Within the heart, there are four valves: aortic, mitral, tricuspid and pulmonic valves. When having heart valve surgery, the most common valve to be replaced is the aortic valve, while the mitral value is often repaired. The other valves are not commonly repaired or replaced. The heart valves are essential for blood flow through the heart. These valves open enough for blood to enter and then close to keep blood from flowing backwards.
What Is Heart Valve Surgery?
There are times in which the heart valve will not open all the way, or has a problem closing. When this happens, it affects the blood that is moving through the heart. This is often called heart valve disease. When this happens, a surgeon will repair the valves or replace the valves that are not functioning properly in order to allow the heart to function properly.
There are two ways in which heart valve surgery happens. This is either heart valve repair or heart valve replacement. There are times in which neither surgery can happen, if the person is not well enough to have these performed. When this is the case, a Transcatheter aortic valve implantation (TAVI) procedure is completed.
When Is Heart Valve Surgery Needed?
There are many situations in which heart valve surgery is warranted. These include:
- When regurgitation happens, which is when the valve allows blood to leak backwards
- When stenosis happens, which is when the blood flow into the heart is limited
The reasons for heart surgery may be:
- Defects that occur in the heart valve which can cause chest pain, fainting, heart failure or shortness of breath
- When heart function is affected by these valve changes
- If you are already having open heart surgery, the surgeon may decide to replace or repair valves while already in the heart
- An infection, known as endocarditis, can cause the valves to become damaged
- Blood clots, bleeding or infections can affect valves that have already been repaired or replaced, and you need this performed again
Surgery can treat many heart valve problems, such as:
- Aortic stenosis
- Aortic insufficiency
- Acute or chronic mitral regurgitation
- Heart valve disease that is congenital
- Mitral stenosis or valve prolapse
- Pulmonary stenosis
- Tricuspid valve stenosis or regurgitation
How Is Heart Valve Surgery Carried Out?
Before the procedure is to take place, you will learn about the procedure and talk with members who will be a part of the surgical team. This includes the surgeon, cardiologist, nurses, and anesthesiologist. The doctor will want to discuss every aspect with you, so that you know what you are getting into. In addition, talking with family members about your time in the intensive care unit (ICU), which is often where recovery takes place.
Right before the surgery, the anesthesiologist will administer general anesthesia so that you will go to sleep and not feel any pain. Once this is fully in your system and you are feeling the effects, the surgeon will make an incision into the breastbone in order to reach the heart. The heart is stopped during this procedure, but your body is connection to a heart-lung bypass machine that is meant to keep your bodily organs working and basically performs the actions of your heart.
Mitral Valve Surgery
There are times in which a large incision is not needed, as this really depends on what type of surgery you are having. For example, percutaneous surgery or robot-assisted surgery. If the surgeon is simply repairing the mitral valve, they can use ring annuloplasty or valve repair surgery. Ring annuloplasty is simple repairing the ring part around the valve with plastic, cloth or tissue. Valve repair is basically rebuilding the value.
Valve Replacement Surgery
If you need a new valve, you will receive valve replacement surgery. The old valve is removed, and the new valve is put in. The new valve can be made from metal or ceramic. When these are put in, you do have to have blood thinners for life in order to ensure that everything works properly. Other options include using human or animal tissue to build these valves. These only last for 15 years at the most, but they do not require that you take blood thinners.
There are times in which the surgeon can use your pulmonic valve as a way to correct the valve. The pulmonic valve is then replaced with an artificial valve. This is an option that is for those who do not want to take blood thinners, but on average the person usually has to have the surgery performed again as the valve gives out.
Watch the video from Nucleus Medical Media to learn all about aortic valve replacement surgery:
Expert from Cleveland Clinic explains mitral valve surgery:
Risks and Recovery
The good news is that heart valve surgery has a high success rate. This surgery can relieve those symptoms that you may be struggling with, as well as prolong your life. This is especially true of mechanic heart valves like metal ceramic. Of course, with this type of heart surgery, there are some risks associated. For example:
- Artificial heart valves can still develop blood clots which can result in a person having a stroke
- Bleeding can occur within these valves, but this is rare
- Infection can be a risk to consider as well
- Other risks associated with having this type of surgery are heart attack, having an irregular heart rhythm and stroke, which are often complications associated with any type of surgery. There are times in which new valves result in more surgeries if they do fail later.
- Those who do get a mechanic heart valve will often heart the clicking in their chest. But, this is completely normal.
The recovery time for this type of procedure varies according to the individual. In most cases, a person can sit up out of bed one day after the procedure. There will be pain after the surgery, thus most people are given medication to counteract this. Within a week, most people are back at home. To fully recover, it can take up to 2 to 3 months.