Heart Valve Surgery

What causes valvular heart disease?

There are several reasons that one or more of your heart valves may not work properly. The ultimate effect of a diseased heart valve is that it interrupts normal blood flow through the heart. Causes may include the following:  -Endocarditis – an infection of the valve tissue.  -Rheumatic fever – a specific type of infection more prevalent in developing countries where the valve tissue becomes inflamed and/or fused together.  -Calcification – over time, calcium in your body can build up on the tissue of your valves making it difficult for them to move properly.  -Congenital defects – a condition you are born with such as having only two leaflets on the aortic valve rather than three.  -Ischemia – also known as coronary artery disease, in which the heart’s own blood vessels become clogged and can no longer deliver the proper amount of blood.  -Degenerative disease -– a progressive process that represents slow degeneration from mitral valve prolapse (improper leaflet movement). Over time, the attachments of the valve thin out or rupture and the leaflets become floppy and redundant.

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How can my heart valve be repaired?

In some cases, it is possible to repair your valve. Repair is most commonly performed on the mitral and tricuspid valves. The goal of the repair procedure is to fix your native valve so that it can open and close properly, thereby restoring normal blood flow through the heart. An implantable device which is usually ring-shaped with a metal core may be placed directly above your valve and tied in place with sutures. This procedure is called ring annuloplasty. The ring helps your valve maintain its proper shape so that blood does not leak out as the heart contracts and relaxes. This surgery can be performed with a conventional, full open-chest or through a less invasive or minimal incision approach as well.

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How can my heart valve be replaced?

If your heart valve cannot be repaired, your doctor may decide to replace your native valve with a prosthetic valve. The aortic valve is the most commonly replaced heart valve. The prosthetic valves are usually one of two types: a mechanical valve or a tissue valve. A mechanical valve is made from synthetic (manmade) materials, primarily carbon. A tissue valve is usually made from either the tissue from a pig’s aorta or the tissue from the pericardium (sac surrounding the heart) of a cow. Valve replacement can be performed with a conventional, full open-chest or through less invasive or minimal incision approaches as well.

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Should I have a mechanical valve or a tissue valve?

You should discuss this question with your doctor as there are advantages and disadvantages to both. The key is to choose the valve that best fits your lifestyle and your goals. A mechanical valve may last longer than a tissue valve (which can wear out over time). However, patients with mechanical valves are required to be on anticoagulants (blood thinners) for life. Tissue valves do not require you to be on blood thinners for the rest of your life. However, they can wear out over time which may require a re-operation.

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How long after heart valve repair or replacement surgery can I resume “normal” levels of activity?

If you have a valve replaced or repaired, the normal recovery period is four to eight weeks, although minimally invasive approaches are often associated with more rapid recovery. Your ability to return to your normal daily activities depends on several factors, including the type of valve repair/replacement you’ve had, how you feel, how well your incision is healing, and the advice of your doctor. Regardless of the pace of your recovery, a supervised cardiac rehabilitation program is always helpful to regain energy and ensure overall good health.