Heart valve

Heart valve surgery

What is heart valve Surgery?

Heart valve surgery is a procedure to treat heart valve disease. Heart valve disease involves at least one of the four heart valves not working properly. Heart valves keep blood flowing in the correct direction through your heart.

The four valves are the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps — called leaflets for the mitral and tricuspid valves and cusps for the aortic and pulmonary valves. These flaps open and close once during each heartbeat. Valves that don’t open or close properly disrupt blood flow through your heart to your body.

In heart valve surgery, your surgeon repairs or replaces the affected heart valves. Many surgical approaches can be used to repair or replace heart valves, including open-heart surgery or minimally invasive heart surgery.

Your treatment depends on several factors, including your age, your health, the condition of the affected heart valve and the severity of your condition.

Why it's done

There are two basic types of heart valve defects: a narrowing of a valve (stenosis) and a leak in a valve that allows blood to back up (regurgitation). You might need heart valve surgery if you have one of these defects and it’s affecting your heart’s ability to pump blood.

Your doctor will evaluate you to determine the most appropriate treatment for your condition. If you don’t have signs or symptoms, or your condition is mild, your doctor might suggest monitoring over time. In that case, healthy lifestyle changes and medications might help manage symptoms.

Eventually, your valve might need to be repaired or replaced. In some cases, doctors recommend heart valve repair or replacement even if you’re not having symptoms. If you need heart surgery for another condition, doctors might repair or replace the affected heart valve at the same time.

Your doctor will discuss with you whether heart valve repair or replacement is more appropriate for your condition. Doctors often recommend heart valve repair when possible, as it preserves your heart valve and might preserve heart function. But sometimes valve replacement is necessary and the best option.Doctors might also evaluate if you’re a candidate for minimally invasive heart surgery. Your doctor will discuss the benefits and risks of each procedure.

If you need heart valve surgery, if possible, choose a medical center that has performed many heart valve surgeries.Eventually, your valve might need to be repaired or replaced. In some cases, doctors recommend heart valve repair or replacement even if you’re not having symptoms. If you need heart surgery for another condition, doctors might repair or replace the affected heart valve at the same time.

Your doctor will discuss with you whether heart valve repair or replacement is more appropriate for your condition. Doctors often recommend heart valve repair when possible, as it preserves your heart valve and might preserve heart function. But sometimes valve replacement is necessary and the best option.
Doctors might also evaluate if you’re a candidate for minimally invasive heart surgery. Your doctor will discuss the benefits and risks of each procedure.If you need heart valve surgery, if possible, choose a medical center that has performed many heart valve surgeries.

During the procedure

You’ll receive anesthetics to put you in a sleep-like state during the procedure. You’ll be connected to a heart-lung bypass machine, which keeps blood moving through your body during the procedure.

Heart valve surgery can be performed using standard open-heart surgery, which involves cutting your chest through your breastbone. Minimally invasive heart surgery involves smaller incisions than those used in open-heart surgery.

Minimally invasive heart surgery includes surgery performed using long instruments inserted through one or more small incisions in the chest (thoracoscopic surgery), surgery performed through a small incision in the chest, or surgery performed by a surgeon using the assistance of a robot (robot-assisted heart surgery).

Minimally invasive heart surgery might involve a shorter hospital stay, quicker recovery and less pain than you’d have with open-heart surgery. Minimally invasive heart surgery ideally should be performed at medical centers with medical teams experienced in performing these types of procedures.

Heart valve repair

Your doctor may often recommend heart valve repair when possible, as it preserves your heart valve and may preserve heart function. Heart valve repair surgery may include:

  • Patching holes in a valve
  • Reconnecting valve flaps (leaflets or cusps)
  • Removing excess valve tissue so that the leaflets or cusps can close tightly
  • Replacing cords that support the valve to repair the structural support
  • Separating valve flaps that have fused
  • Tightening or reinforcing the ring around the valve (annulus)

Some heart valve repair procedures are performed using a long, thin tube (catheter) and clips, plugs or other devices, and regular technology advances allow new procedures to be done.

Doctors might treat a valve with a narrowed opening with a catheter procedure called a balloon valvuloplasty. A doctor inserts a catheter with a balloon on the tip into an artery in your arm or groin and guides it to the affected valve.

The balloon is inflated, which expands the opening of the heart valve. Doctors then deflate the balloon and remove the catheter and balloon.

Heart valve replacement

To replace a heart valve, your doctor removes the heart valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).

Biological valves often eventually need to be replaced, as they degenerate over time. If you have a mechanical valve, you’ll need to take blood-thinning medications for the rest of your life to prevent blood clots. Doctors will discuss with you the risks and benefits of each type of valve.

A minimally invasive catheter procedure might be used to replace certain heart valves. For example, a catheter procedure might be performed to insert a replacement valve into a biological replacement valve in the heart that is no longer working properly.