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What is Heart Valve Replacement Surgery?

Heart valve replacement surgery is a critical procedure to restore normal blood flow in individuals with heart valve disease. The heart, a muscular pump, relies on four valves—the tricuspid, pulmonary, mitral, and aortic- to regulate blood flow through its four chambers and ensure it moves in the right direction. When these valves are damaged due to conditions like valve stenosis (narrowing) or regurgitation (leakage), the heart struggles to function efficiently, leading to potential health complications.

In cases where heart valve disease is severe and symptoms affect quality of life, replacement surgery may be recommended. By removing the diseased valve and implanting a new one, this surgery improves heart function and helps patients lead healthier, more active lives. While traditionally performed as open-heart surgery, modern advancements now offer minimally invasive options that allow for faster recovery and less postoperative discomfort.

When Heart Valve Replacement Surgery is done?

Heart valve replacement surgery is performed when a heart valve is severely damaged and cannot be repaired, affecting blood flow. It’s necessary in conditions such as:

  1. Valve Dysfunction (Stenosis or Regurgitation):
  • Stenosis: A valve that doesn’t open fully, restricting blood flow and forcing the heart to work harder.
  • Regurgitation: A valve that doesn’t close properly, causing blood to flow backward and reducing heart efficiency.
  1. Severe Symptoms of Heart Valve Disease: Symptoms like chest pain, shortness of breath, fatigue, dizziness, fluid retention, or fainting may indicate severe valve dysfunction, requiring replacement to prevent heart failure.
  2. Disease-Specific Conditions: Conditions such as aortic stenosis, mitral stenosis, mitral regurgitation, or congenital valve issues may require replacement due to severe valve impairment.
  3. Infection or Damage: Infections like endocarditis or damage from rheumatic fever may damage the valve beyond repair, requiring replacement.
  4. Previous Valve Replacement Failure: A previously replaced or repaired valve may need replacing again if it fails due to wear, infection, or blood clotting issues.
  5. Other Heart Surgeries: Valve replacement may be performed alongside other procedures, like coronary artery bypass surgery, if the valve condition is expected to worsen over time.

Valve replacement is recommended when the condition is severe, symptoms impact daily life, and other treatments are no longer effective, improving heart function and quality of life.

Types of Valve Replacement Surgery

  1. Mechanical Valve Replacement
  2. Biological (Tissue) Valve Replacement
  3. Transcatheter Aortic Valve Replacement (TAVR)
  4. Balloon Valvuloplasty
  5. Bio prosthetic Valve-in-Valve Replacement
  6. Minimally Invasive Valve Surgery
  7. Traditional Open-Heart Valve Replacement
  8. Transcatheter Mitral Valve Repair (TMVR)

A minimally invasive approach to treating mitral regurgitation, a condition where the mitral valve doesn’t seal properly, allowing blood to flow backward into the heart. 

Diagnostic Criteria and Preparation for Heart Valve Replacement Surgery

Before recommending a valve replacement surgery, our doctors will first conduct a detailed consultation, perform a physical examination, and order several diagnostic tests. The physical exam includes listening to the sounds made by the heart as its valves open and close. Additionally, the doctor will assess the circulation and function of other organs in the body.

The physician will carry out a range of tests, including:

  • Transesophageal Echocardiography: delivers high resolution  images of the heart’s valves and chambers.
  • Echocardiography: A non-invasive test that uses sound waves to create images of the heart’s structure and function.
  • Chest X-Ray: Helps assess the size of the heart and the presence of any fluid in the lungs.
  • Electrocardiogram (EKG): Monitors the heart’s electrical activity to check for irregularities
  • Cardiac catheterization (angiogram): A procedure to examine the coronary arteries and heart chambers for blockages or defects.

Based on the results of these diagnostic tests, the progression of the valve disease will be evaluated, and further treatment options will be recommended by the expert heart specialists at Tx hospitals.

What Happens During the Heart Valve Replacement Procedure

Heart valve replacement surgery involves several steps:

  1. Preparation: An IV line is placed, and monitoring devices track vital signs. An anesthesiologist administers general anesthesia to ensure you remain asleep and comfortable during the procedure.
  2. Positioning: You’re positioned on the operating table, with a breathing tube inserted to assist with breathing. Additional devices like a Transesophageal Echocardiogram (TEE) probe may be used to monitor the heart during surgery.
  3. Incision: In open-heart surgery, a large incision is made down the chest, and the breastbone is split for access to the heart. Minimally invasive procedures use smaller incisions.
  4. Stopping the Heart: The heart is temporarily halted using a cold solution, while a heart-lung machine takes over the task of pumping and oxygenating the blood.
  5. Valve Replacement: The surgeon removes the damaged valve and replaces it with a mechanical or biological valve, depending on the condition.
  6. Restarting the Heart: Once the new valve is in place, small paddles are used to restart the heart, and the heart-lung machine is disconnected once circulation is restored.
  7. Post-Surgery Monitoring: The heart’s function is closely monitored, and temporary pacemaker wires may be inserted if necessary to stabilize the heart rhythm.
  8. Closing: The sternum is wired together, and the skin is closed with stitches or staples. Drainage tubes may be inserted to drain excess fluid.
  9. Recovery: After surgery, you are transferred to a recovery room or ICU for monitoring. You will remain in the hospital for a few days, with a quicker recovery time for minimally invasive surgery

Recovery and Lifestyle Changes after Heart Valve Replacement Surgery

Recovery after Surgery

  • Hospital Stay: Typically, patients remain in the hospital for 5–7 days, depending on the type of surgery. If minimally invasive surgery was performed, the stay may be shorter.
  • Intensive Care Unit (ICU): Immediately after surgery, patients are closely monitored in the ICU. Once stable, they are moved to a regular room.
  • Pain Management: Discomfort is expected, but pain control measures will be in place. It’s crucial to report any worsening or unusual pain.
  • Physical Recovery: Gradual movement, starting with short walks, is encouraged to rebuild strength. Cardiac rehabilitation may be recommended.
  • Full Recovery: Complete recovery can take weeks to months. Regular follow-up appointments are essential for monitoring heart health and the functionality of the new valve.

    Signs of Complications to Watch For

    • Infection (fever, redness, swelling, increased drainage from the incision)
    • Difficulty breathing, chest pain, or palpitations
    • Sudden weight gain (fluid retention)
    • Uncontrolled pain or unexpected drainage from the incision site

    Lifestyle Changes for Recovery

    • Diet: A heart-healthy diet is vital for recovery and long-term health. Focus on lean proteins, whole grains, fruits, vegetables, and healthy fats. Avoid high-sodium and high-fat foods.
    • Exercise: Exercise is essential for strengthening the heart. Start with walking, swimming, or cycling. Gradually increase activity under medical guidance. Refrain from heavy lifting for a minimum of 6 to 8 weeks.
    • Medications: Take prescribed medications as directed, including blood thinners, beta-blockers, and pain relief medications.
    • Stress Management: Managing stress is essential for maintaining a healthy heart, and practices like mindfulness or relaxation techniques can be beneficial.
    • Avoiding Risk Factors: Quitting smoking, reducing alcohol intake, and maintaining a healthy weight are important steps for preventing future heart problems.

When to call a Doctor

  • Increased pain, changes in incision site, difficulty breathing, chest pain, or fever.
  • Any signs of infection or complications should be reported immediately to ensure quick treatment.

Making these lifestyle adjustments will not only help with recovery but also reduce the risk of future heart issues.

FAQ

It’s a procedure to replace a damaged heart valve with a new one to improve blood flow and heart function.

It’s needed when a valve is severely damaged, causing symptoms like chest pain, shortness of breath, or fatigue due to conditions like stenosis or regurgitation.

Mechanical Valves, Biological Valves, TAVR (Transcatheter Aortic Valve Replacement) and Minimally Invasive Surgery

The heart is temporarily stopped, the damaged valve is replaced, and the heart is restarted. The chest is then closed, and recovery begins.

Recovery can take weeks to months, with a hospital stay of 5-7 days, depending on the procedure.

Follow a heart-healthy diet, exercise regularly, and avoid heavy lifting for 6-8 weeks. Take prescribed medications and manage stress.

Signs include infection (fever, swelling), difficulty breathing, chest pain, or unexpected weight gain.

If you experience increased pain, breathing issues, chest pain, fever, or signs of infection, call your doctor right away.