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Heart valve surgery is used to repair or replace diseased heart valves.
Blood that flows between different chambers of your heart must flow through a heart valve. Blood that flows out of your heart into large arteries must also flow through a heart valve.
These valves open up enough so that blood can flow through. They then close, keeping blood from flowing backward.
There are four valves in your heart:
The aortic valve is the most common valve to be replaced because it cannot be repaired. The mitral valve is the most common valve to be repaired. Only rarely is the tricuspid valve or the pulmonic valve repaired or replaced.
Valve replacement; Valve repair; Heart valve prosthesis; Mechanical valves, Prosthetic valves
Before your surgery you will receive general anesthesia. You will be asleep and unable to feel pain.
In open heart surgery, the surgeon makes a large surgical cut in your breastbone to reach the heart and aorta. You are connected to a heart-lung bypass machine or bypass pump. Your heart is stopped while you are connected to this machine. This machine does the work of your heart, providing oxygen and removing carbon dioxide.
Minimally invasive valve surgery is done through much smaller cuts than open surgery, or through a catheter inserted through the skin. Several different techniques are used:
If your surgeon can repair your mitral valve, you may have:
If your valve is too damaged, you will need a new valve. This is called valve replacement surgery. Your surgeon will remove your valve and put a new one in place. The main types of new valves are:
In some cases, surgeons can use your own pulmonic valve to replace the damaged aortic valve. The pulmonic valve is then replaced with an artificial valve (this is called the Ross Procedure). This procedure may be useful for people who do not want to take blood thinners for the rest of their life. However, the new aortic valve does not last very long and may need to be replaced again by either a mechanical or a biologic valve.
Related topics include:
You may need surgery if your valve does not work properly.
You may need heart valve surgery for these reasons:
Some of the heart valve problems treated with surgery are:
The risks for cardiac surgery include:
It is very important to take steps to prevent valve infections. You may need to take antibiotics before dental work and other invasive procedures.
Your preparation for the procedure will depend on the type of valve surgery you are having:
Your recovery after the procedure will depend on the type of valve surgery you are having:
The average hospital stay is 5 - 7 days. The nurse will tell you how to care for yourself at home. Complete recovery will take a few weeks to several months, depending on your health before surgery.
The success rate of heart valve surgery is high. The operation can relieve your symptoms and prolong your life.
Mechanical heart valves do not often fail. Artificial valves last an average of 8 - 20 years, depending on the type of valve. However, blood clots can develop on these valves. If a blood clot forms, you may have a stroke. Bleeding can occur, but this is rare.
There is always a risk of infection. Talk to your doctor before having any type of medical procedure.
The clicking of mechanical heart valves may be heard in the chest. This is normal.
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Otto CM, Bonow RO. Valvular heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 66.
Nishimura. RA, Otto CM, Bownow RO et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg. 2014;148(1):e1-e132.
Bernstein D. General principles of treatment of congenital heart disease. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 428.