Sunday, April 14, 2024

Surgery For Heart Valve Replacement

When Is Surgical Repair Of A Mitral Valve Advisable

Watch a Transcatheter Aortic Valve Replacement (TAVR) Procedure at St. Luke’s in Cedar Rapids, Iowa

Your mitral valve is two little flaps of tissue that control the flow of blood from the upper chamber to the lower chamber on your heart’s left side. If it’s seriously damaged, especially if it’s leaky, it is strongly advisable to consider surgical repair.

If you are diagnosed with a damaged mitral valve, your surgeon will evaluate the specifics of your situationespecially whether your valve is leaky or blocked . Then it will be possible to weigh the risks of surgery against the risks of managing the disorder with medication and other nonsurgical treatments. Sometimes, if your symptoms are not serious, they can be managed with lifestyle changes and/or medication. But often it will be advisable, especially for a leaky valve, to consider surgery to address the deficiency.

If your valve is severely leakyas long as it hasn’t been damaged by rheumatic fever and hasn’t become calcified, or hardenedit is usually a good idea to repair the valve before it either results in significant damage to your heart or becomes so defective that it can’t be repaired and must be replaced.

When To Call The Doctor

  • You have chest pain or shortness of breath that does not go away when you rest.
  • You have pain in and around your incision that does not continue to get better at home.
  • Your pulse feels irregular, very slow or very fast .
  • You have dizziness or fainting, or you are very tired.
  • You have a very bad headache that does not go away.
  • You have a cough that does not go away.
  • You have redness, swelling, or pain in your calf.
  • You are coughing up blood or yellow or green mucus.
  • You have problems taking any of your heart medicines.
  • Your weight goes up by more than 2 pounds in a day for 2 days in a row.
  • Your wound changes. It is red or swollen, it has opened, or it has drainage coming from it.
  • You have chills or a fever over 101°F .

If you are taking blood thinners, call your provider if you have:

  • A serious fall, or you hit your head
  • Pain, discomfort, or swelling at an injection or injury site
  • A lot of bruising on your skin
  • A lot of bleeding, such as nosebleeds or bleeding gums
  • Bloody or dark brown urine or stool
  • Headache, dizziness, or weakness
  • An infection or fever, or an illness that is causing vomiting or diarrhea
  • You become pregnant or are planning to become pregnant

What Is A Heart Valve Replacement

Heart valve replacement is a procedure to replace one of your hearts valves with a biological or mechanical valve.

Sometimes, a valve doesnt form right when youre born. Some people may have a valve that gets too narrow, stiff or leaky. In these cases, your blood cant move through your heart efficiently.

You have four valves that control where your blood goes in your heart. Normally, your hearts valves are all opening and closing completely when your heart beats. This allows blood to move in an organized way.

Your blood moves:

  • From one part of your heart to the next.
  • To your lungs to get oxygen.
  • To your aorta, which sends your oxygen-rich blood out to the rest of your body.

Like a sink drain that doesnt hold all the water or completely drain it, a diseased valve keeps some of your blood from going where its supposed to go.

If one of your valves isnt working right, you may need to take medicine or have your valve repaired. If these treatments dont work, you may need a heart valve replacement.

Types of Heart Valves

Biological valves are made of:

In general, theres no difference in durability between the types of biological valves. Biological valves may have some artificial parts to give the valve support and make it easier to put in place.

Homograft Valves

A homograft is:

Mechanical Valves

Mechanical valves are:

  • Designed to last a lifetime.

Heart valve replacement: mechanical vs. tissue

Biological valves
Mechanical valves

Types of Heart Valve Replacement Surgery

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Replacing The Aortic Valve

Your surgeon will open up your aorta so that they can see the aortic valve. The damaged valve is removed, and the new one put into place and attached with a fine thread .

The surgeon will start your heart again, using controlled electric shocks, before taking you off the heart-lung machine. Your breastbone will be joined up with wires, and the wound on your chest closed using dissolvable stitches. Tubes are inserted into small holes in your chest to drain away any blood and fluid that builds up.

The operation may be performed using smaller incisions and instruments, but you will still need to go on the heart-lung machine. In the future, it may be possible to perform this operation in a less invasive way, without the need for a heart-lung machine.

When Is It Necessary To Replace The Aortic Valve

Mechanical Heart Valve Stock Photos, Pictures &  Royalty

The aortic valve may need to be replaced for 2 reasons:

  • the valve has become narrowed the opening of the valve becomes smaller, obstructing the flow of blood out of the heart
  • the valve is leaky the valve allows blood to flow back through into the heart

The problems can get worse over time and in severe cases can lead to life-threatening problems such as heart failure if left untreated.

There are no medicines to treat aortic valve problems, so replacing the valve will be recommended if you’re at risk of serious complications but are otherwise well enough to have surgery.

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Can A Heart Valve Repair Itself

No, a heart valve cant repair itself. Valve disease doesnt go away. It gets worse with time. As the disease gets worse, youll have more symptoms and your overall health will suffer. These changes often happen slowly, but they can also occur very quickly.

Depending on the type and extent of valve disease you have, you may be able to take medication for the short term. Surgery is the only effective long-term solution, and your healthcare provider will help determine when its time to pursue that option.

Preparing For Your Aortic Valve Surgery

Before having an aortic valve replacement, you will attend a pre-admission clinic. Here, you’ll be seen by a member of the team who will look after you in hospital.

At the clinic, you will have a physical examination and will be asked for details of your medical history.

Any investigations and tests that you need will be arranged. For example, these will include a blood test or an X-ray. This is a good time to ask questions about the procedure, although you can discuss your concerns with your doctor at any time.

You will be asked if you are taking any tablets or other types of medication. These might be prescribed by your GP or bought over-the-counter in a pharmacy. It helps if you bring details with you about any medication you are taking, for example by bringing the packaging with you.

You will be asked about any previous anaesthetics you have had, and whether you had any difficulties or side effects with these, such as nausea. You will also be asked whether you are allergic to anything. This is to prevent you having an allergic reaction to any medication you might need.

If you smoke, you will be advised to stop. Quitting smoking will lower the risks of complications occurring after surgery, such as chest infection or blood clots.

It is likely you will be in hospital for 5 to 7 days, so you will need to make some practical preparations. These include bringing clothes, toiletries and any equipment you use, such as a walking stick or hearing aid.

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Will I Need To Take Blood

The need for anticoagulant medication after surgery depends on the type of surgery you have. The medication prevents blood clots from forming and causing problems with your heart valve. Currently, warfarin is the only approved blood thinner for mechanical heart valves.

If you have a mechanical heart valve, youll need to take this medication for the rest of your life.

If you have valve repair or a biological valve replacement, you may need to take this medication for several weeks after surgery, or maybe not at all.

You may need to take an anticoagulant for a condition not related to your heart valves. This medication also treats:

  • An irregular heartbeat.

What To Expect At Home

Transcatheter Aortic Valve Replacement (TAVR) – A Less-Invasive Alternative to Open Heart Surgery

It will take 4 to 6 weeks or more to heal completely after surgery. During this time, it is normal to:

  • Have some pain in your chest around your incision.
  • Have a poor appetite for 2 to 4 weeks.
  • Have mood swings and feel depressed.
  • Feel itchy, numb, or tingly around your incisions. This may last 6 months or more.
  • Be constipated from pain medicines.
  • Have mild trouble with short-term memory or feel confused.
  • Feel tired or have little energy.
  • Have trouble sleeping. You should be sleeping normally within a few months.
  • Have some shortness of breath.
  • Have weakness in your arms for the first month.

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How Is A Heart Valve Replacement Surgery Performed

Heart valve replacement surgery can be performed via any of the two approaches:

  • Open-heart surgery: Traditional method of heart surgery in which a large incision is made in the chest the heart is stopped for a time so that the surgeon can repair or replace the valve.
  • Minimally invasive heart surgery: These are the newer techniques in which the doctors make smaller incisions over the chest to replace the heart valves.

The diseased valves may be replaced by any of the artificial valves that include:

  • Manufactured mechanical valve: Made up of carbon-coated plastic, the mechanical valve is the most durable type of valve that will usually last for your entire lifetime.
  • Donors valve: This is an actual human valve taken from a donor and implanted in your heart . It usually lasts for anywhere between 10 to 20 years.
  • Tissue valve: Created from animal valves or tissues, this type of heart valve is expected to stay healthy for 10 to 20 years after the surgery.

Your doctor will discuss the benefits and risks of the available surgical options as well as of the types of valves.

What Happens During Heart Valve Surgery

  • Youll receive medicine through an IV in your arm or hand so you can sleep deeply and painlessly.
  • Your healthcare provider will use the smallest incision they can for your surgery.
  • Your surgeon may have a machine take over for your heart and lungs during surgery.
  • Depending on which surgery youre having, your provider will repair or replace your heart valve.
  • Heart valve surgery options include:

    • Traditional or open heart surgery: An incision through your breastbone.
    • Minimally invasive heart valve surgery: A smaller incision . Techniques include endoscopic or keyhole approaches and robotic-assisted surgery.
    • Transcatheter: Your provider will put a catheter into a larger artery, such as your femoral artery in your groin, and do the work without making a cut in your chest.

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    What Are Heart Valves And How Do They Work

    The heart is made up of four chambers: two upper chambers and two lower chambers . As the heart beats, blood moves through the heart, flowing into and out of these chambers, then passes onward to the lungs and the rest of the body.

    The flow of blood through the heart is regulated by four valves. These valves ensure that blood moves only in one direction as it passes through the heart. The four valves are:

    • The tricuspid valve regulates blood flow from the right atrium to the right ventricle.
    • The mitral valve regulates blood flow from the left atrium to the left ventricle.
    • The pulmonary valve regulates blood flow from the right ventricle to pulmonary artery .
    • The aortic valve regulates blood flow from the left ventricle to the aorta. Each valve has leaflets, or flaps, that act like small gates. These leaflets open to let blood flow into the hearts chambers or to the bodys arteries, and close to keep the blood from flowing backward.

    Sex After Heart Surgery

    Heart Cardiac Surgery Aortic Valve Replacement High

    Before your operation, symptoms of fatigue or shortness of breath may affect your sex life. After your operation, you may feel like having a more active sex life. You can do so as soon as you feel able to, although avoid strenuous positions and be careful not to put any pressure on your wound until it has fully healed.

    Some people find that having a serious illness can cause them to lose interest in sex. In men, the emotional stress can also cause impotence, where it is difficult to get and maintain an erection. If you are worried about your sex life, talk to you partner, a support group or your GP.

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    Recovering From An Aortic Valve Replacement

    You’ll usually need to stay in hospital for about a week after an aortic valve replacement, although it may be 2 to 3 months before you fully recover.

    You should take things easy when you first get home, but you can start to gradually return to your normal activities over the next few weeks.

    You’ll be given specific advice about any side effects you can expect while you recover and any activities you should avoid.

    You won’t usually be able to drive for around 6 weeks and you’ll probably need 6 to 12 weeks off work, depending on your job.

    Read more about recovering from an aortic valve replacement.

    Preparing For The Surgery

    Preparation for a valve replacement depends on the type of procedure a person is having.

    Prior to open-heart surgery, people will typically meet with the medical team performing the procedure to discuss the steps involved and any possible risks and complications.

    People will likely have to stay in the hospital the night before surgery to have blood work and other testing done. They must not eat after midnight before the surgery.

    Before the surgery, a hospital employee will shave the surgical area and direct the person to put on a hospital gown. They may administer a sedative to help the person relax. They will then move the person to the operating area, where the person will receive general anesthesia.

    What happens during the surgery depends on the type of procedure.

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    What Is The Recovery Time

    Heart valve replacement recovery takes about one or two months. You might have a quicker recovery if you had a minimally invasive operation.

    For the first three weeks of your recovery, youll probably get tired easily.

    Youll need to avoid driving for several weeks after your operation.

    During the first six to eight weeks after surgery, dont pick up anything more than 10 pounds.

    Heart Valve Repair And Replacement Surgery

    Transcatheter Aortic Valve Replacement (TAVR) for Aortic Stenosis
    • Heart Valve Repair and Replacement Surgery

    Your heart valves keep blood flowing in the right direction throughout your heart. If one of your valves isnt working properly, blood flow can be reduced or head in the wrong direction. Over time, heart valve problems can affect your heart rate, breathing, energy level and more.

    Mercy heart specialists can determine how serious your valve condition is and discuss your treatment options. The first decision is whether your valve should be repaired or replaced. Your doctor will consider your general health, the amount of valve function, the presence of other health conditions and the expected benefits of surgery.

    Heart valve problems that may require surgical repair or replacement include:

    Although repairing or replacing a heart valve is intricate surgery, its a procedure with a high success rate and a low risk of complications.

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    When Do You Need Heart Valve Replacement Surgery

    A heart valve disease develops when the valve becomes either stiff, narrow , or leaky . These two disease states of the valve disrupt the flow of blood in and out of the heart.

    Heart valve diseases can be present by birth or occur as a complication of other health conditions, such as rheumatic heart disease.

    Many people who have heart valve disease may never experience any symptoms. Sometimes, the valve disease is diagnosed when a woman is pregnant. Doctors may still recommend heart valve replacement surgery to prevent the worsening of the heart condition.

    With a diseased valve, heart valve replacement surgery becomes an emergency if you experience:

    What Is Heart Valve Disease

    Heart valve disease occurs when an abnormality develops in a heart valve and impairs its ability to work properly.

    There are two main problems that affect the heart valves:

    • Regurgitation or leaky valve. A defect in a valve can impair its ability to fully close. This can cause blood to regurgitate, or leak, backwards through the valve.
    • Stenosis. This happens when a valves opening becomes narrowed, reducing the amount of blood that can flow through it.

    Regurgitation and stenosis can affect any of the hearts valves, and more than one valve can be affected at the same time. A valve can be simultaneously leaky and narrowed.

    Each of these conditions interferes with the hearts ability to pump blood around the body. They make the heart work harder than usual and can cause heart failure and other heart problems.

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    What Are Heart Valve Replacements Made Of

    There are two types of heart valve replacements:

    Mechanical heart valves. These valves are created from man-made materials, which can be plastic or metal. Because they are considered to be the most durable, these valves are often used for younger patients. People who have a mechanical valve must take blood-thinning medications such as warfarin. They are also at higher risk for thrombosis . Though this is rare, it is a serious complication that is more likely to occur with a mechanical valve.

    Tissue valves. While a tissue valve does not require long-term use of blood-thinners , and they are less likely to be associated with thrombosis, they are also less durable. Most will need to be replaced in 10 to 20 years. The tissue can be taken from animals or cadavers. A third option is the Ross procedure, a surgery that replaces a defective aortic valve with the patients own pulmonary valve.

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