Heart Valve Surgery Procedure
Overview
Heart valve surgery is a major medical procedure that corrects problems with the heart’s valves. These valves—mitral, tricuspid, pulmonary, and aortic—help control the flow of blood through the heart. Each valve has small flaps that open and close with every heartbeat. When these flaps do not function correctly, blood flow can be disrupted, causing health issues.
Heart specialists, such as cardiologists, assess the condition and decide on the best treatment. Surgeons repair or replace a valve. The procedure may occur as open-heart surgery or through smaller incisions with minimally invasive methods, including robotic assistance. Key considerations for surgery include:
- Type and severity of the valve problem.
- Patient’s age and overall health.
- Which specific valve is affected.
Cardiologists and other experts work closely with patients to choose the safest and most effective option to restore proper heart function.
Varieties Available
Doctors use different ways to fix or replace heart valves, especially for the aortic and mitral valves. Some main approaches include:
Annuloplasty: Surgeons tighten or reinforce the ring around a valve. They often use this in mitral valve repair to help the valve close better and reduce problems like regurgitation or stenosis.
Valvuloplasty: Doctors use a balloon to stretch open a valve that is too narrow. This minimally invasive procedure commonly treats aortic stenosis or mitral stenosis.
Both methods help improve heart function and symptoms. Surgeons can use them on their own or as part of a larger surgical treatment, such as valve replacement or other repairs. Minimally invasive techniques are often preferred when suitable, offering faster recovery for many patients.
Reasons for Heart Valve Procedures
Doctors perform heart valve procedures to fix problems that stop the heart from working the right way. These problems are known as heart valve diseases. There are two main types:
- Valve Narrowing (sSenosis): This makes it hard for blood to move through the valve.
- Valve Leaking (Regurgitation): This allows blood to go backward instead of moving forward.
People may need these surgeries if their valve disease causes issues such as:
| Symptom | Description |
|---|---|
| Chest pain (angina) | Tightness or pain in the chest |
| Shortness of breath (dyspnea) | Feeling unable to catch breath |
| Heart failure | Trouble pumping enough blood |
| Swelling or fatigue | Tiredness and fluid buildup |
Several causes, such as endocarditis (an infection of the heart’s inner lining) or diseases affecting the mitral valve, can damage heart valves. Even without obvious symptoms, a doctor might suggest valve surgery during another heart operation to prevent future issues.
Treatment decisions depend on the seriousness of the valve problem, other health conditions, and how well symptoms can be managed with medicines or lifestyle changes. Options can include standard open surgery or less invasive approaches.
Risks
Possible risks include:
- Bleeding
- Infection
- Arrhythmia (irregular heart rhythm)
- Issues with the replacement valve
- Heart attack
- Stroke
- Problems linked to general anesthesia
In rare cases, these risks can lead to death.
Getting Ready for Your Procedure
Eating, Drinking, and Medications
Talk to your care team about all medicines you use each day. Some medicines need to be stopped before heart valve surgery. Share information about any allergies or past bad reactions to drugs, iodine, latex, or tape.
A full health check — including blood tests, a physical exam, and sometimes an electrocardiogram (EKG) — usually happens in the days before the operation. Mention recent dental work, which might affect the surgery. Patients sign a consent form after these steps.
Most people are told not to eat or drink anything after a set time, usually midnight before surgery. These restrictions help lower the risk of problems during surgery. If you are unsure about when to stop food or water, ask the medical team.
What to Wear and What to Bring
- Choose loose and soft clothing for the hospital, as it is easier to put on after surgery.
- Bring a clear list of all current medicines and any special aids, such as glasses, hearing aids, or dentures.
- Pack personal care items, like a toothbrush, comb, and any items you use daily.
Create a small table for easy packing:
| Must-Haves | Optional Comforts |
|---|---|
| Medicine list | Book or music device |
| Glasses/hearing aid | |
| Toothbrush/comb |
Leave jewelry, nail polish, and contact lenses at home or remove them before surgery. Bring your advance directive if you have one. Following these steps helps the day go smoothly and prevents delays.
What You Should Know
Before heart valve surgery, the medical team prepares the patient to help prevent infections and make the procedure safer. Staff may shave body hair at the spots where the doctor will make cuts. They clean the skin with a special soap to reduce the risk of germs.
Vital signs such as blood pressure and heart rate are checked. The patient has a chance to ask questions and learn what to expect. Nurses might use a checklist to make sure all steps are completed before moving forward:
| Preparation Step | Purpose |
|---|---|
| Shave body hair near incision | Prevent infection |
| Wash skin with antiseptic soap | Reduce germs |
| Confirm medical history | Identify risks |
| Review medications | Avoid dangerous drug effects |
| Check vital signs | Assess health |
What Happens in the Operating Room
On surgery day, the anesthesiologist gives the patient medicine to ensure deep sleep and no pain. Special machines track vital signs during the operation. The team may use a breathing tube and sometimes a ventilator to help with breathing.
For standard open-heart surgery, the surgeon makes a cut down the middle of the chest to reach the heart. For certain cases, the surgeon makes small cuts in the chest for minimally invasive approaches. These methods, such as robot-assisted surgery or thoracoscopic techniques, use tiny tools and cameras, which may lead to a faster recovery.
A heart-lung bypass machine keeps blood and oxygen flowing while the surgeon works on the heart. The length of the procedure depends on the type of surgery and the valve’s condition. Here are two main types of surgery:
- Open-Heart Surgery: Larger incision, longer healing, often needed for serious repairs.
- Minimally Invasive Surgery: Smaller cuts, less pain, shorter hospital stay, and usually a faster recovery.
Some patients need surgery in a medical center with a team experienced in these special techniques.
Approaches to Repairing Valves
Doctors prefer to fix a heart valve if possible, rather than to replace it. Preserving the original valve keeps heart function closer to normal. Surgeons use several valve repair surgery methods:
- Patching: Seals holes in the valve.
- Reshaping Leaflets: Reconstructs valve parts so they close better.
- Trimming Tissue: Removes extra tissue if the valve doesn’t close tightly.
- Replacing Chords: Swaps out damaged structures that support valve movement.
- Separating Stuck Sections: Loosens parts that have grown together.
- Reinforcing the Annulus: Tightens or strengthens the valve’s outer ring.
Some repairs do not require open-heart surgery. Doctors can use a thin tube called a catheter. They thread this tube to the valve through a blood vessel, and tools on the end help repair it. One common method uses a balloon on the tube. This is called balloon valvuloplasty.
The balloon is guided to the narrowed valve and then inflated to help widen the opening. Afterward, the team removes the balloon and catheter. Repairs using a catheter often mean less pain, less time in the hospital, and a faster return to daily life.
Options for Valve Replacement
If doctors cannot repair the heart valve, they remove the damaged valve and put in a new one. There are two main kinds of new valves:
- Mechanical Valves: Made from strong materials like metal or carbon. These do not wear out quickly but require the patient to take blood thinners to avoid clots.
- Biological Tissue Valves: Made from tissue taken from cows, pigs, or donated human hearts. These act more like natural valves but may need to be replaced again in the future.
Doctors discuss the pros and cons with patients. Some patients may have a new valve placed in their heart using a catheter instead of open surgery. This can make recovery faster and is sometimes used if a tissue valve needs to be replaced later.
Comparison Table: Types of Replacement Valves
| Valve Type | Made From | Pros | Cons |
|---|---|---|---|
| Mechanical Valve | Metal/Carbon | Long-lasting | Needs blood thinners |
| Biological Tissue | Animal/Human | Acts more natural | May need replacement |
Recovery and Hospital Care After Surgery
After heart valve surgery, staff take the patient to the intensive care unit (ICU) for careful monitoring. The team checks heart rate, blood pressure, and watches for any signs of infection or other problems. Fluids and medicine are given through tubes called IVs. Tubes may drain urine and fluids or blood from the chest.
The patient might get oxygen through a mask or a nasal tube. Medicine helps manage any pain. Nurses and doctors encourage the patient to start moving as soon as it is safe. Walking and deep breathing exercises help the lungs and help prevent problems. Here is what to expect during recovery in the hospital:
- Time in the ICU, followed by several days in a regular room.
- Careful monitoring for infection or blood clots.
- Frequent checks of blood pressure, heart rate, and breathing.
- Instructions for taking medicine and caring for the cut areas.
- Support with pain control and activity planning.
Tips for Recovery
- Follow all instructions from nurses and doctors.
- Watch for fever, redness, or swelling at the incision.
- Take medicines at the required times.
- Practice coughing and breathing exercises to keep the lungs clear.
- Try to walk each day, as guided by the care team.
Most people stay in the hospital for several days or longer, depending on their type of surgery and how they feel. Once home, recovery continues, and regular check-ups are needed.
Post-Surgical Outcomes
After heart valve surgery, most patients attend regular check-ups to track their recovery. Healthcare teams provide clear recommendations about when it is safe to return to normal activities. There are often some short-term limits on physical activity to support healing.
Key Points
- Follow-Up Visits: Routine appointments help doctors monitor heart function and spot any problems early.
- Activity Restrictions: Patients may be advised to avoid heavy lifting or intense exercise for a period of time.
- Healthy Habits: Doctors often encourage a balanced diet, regular physical activity, stress management, and quitting smoking.
Many people are also invited to join a cardiac rehabilitation program, which offers support and structured exercise to help improve heart health.
