Heart Valve Surgery
Heart Valve Surgery: Three Ways to Treat Heart Valve Problems
During heart valve surgery, one or more valves are repaired or replaced. There are three possible ways your doctor may approach heart valve surgery:
- Repair the valve: Whenever possible, surgeons prefer to repair a valve rather than replace it. The most common kind of repair involves sewing a ring around the entrance to a valve to improve its size or shape. Another involves cutting tissue to let leaflets open or close better.
- Replacement with a mechanical valve: Mechanical valves are made of metal or hard carbon. There are many designs. Valves can last for decades. But blood tends to stick to them, forming clots. So if you receive a mechanical valve, you have to take Coumadin, an anticoagulant medication, for life to prevent blood clots.
- Replacement with a tissue valve: A tissue valve usually comes from a pig or a cow. Blood does not clot as easily on tissue valves. So patients getting tissue valves may need Coumadin for only a short time. Aspirin is sometimes used instead. Tissue valves may wear out faster than mechanical valves, so they may have to be replaced sooner.
Different problems call for different treatments. Your doctor will talk with you in advance about the treatment that is best for you. In some cases, your doctor may need to change his approach once surgery has begun.
At St. Joseph's Heart & Vascular Institute, our expert cardiac surgeons develop personalized treatment plan for every patient. Learn more about our expertise and approach to Diagnosis and Treatment.
What to Expect During Open Heart Valve Surgery
Open heart valve surgery requires a large incision in your chest. You will be asleep under general anesthesia during the procedure. Here's what to expect:
- Your surgeon makes an incision along your breastbone to gain access to your heart. He then separates the breastbone (sternum).
- A heart-lung machine will oxygenate your blood so your heart and lungs can be still during the surgery.
- Your doctor will either repair or replace the problem valve. If you have another heart problem, a second procedure may be done at the same time to take care of it, too.
- After open surgery, your doctor rejoins the breastbone with wires. In many cases, the breastbone heals in six to eight weeks.
Recovery after Heart Valve Surgery
After surgery, you'll spend at least a day in the intensive care unit (ICU). Highly trained nurses will monitor you closely. When you're ready, you will be moved to a general care room. You'll stay there for five to six days. While there, you'll recover further and prepare to go home.
Give yourself time to get better little by little. Expect good days and bad days. At first, you may tire easily. But being active will help you recover. Find the right balance between rest and activity. And follow all instructions you're given.
During your recovery, call your doctor if you:
- Are short of breath while resting, or after only a little exertion
- Notice your heart beating fast or slow or skipping beats (palpitations)
- Gain more than two pounds in one day or five pounds in seven days, or your legs swell (retaining fluids)
- Feel dizzy or lightheaded
- Have fever of 100°F or higher
- Notice changes in your incision, such as swelling, oozing, or getting red or tender (call your surgeon)
- Have pain in your chest or shoulder that gets worse instead of better
- Have clicking or grinding in your breastbone
Heart Valve Surgery: Risks and Complications
Most valve surgeries have an excellent outcome. But any major surgery carries risk. Valve surgery risks include:
- Bleeding, need for a transfusion
- Infection
- Blood clot
- Heart rhythm problems, stroke, heart attack or death
- Problems in the lungs or kidneys
- Failure of the new or repaired valve
- Damage to the heart