Valve Repair and Replacement
Heart valves control the flow of blood through the chambers of the heart. There is a valve between the right atrium and the right ventricle (tricuspid valve), between the left atrium and the left ventricle (mitral valve), between the right ventricle and the pulmonary artery (pulmonary valve) and between the left ventricle and the aorta (aortic valve).
When a valve is defective, it does not properly control the flow of blood surging into or out of the chamber. Improperly functioning valves permit leakage (regurgitation) if they don't close completely, and blood flow restriction if they become narrowed (stenotic). Either of these conditions place tremendous strain on the heart muscle by causing it to work harder to maintain proper blood flow.
To correct improperly functioning valves, heart surgery is performed, and the affected valve is either repaired or replaced. Valve repair is always the first option, but upon inspection, if it is too diseased or damaged, valve replacement is performed. The cardiac surgeons at Beth Israel offer minimally invasive valve repair and replacement surgery, as well as the following options for open heart valve replacement:
- Pulmonary autograft, or Ross Procedure, for aortic valve replacement in younger patients.
- Human donor valves, called a homograft. Homograft valves are an ideal option for valve replacement, especially in younger patients, but are limited in availability.
- Animal tissue valves, from a pig, cow or horse. These valves, chemically processed for transplantation from animals to humans, respond well in the human body because of the similarities in tissue structure. The disadvantage, however, is that the animal valve is not as durable as human donor valves, is more susceptible to calcification and may need replacement after 10 to 15 years.
- Mechanical valves are constructed of metals, plastics and/or carbon ceramics. These valves are extremely durable, but may also cause blood clots. Patients receiving a mechanical valve must take anticoagulants for the rest of their lives to guard against these complications.
Beth Israel cardiac surgeons have extensive experience in valve repair and replacement, with a long, consistent history of successful patient outcomes. Again, repair of a malfunctioning valve is always the first option, with valve replacement only being done on valves that are too damaged or diseased. The length of a valve replacement operation averages 3-6 hours, depending on complexity. The hospital stay after valve replacement can vary depending on the age and general health of the patient, but the average stay is 4-6 days for most people.
To maintain your cardiovascular health after surgery, making lifestyle changes and taking medications as prescribed are strongly recommended. Heart-healthy lifestyle changes that are important to your recovery include:
- Quitting smoking
- Treating high cholesterol
- Managing high blood pressure and diabetes
- Exercising regularly
- Maintaining a healthy weight
- Eating a heart-healthy diet
- Participating in a cardiac rehabilitation program, as recommended
- Following up with your doctor for regular visits