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Heart valve surgery

Definition

Heart valve surgery is used to repair or replace diseased heart valves.

Alternative Names

Valve replacement; Valve repair; Heart valve prosthesis

Description

There are four valves in your heart:

  1. Aortic valve
  2. Mitral valve
  3. Tricuspid valve
  4. Pulmonary valve

The valves control the direction of blood flow through your heart. The opening and closing of the heart valves produce the sound of the heartbeat.

Heart valve surgery is open-heart surgery that is done while you are under general anesthesia. A cut is made through the breast bone (sternum). Your blood is routed away from your heart to a heart-lung bypass machine. This machine keeps the blood circulating while your heart is being operated on.

Valves may be repaired or replaced. Replacement heart valves are either natural (biologic) or artificial (mechanical):

  • Natural valves are from human donors (cadavers).
  • Modified natural valves come from animal donors. (Porcine valves are from pigs, bovine are from cows.) These are placed in synthetic rings.
  • Artificial valves are made of metal.

If you receive an artificial valve, you may need to take lifelong medication to prevent blood clots. Natural valves rarely require lifelong medication.

Why the Procedure Is Performed

Heart valve surgery may be recommended for the following conditions:

  • Narrowing of the heart valve (stenosis)
  • Leaking of the heart valve (regurgitation)

Valve problems may be caused by:

  • Birth defects
  • Calcium deposits (calcification)
  • Infections such as rheumatic fever
  • Medications

Defective valves may cause congestive heart failure and infections (infective endocarditis).

Risks

The risks for any anesthesia include:

  • Problems breathing
  • Reactions to medications

The risks for any surgery include:

  • Bleeding
  • Infection

The risks for cardiac surgery include:

  • Death
  • Heart attack
  • Irregular heartbeat (arrhythmia)
  • Kidney failure
  • Stroke
  • Temporary confusion after surgery due to the heart-lung machine

It is very important to take steps to prevent valve infections. You may need to take antibiotics indefinitely, or before dental work and other invasive procedures.

After the Procedure

The success rate of heart valve surgery is high. The operation can relieve your symptoms and prolong your life.

The death rate averages 2% to 5%, depending on the heart valve. About 2 of every 3 patients who received an artificial mitral valve are still alive 9 years after the surgery.

The clicking of the mechanical heart valve may be heard in the chest. This is normal.

Outlook (Prognosis)

You will stay in an intensive care unit for the first 2 or 3 days following the operation. Your heart functions will be monitored constantly. The average hospital stay is 1 - 2 weeks. Complete recovery will take a few weeks to several months, depending on your health before surgery.

Review Date: 5/15/2008
Reviewed By: Robert A Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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