What is Heart Valve Replacement?
Heart Valve Replacement refers to the method of replacing heart valves that have narrowed and hindered the blood flow in & out of the heart with the artificial valve by sewing it to the natural valve. There are four types of heart valves- Tricuspid Valve, Pulmonary Valve, Mitral Valve, Aortic Valves.
Types of Heart Valve Replacement
Open-heart valve replacement surgery
It is a surgical procedure wherein the patient’s heart is exposed in the operation theatre and surgery is performed on the internal structures of the heart. During the surgery, the patient is placed on a heart-lung machine that allows blood to flow through the heart while the surgery is being performed.
Minimally Invasive Heart Surgery
Minimally Invasive Heart Surgery, also known as Keyhole surgery, is performed by making small incisions of about 3 to 4 inches in the heart muscle, through specialized surgical instruments. In most cases, minimally invasive heart surgery focuses on Mitral valve repair, Aortic valve repair and Tricuspid valve repair.
It is a technique wherein the stiff aortic valves are treated with the help of a balloon catheter. The balloon is positioned in the aortic valve and subsequently inflated to expand the size of the valve, leading to improved blood flow.
Types of Valves Used in Replacement
A mechanical valve or prosthetic refers to the artificial substitute of the native heart valve. Like your native heart valve, the mechanical valve to has a ring to support the leaflets.
It is a native valve taken from an animal. Before placing it into the human body, the tissue valve is chemically treated and replaced with the diseased valve.
Homografts or Allografts
When a valve is obtained from the body of a donor, it is known as homograft or allograft. This type of valve is beneficial for children and pregnant women as it does not require long-term anticoagulation therapy.
The procedure of Valve Replacement Surgery
During an Aortic valve replacement surgery, an incision is made by cutting through the sternum. It is also known as a median sternotomy. Following the incision being made, the pericardium is opened and subsequently, the patient is placed on a cardiopulmonary bypass machine (heart-lung machine). The machine helps in pumping through the heart while the surgeon replaces the heart valve. Once the patient is on bypass, an incision is made in the aorta and a cross-clamp is applied. Thereafter the surgeon removes the diseased aortic valve and replaces it with the mechanical one. Once the valve is in place and the aorta has been closed, the patient is taken off from the cardiopulmonary bypass machine. Later, Transesophageal echocardiogram is done to confirm whether the new valve is functioning properly or not.
Benefits of Heart Valve Surgery
Damaged heart valves cause a multitude of symptoms such as breathing difficulties, chest pain, edema and heart palpitations. Post Heart Valve surgery, you get rid of all these problems.
FAQs for Heart Valve Replacement Surgery
The heart has four types of valves- Tricuspid Valve, Pulmonary Valve, Mitral Valve, and Aortic Valves. Mitral Valve and Aortic Valve are placed on the left side of the heart and the Tricuspid Valve and Pulmonic Valve are on the right side of the heart. For a proper movement of blood in the heart, each valve must open and close properly as the heart beats. These valves prevent the backward flow of blood. They are the actual flap which acts as a one-way inlet of blood on one side of the ventricle and a one-way outlet of blood from another side of the ventricle.
The normal heart beats 100,000 times per day till an average 70 years old, which is over 2.5 billion beats.
There are many causes for valvular heart disease from which some can be congenital while others may be acquired later in life. The diseased heart valve can disrupt the normal blood flow through the heart. Some causes of valvular heart disease may include the following:
- Endocarditis – It is an infection in the inner lining of the heart chambers and heart valves. It occurs when bacteria and other germs spread through the bloodstream to the heart.
- Rheumatic Fever – It is a disease that can affect the heart, joints, brain, and skin. It can easily develop if strep throat and scarlet fever infections are not treated properly. Early diagnosis and treatment with antibiotics always help to prevent this fever.
- Calcification – It happens when calcium is deposited in tissue, blood vessels, or organs. These deposits can narrow down the opening of the valve, which resulted in reduced blood flow through the valve.
- Congenital Defects – It is a condition that occurs before birth.
- Ischemia – It is also known as coronary artery disease where the heart’s blood vessels become clogged and can no longer deliver the proper amount of blood.
- Degenerative Disease – It is a progressive process that represents slow degeneration from mitral valve prolapse.
There are various methods for treating valvular heart disease. In a few cases, the doctor prescribes medications to improve symptoms. In the advanced stage of the disease, the doctor recommends two options to treat valvular heart disease – the first is to repair the heart valve and the other one is to replace the heart valve with a prosthetic valve. The final treatment will be decided by the doctor after having a detailed physical consultation and by considering all the medical conditions.
It is possible to repair heart valves in some cases. The procedure to repair the valve is mostly performed on the mitral and tricuspid valves. The main aim to repair the valve is to resolve the malfunctioning of the heart valve and to restore the normal blood flow. During the procedure, a ring-shaped metal core implantable device is placed on the value, which helps the valve to get back in proper shape and prevents blood leakage. This procedure is known as ring annuloplasty and can be performed with an open chest and is sometimes minimally invasive.
When a heart valve is damaged or diseased and cannot be repaired, then, in that case, the doctor recommends the replacement of the heart valve with the prosthetic valve. There are two types of prosthetic valves available, mechanical and tissue valves.
Valve replacement surgery can be performed under general anesthesia that is either traditional open-chest or minimally invasive.
The durability and longevity of an artificial valve depend on the medical condition of the patient and several other factors. Tissue valves can last up to 10 to 20 years. However, it is impossible to forecast how long a valve or repair device will last. Patients who have prosthetic heart valves should have a yearly follow-up with the doctor to check the functioning of the valve.
This depends on every patient – some get relief immediately and some get after a few weeks of surgery. To evaluate your physical health and progress, a doctor will give you proper guidance and instructions.
It will take almost 6 to 8 weeks to get back to the normal routine and resume daily activities after the surgery. It also depends on various factors such as the type of surgery and healing of incisions. The doctor advised accordingly after the checkup. The patient can also join a Cardiac rehabilitation program to regain energy and good health.
It depends on several factors such as age and overall health. However, it takes almost 6 to 8 weeks to heal the breastbone and it may also take about 2 to 3 months before it starts feeling normal after the surgery.
With any surgical procedure, there is always a risk. Patients who have undergone heart valve surgery generally have a risk of infection, excessive bleeding, and anesthesia reaction. There are some other risks related to heart valve surgery including abnormal heart rhythms (Arrhythmias), blood clots, valve leakage, and strokes.
Yes, special care is required after heart valve replacement. It is important to focus on eating a healthy diet and maintaining a healthy lifestyle. During the consultation with the dentist and other specialty doctors, it is necessary to inform them about the replacement surgery. So that the doctor will prescribe antibiotics accordingly.
Yes, it is normal to have a little noise from your mechanical valves. The heartbeat has two sounds, which are caused by the closing of valves inside the heart.
To maintain a lifestyle one should be on regular medications, avoid weight gain, take a healthy diet, avoid heavy exercise, and other heavy activities. If you experience any lifestyle change, pain, fever, and other symptoms, then consult with a doctor on an immediate basis.
TAVR is also known as Transcatheter Aortic Valve Implantation (TAVI). It is a minimally invasive procedure for replacing a diseased aortic valve. During the procedure, the doctor uses a catheter to implant a new valve inside the diseased valve. This procedure can be performed with multiple methods and mostly it is performed with a small incision in the leg.
As this is a less invasive procedure, the patient can return to their daily activities very soon in comparison to open-heart surgery. It also reported that patients can have a better quality of life after the procedure. There are other benefits too such as short hospital stay, relief of symptoms (sometimes immediately), improved heart function, and reduced pain and anxiety.
The patient usually needs to stay in the hospital for about 5-7 days. They may require to stay longer depending on the recovery. After doctor's clearance patients can be discharged.
You can resume sexual activity after approximately 6 weeks and avoid positions that put extra strain on your chest.
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