FAQ: Robin Williams Needs Heart Surgery

March 6, 2009 -- Comedian and actor Robin Williams abruptly postponed upcoming performances of his one-man show, "Weapons of Self-Destruction," announcing on his web site that he needs to undergo surgery for an aortic valve replacement.

The brief announcement said that Williams, who began the 80-city tour in September 2008, hopes to pick it up again in the fall. Williams, 57, is known not only for comedy but for his role in the TV show Mork and Mindy and the 1997 movie Good Will Hunting.

The aortic valve replacement surgery that Williams needs, termed "routine" by cardiac surgeons, is the same procedure that former first lady Barbara Bush underwent earlier this week.

WebMD contacted two cardiac surgeons -- neither involved in the care of Williams -- to get more information on the valve condition and what can be done.

Where is the aortic valve and what does it do?

The aortic valve sits between the main "pipe" coming out of the heart -- the aorta -- and the left ventricle, the pumping chamber, says John Robertson, MD, director of thoracic and cardiac surgery at St. John's Health Center, Santa Monica, Calif. "It helps maintain the forward flow of blood out of the heart into the body," he says.

Why would the aortic valve need replacing?

The valve might have become thick and narrowed, a condition called stenosis, says Abe DeAnda, MD, a cardiac surgeon and director of aortic surgery at Montefiore -- Einstein Heart Center at Montefiore Medical Center/Albert Einstein College of Medicine, New York.

Or, the valve might have become leaky, a condition known as aortic valve insufficiency. Sometimes, the valve has both problems, DeAnda says.

"Aortic stenosis is becoming more common as the population ages," Robertson says. In some cases, people may have a congenital abnormality of the valve and it then becomes leaky or narrowed.

In 2007, 17,592 aortic valve replacement surgeries were done in the U.S., according to the Society of Thoracic Surgeons. That figure includes only "isolated" valve replacements, not procedures in which the aortic valve was replaced and other heart procedures were also done.

Which of these conditions might Robin Williams have?

It is difficult to say without information about symptoms and medical history, Robertson and DeAnda say. Stenosis is more commonly the reason for valve replacement, in Robertson's experience.

Stenosis usually comes on more gradually than a leakage problem, DeAnda says.

Isn't Williams, at 57, relatively young to have this condition?

Not really. The average age for symptoms associated with aortic valve stenosis is the early 60s, Robertson says.

Many of the patients that DeAnda performs aortic valve replacement on are in their 50s and 60s. But others, like Barbara Bush, are in their 80s. Some teenagers need the procedure, often because of a congenital abnormality of the valves.