Aortic valve replacement surgery may be done as an open-heart surgery or as a less invasive surgery (where the surgeon makes smaller incisions and does not open the chest). This slideshow shows the surgery as an open-heart surgery. To replace the damaged aortic valve, the surgeon first makes an incision in the chest and cuts through the breastbone (sternum).

Then, the surgeon opens the chest with a retractor to expose the heart. The surgeon opens the lining that protects the heart (pericardium).

Next, the surgeon removes the damaged aortic valve.

Finally, the surgeon inserts the artificial valve into the aorta. The artificial valve (also called a prosthetic valve) may be either mechanical or made of human or animal (pig) tissue. The surgeon sews the valve to the annulus, which is a ring of tissue that connects to the leaflets of the aortic valve.