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Heart Valve Surgery

Heart valve surgery is necessary when a heart valve needs to be replaced or repaired. This can mean a heart valve has trouble closing fully, called insufficiency or regurgitation, and allows blood to leak back through the valve the wrong way. Insufficiency can be caused by degeneration or tearing of the valve’s supporting structures or of the valve itself. A heart valve may also fail to open fully, called stenosis, and not allow enough blood through to the next chamber. This is usually caused by a hardening of the description.

There are four valves in your heart:

1. Aortic valve

2. Mitral valve

3. Tricuspid valve

4. Pulmonary valve

When any one of these because diseased or injured, it must be replaced immediately so as to minimize future cardio or pulmonary complications. The surgery reroutes, or "bypasses," blood around clogged arteries to improve blood flow and oxygen to the heart. In most cases, one of three replacement valves may be offered for valve replacement surgery: donor human heart valves, tissue heart valves from animals, or mechanical heart valves. Almost all valve replacement surgeries concern the aortic valve or the mitral valve.

During a valve replacement surgery, the cardiac surgeon will make an incision in the chest and separate the breastbone. The patient's heart is then stopped, and blood is circulated through a heart-lung bypass machine to keep the vital signs stable. The aortic or mitral valve is removed and replaced with either the mechanical or biological valve, the breastbone is carefully moved back into place, and the incision is stitched closed. A typical valve replacement surgery lasts anywhere from two to four hours.

Most valve replacement patients are hospitalized for about one week. The first few days are generally spent in the Intensive Care Unit (ICU) where they can be carefully monitored for any serious post-surgery complications. Total recovery times vary depending on the age and general health of the patient, but most people are able to return to work within four to six weeks. Those with more physically demanding jobs usually have to wait longer to return to work.

Valve replacement surgeries are usually successful, but in rare cases a second procedure is needed to correct the placement or functionality of the new valve. Most patients will be advised to begin an exercise program to keep the heart healthy, unless other physical conditions prevent them from doing so. They are

also encouraged to follow a heart-healthy diet that is low in fat and sodium. Individuals who have undergone a valve replacement surgery should always make sure their doctors and dentists are aware of the procedure, especially prior to surgery. Bacteria can enter the bloodstream during surgical procedures, and bacterial infections of replacement valves can lead to serious and potentially fatal complications. Valve replacement patients are usually placed on antibiotics prior to surgery to minimize these risks.

 

The Procedure Valve Replacement Surgery

An expert cardiologist is required to perform valve replacement surgery. During cardiac valve repair or replacement surgery, your breastbone is divided in half to expose your heart. The surgery takes 3-4 hours during which the patient is sedated with general anesthesia. Your heart is then connected to a heart-lung machine which completely takes over the function of your heart and lungs, permitting the surgeon to temporarily stop your heart. A portion of your heart is then open, exposing the malfunctioning valve and the surgeon repairs or replaces it. Once the valve is fixed, the heart is closed. Your heart is then allowed to resume beating, it is disconnected from the heart-lung machine, and your breastbone is closed with wires. The operation usually takes from three to five hours. After the defective heart valve is replaced with the new one, the patient must reside in an intensive care unit for 2-3 days for observation. An additional week’s stay is usually required before the patient may be discharged. Light activity can resumed within a matter of days, while more strenuous exercise should be suspended until the patient has fully recovered.

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