Valves can become narrow and stiff from infection such as rheumatic fever or staph and aging. If one or more valves become leaky, blood leaks backwards, which means less blood is pumped in the right direction. Based on your symptoms and the overall condition of your heart, your healthcare provider may decide that the diseased valve s needs to be surgically repaired or replaced.
Traditionally, open-heart surgery is used to repair or replace heart valves. This means that a large incision is made in the chest and the heart stopped for a time so that the surgeon can repair or replace the valve s.
Newer, less invasive techniques have been developed to replace or repair heart valves. Minimally invasive procedures make smaller incisions, and mean less pain afterward and shorter hospital stays. The diseased valve may be repaired using a ring to support the damaged valve, or the entire valve may be removed and replaced by an artificial valve. Artificial valves may be made of carbon coated plastic or tissue made from animal valves or human valves taken from donors.
You and your healthcare provider will talk about the pros and cons of each type and what might be best for you. Valve repair or replacement surgery is done to correct the problems caused by one or more diseased heart valves.
There may be other reasons for your healthcare provider to recommend heart valve repair or replacement surgery. There may be other risks depending on your specific medical condition.
Be sure to discuss any concerns with your healthcare provider before the procedure. You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if anything is unclear. Along with a complete medical history, your healthcare provider may do a complete physical exam to make sure that you are in otherwise good health before surgery.
You may need blood tests or other diagnostic tests. You will be asked to fast not eat or drink for 8 hours before the procedure, generally after midnight. Tell your healthcare provider if you are sensitive to or are allergic to any medicines, iodine, latex, tape, or anesthetic agents local and general. Be sure your healthcare provider knows about all medicines prescription and over-the-counter , vitamins, herbs, and supplements that you are taking. Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any anticoagulant blood-thinning medicine, aspirin, or other medicines that affect blood clotting.
You may be told to stop some of these medicines before surgery. Your healthcare provider may do a blood test before surgery to see how long it takes your blood to clot. Tell your healthcare provider if you have a pacemaker or any other implanted cardiac devices. If you smoke, stop smoking as soon as possible. This improves your chances for a successful recovery from surgery and benefits your overall health status.
Based on your medical condition, your healthcare provider may request other specific preparation. Heart valve repair or replacement surgery requires a stay in a hospital.
Procedures may vary depending on your condition and your healthcare providers practice. You will be asked to remove any jewelry or other objects that may interfere with the procedure. A healthcare professional will start an intravenous IV line in your arm or hand for injection of medicine and to give IV fluids. More catheters will be put in blood vessels your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples. The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
Your doctor will put a breathing tube through your mouth into your lungs and connect you to a ventilator, a machine that will breathe for you during the surgery. Your doctor will place a transesophageal echocardiogram TEE probe into your esophagus swallowing tube so he or she can monitor the function of the valves.
A soft, flexible tube called a Foley catheter will be put into your bladder to drain urine. A tube will be put through your mouth or nose into your stomach to drain stomach fluids. Page last reviewed: 20 December Next review due: 20 December The aortic valve controls the flow of blood out from the heart to the rest of the body. When is it necessary to replace the aortic valve? The aortic valve may need to be replaced for 2 reasons: the valve has become narrowed aortic stenosis — the opening of the valve becomes smaller, obstructing the flow of blood out of the heart the valve is leaky aortic regurgitation — 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.
Find out more about why aortic valve replacements are carried out How is an aortic valve replacement carried out? This means you'll be asleep during the operation and won't feel any pain while it's carried out.
During the procedure: a large cut incision about 25cm long is made in your chest to access your heart — although sometimes a smaller cut may be made your heart is stopped and a heart-lung bypass machine is used to take over the job of your heart during the operation the damaged or faulty valve is removed and replaced with the new one your heart is restarted and the opening in your chest is closed The operation usually takes a few hours.
Find out what happens during an aortic valve replacement 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.
Risks of an aortic valve replacement An aortic valve replacement is a big operation and, like any type of surgery, carries a risk of complications. Most people who survive surgery have a life expectancy close to normal.
Updated by: Mary C. Review provided by VeriMed Healthcare Network. Editorial team. Aortic valve surgery - minimally invasive. You may need aortic valve surgery to replace the aortic valve in your heart if: Your aortic valve does not close all the way, so blood leaks back into the heart.
This is called aortic regurgitation. Your aortic valve does not open fully, so blood flow out of the heart is reduced. This is called aortic stenosis. The aortic valve can be replaced using: Minimally invasive aortic valve surgery, done using one or more small cuts Open aortic valve surgery , done by making a large cut in your chest. Before your surgery, you will receive general anesthesia.
You will be asleep and pain-free. To perform the different procedures: Your surgeon may make a 2-inch to 3-inch 5 to 7. The muscles in the area will be divided. This lets the surgeon reach the heart and aortic valve. Your surgeon may split only the upper portion of your breast bone, allowing exposure to the aortic valve. For robotically-assisted valve surgery, the surgeon makes 2 to 4 tiny cuts in your chest. The surgeon uses a special computer to control robotic arms during the surgery.
A 3D view of the heart and aortic valve are displayed on a computer in the operating room. You may need to be on a heart-lung machine for all of these surgeries. There are two main types of new valves: Mechanical, made of man-made materials, such as titanium or carbon.
These valves last the longest. You will need to take blood-thinning medicine, such as warfarin Coumadin , for the rest of your life if you have this type of valve. Biological, made of human or animal tissue. These valves last 10 to 20 years, but you may not need to take blood thinners for life.
Once the new valve is working, your surgeon will: Close the small cut to your heart or aorta Place catheters flexible tubes around your heart to drain fluids that build up Close the surgical cut in your muscles and skin The surgery can take 3 to 6 hours, however, a TAVR procedure is often shorter. Why the Procedure is Performed. Surgery may be done for these reasons: Changes in your aortic valve are causing major heart symptoms, such as chest pain, shortness of breath, fainting spells, or heart failure.
Tests show that changes in your aortic valve are harming the work of your heart. Damage to your heart valve from infection endocarditis. Risks of any surgery are: Bleeding Blood clots in the legs that may travel to the lungs Breathing problems Infection, including in the lungs, kidneys, bladder, chest, or heart valves Reactions to medicines Other risks vary by the person's age.
Some of these risks are: Damage to other organs, nerves, or bones Heart attack, stroke , or death Infection of the new valve Kidney failure Irregular heartbeat that must be treated with medicines or a pacemaker Poor healing of incision Death.
Before the Procedure. Always tell your health care provider: If you are or could be pregnant What medicines you are taking, even drugs, supplements, or herbs you bought without a prescription You may be able to store blood in the blood bank for transfusions during and after your surgery. Some of them are aspirin, ibuprofen Advil, Motrin , and naproxen Aleve, Naprosyn.
If you are taking warfarin Coumadin or clopidogrel Plavix , talk with your surgeon before stopping or changing how you take these drugs. During the days before your surgery: Ask which medicines you should still take on the day of your surgery. If you smoke, you must stop. Ask your provider for help. Always let your provider know if you have a cold, flu, fever, herpes breakout, or any other illness in the time leading up to your surgery. Prepare your house for when you get home from the hospital.
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