Heart valve repair or replacement depends on how damaged the valve is
There are four types of heart valves: aortic, mitral, pulmonary and tricuspid. Aortic valves and mitral valves are the ones most commonly repaired or replaced. This is due to conditions such as mitral stenosis (narrowing of the mitral valve opening) or aortic stenosis (narrowing of the aortic valve), thus limiting blood flow to and through the heart. Heart valve repair or replacement may also be recommended if you have aortic regurgitation (blood flows back into the heart instead of moving out through the body) or mitral regurgitation (blood flows back into lungs instead of into the heart).
Whenever possible, surgeons prefer to repair heart valves, by preserving and using your own heart tissue to fix holes or reconnect valve flaps, for example. In some cases, removal of excess tissue will solve the problem. Balloon valvuloplasty is an example of a minimally invasive heart valve repair procedure involving an incision in the groin and threading of a balloon up into the heart (cardiac catheterization). The balloon is then expanded gently to separate the leaflets so blood can flow freely again. Transcatheter mitral valve repair, such as with MitraClip, is another example of a minimally invasive surgery to repair the mitral valve.
If the heart valves are too diseased or damaged for repair, heart valve replacement surgery may be the preferred option. Types of heart valve replacement include:
- Mechanical (wire mesh or another material doing the work of the valve)
- Tissue valve (animal donor, commonly pig)
- Transcatheter aortic valve replacement (TAVR)
With heart valve replacement, the replacement valve will eventually need to be replaced again. With mechanical valve replacement, you’ll need to take blood-thinning medication for the rest of your life to ensure blood clots don’t form around the replaced valve.
81 percent of all isolated aortic valve procedures and 91 percent of all isolated mitral valve procedures at Lankenau Medical Center are performed using minimally invasive techniques.
Preparation and recovery from heart valve repair or replacement surgery
Before your surgery, your doctor will provide you with detailed information about what to expect and what you need to do beforehand. For example, you will need to arrange for a friend or family member to provide support once you return from the hospital. You may also be required to discontinue certain medications before surgery and you’ll also need to fast (not eat or drink anything) the day of surgery because you’ll be receiving anesthesia (medication to make you sleep). You will be unconscious during the procedure.
After surgery, you will spend a day or more in the intensive care unit (ICU) where you will be monitored closely. Your nurses will check blood pressure, heart rate, and breathing to make sure you are stable before being moved to a regular hospital room.
In general, if you have had a minimally invasive surgery, your hospital stay will be shorter and you will experience less pain and a faster recovery.
Heart valve repair and replacement surgeries have high success rates and you should be able to return quickly to your daily activities such as walking, driving and going to work. Your doctor may also recommend cardiac rehab to ensure you help strengthen your heart after surgery.