Heart Valve Repair and Replacement FAQs
Close to one million heart valve operations are performed in the United States each year and nearly all of these procedures are done to repair or replace heart valves. The success rate of valve repair or replacement is very high and advances in surgical treatment of diseased heart valves can pinpoint with great accuracy the location, type and extent of valve disease.
Valves are the doorways of the heart. When open, valves only permit blood to flow in one direction. When closed, they form a strong seal between the different chambers of the heart and between the chambers and the blood vessels. The four heart valves are: tricuspid, pulmonary, mitral, and aortic. Damage to the heart through degeneration, infection, injury, congenital defects, heart attack or calcification can cause the heart to compensate by working harder. This can result in inadequate blood circulation. Eventually the heart may weaken or enlarge, and can also lead to congestive heart failure or infections.
What is heart valve repair or replacement?
Valve repair can be performed by using a ring to support a person's diseased valve, using tissue patches to cover holes or tears in the valve, or removing calcium buildup from the valve. If the damage to the valve is severe enough, the entire valve may need to be replaced. An artificial replacement valve may be either:
- Mechanical (made of metal or plastic)
- Biological (made by animal valves or valves from cadavers).
Sometimes a patient's own tissue can be used for valve replacement.
Who is eligible for heart valve repair or replacement?The severity of valve damage is one of the determining factors for either valve repair or valve replacement surgery. Mild damage may be treated with medication instead of invasive surgery. Other determining factors may include age of the patient and the patient's overall cardiovascular health.
The type of procedure being performed must also be determined. Three types of valve surgery are available:
- Sternotomy, in which the sternum is separated
- Minimally invasive approach through the right thoracotomy
- Minimally invasive approach through the partial upper sternotomy
What does the procedure involve?
The average time required for heart valve surgery is four hours. The heart valve surgery will be performed by a specialized team.
In traditional valve repair or valve replacement surgery, the patient's vital functions will be fully supported by a cardiopulmonary bypass pump, or a "heart-lung machine", which takes control over the function of the heart and lungs, blood circulation and oxygen content of the body.
What is involved in the post-operative recovery?
Depending on the patient's condition, they should expect to stay in the hospital for about a week, including at least 1 to 3 days in the intensive care unit (ICU) to monitor the heart, blood pressure, respiration and other bodily functions. Necessary medication will be prescribed by the physician and post-operative care, including incision care, nutrition, exercise, and diet, will be discussed at length. It is important that patients take an active role in educating themselves about the limitations, if any, that valve repair or valve replacement will place on their unique lifestyle.
Recovery rates vary. If the patient has a sedentary job, they can usually return to work in 4-6 weeks. Those who have more physically demanding jobs may need to wait longer.