patients Reviews
Mr Casula is lovely mild mannered surgeon. Very approachable and attentive. He updated all concerned pre and post surgery. Visited and treated in ITU and flowing making suggestions to recoup and ensuring all due diligence was followed. Would highly recommend to others who need aortic valve replacement.
Sophie Brown
I had severe aortic stenosis, and was scheduled to have a new aortic valve using TAVI procedure. After consultation with four radiologists the TAVI consultant decided that for me there were unacceptable risks, and it would be better to replace the valve using minimalist surgery and he introduced me to Roberto Casula who explained that replacing the valve by surgery was a safer and better option, and furthermore the valve would last for life (and even if it did not, then TAVI could be used). Dr Casula was very reassuring and I had every confidence in him. The operation was done at the Cromwell hospital London, and I was only in hospital 5 nights. It is now 6 weeks since the operation and am recovering well, and having physio. Am nearly back to normal. I am very grateful to Dr Casula and his team.
Oliver Smith
Highly recommend Mr Casula and his team. Absolute life savers! Mr Casula was very professional, kind, understanding and talked through the entire procedure. We had booked in very last minute but everything was done professionally and efficiently. Family members were kept upto date by Victoria who supported us through the entire process making sure everything was booked and all appointments ran smoothly. The coordination from start of surgery to end was excellent. Mr Casula and Victoria were both very supportive and reassuring. Thank you for everything
Jack Taylor
From the our first meeting Mr Casula was incredibly reassuring and calming, his explanations were clear and complete. His advice was well substantiated with the pro’s and con’s of the possible approaches explained. The operation itself was successful and is leading to a fast recovery - I am in no doubt this is due to Mr Casula’s vast experience and skill, especially with the ‘open heart’ type surgery I required. Throughout my stay in hospital his care and attention to detail was evident through a number of visits and his direct communication with the nurses. Communication pre and post surgery to make all the necessary appointments and provide the required information etc was easy and a pleasure thanks to Mr Casula’s practice manager, Victoria.
Harry Williams
Mr Casula was clear and decisive when he explained the surgery I required and how it would be done. For someone who has not had any surgery before, his easy explanation and friendly manner put me at my ease and I felt I could trust him completely. He knew what he was doing and he was a professional.