Definition There are 4 valves in the heart. They connect the 4 heart chambers. The valves help move the blood through the heart as it pumps. Valves that are not working properly can sometimes be repaired with surgery.
Who is a candidate for the procedure? The following conditions may require heart valve surgery:
heart valves that become narrow and stiff, blocking the flow of blood through the heart
heart valves that leak, allowing blood to flow the wrong way through the heart
heart valve infections, such as those caused by rheumatic fever
How is the procedure performed? Some heart valve problems can be fixed with a minimally invasive procedure. A narrow tube, called a catheter, is inserted into an artery in the groin. The catheter is threaded through the body into the heart. The surgeon repairs the heart valve using special tools inserted through the catheter. Most people, however, require open heart surgery for repair of heart valve defects. This is an extensive operation that is performed under general anaesthesia.
Before the procedure, the person is put to sleep with general anaesthesia. The chest area is first cleaned with antibacterial chemicals. Next, an incision is made into the breastbone or sternum to expose the heart. The person is then put on a heart-lung bypass machine. This device keeps the blood full of oxygen and blood circulating around the heart.
A heart valve operation can involve repair of the valve or a complete replacement. There are two types of replacement valves: artificial and biologic. Artificial valves are generally made of metal or plastic. Biologic valves may come from human organ donors or from animals such as pigs.
After the valve is repaired or replaced, the person is taken off the heart-lung machine. Once the person's heart is working again to pump the blood, the chest incision is closed. The person is taken off general anaesthesia and sent to the surgery recovery room.
What happens right after the procedure? The person will spend at least an hour in the surgery recovery room until the anaesthesia has worn off. The person then must stay in the hospital a few days to recover. Analgesias are given as needed for discomfort.
What happens later at home? It may take months for a person to fully recover from open heart valve surgery. Activity should be increased gradually as the person is able to tolerate it. People with artificial valves are usually put on blood thinning medications to prevent blood clots. Individuals with biologic valves generally do not need blood-thinning medications. However, biologic valves tend to wear out after several years and may need to be replaced.
What are the potential complications after the procedure? All major surgery carries the risks of bleeding, infection and death. Chest pain may last for months. Some numbness in the skin near the incision may also occur. However, this problem often gets better over time.
Author: Adam Brochert, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
