The heart is a pump made of muscle tissue. It has 4 pumping chambers: 2 upper chambers, called atria, and 2 lower chambers, called ventricles. Valves between each of the heart's pumping chambers keep blood flowing forward through the heart.
When valves are damaged or diseased and do not work the way they should they may need to be repaired or replaced. Conditions that may cause heart valve dysfunction are valve stenosis (stiffness) and valve regurgitation (leaky valve).
When one (or more) valve(s) becomes stenotic (stiff), the heart has to work harder to pump the blood through the valve. Valves can become narrow and stiff from infection (such as rheumatic fever or staph) and aging. If one or more valves become leaky, blood leaks backwards, which means less blood is pumped in the right direction. Based on your symptoms and the overall condition of your heart, your healthcare provider may decide that the diseased valve(s) needs to be surgically repaired or replaced.
Traditionally, open-heart surgery is used to repair or replace heart valves. This means that a large incision is made in the chest and the heart stopped for a time so that the surgeon can repair or replace the valve(s). Newer, less invasive techniques have been developed to replace or repair heart valves. Minimally invasive procedures make smaller incisions, and mean less pain afterward and shorter hospital stays.
The diseased valve may be repaired using a ring to support the damaged valve, or the entire valve may be removed and replaced by an artificial valve. Artificial valves may be made of carbon coated plastic or tissue (made from animal valves or human valves taken from donors). You and your healthcare provider will talk about the pros and cons of each type and what might be best for you.
Valve repair or replacement surgery is done to correct the problems caused by one or more diseased heart valves.
If your heart valve(s) becomes damaged or diseased, you may have the following symptoms:
There may be other reasons for your healthcare provider to recommend heart valve repair or replacement surgery.
Possible risks of heart valve repair or replacement surgery include:
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
Heart valve repair or replacement surgery requires a stay in a hospital. Procedures may vary depending on your condition and your healthcare providers practice.
Generally, open-heart valve repair or replacement follows this process:
After the surgery, a member of the surgical team will take you to a recovery room and later the intensive care unit (ICU) to be closely monitored for several days. A nurse will connect you to machines that will constantly display your electrocardiogram (ECG) tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. Open-heart valve repair or replacement surgery generally requires an in-hospital stay of several days or longer.
You will most likely have a tube in your throat that's connected to a ventilator to help you breath until you are stable enough to breathe on your own. As you wake up from the anesthesia more and start to breathe by yourself, your doctor can adjust the breathing machine to allow you to take over more of the breathing. When you are awake enough to breathe completely by yourself and are able to cough, your doctor will remove the breathing tube. He or she may also remove the stomach tube at this time.
After the breathing tube is out, a nurse will help you cough and take deep breaths every couple of hours. This will be uncomfortable due to soreness, but it is very important that you do this to keep mucus from collecting in your lungs and possibly causing pneumonia. Your nurse will show you how to hug a pillow tightly against your chest while coughing to help ease the discomfort.
You will get pain medicine if you are hurting. Ask for the medicine before you become extremely uncomfortable.
You may be on IV (intravenous) medicines to help your blood pressure and your heart and to control any problems with bleeding. As your condition stabilizes, your doctor will gradually decrease then stop these medicines. He or she will also remove any pacing wires in your heart you may have.Once your doctor has removed the breathing and stomach tubes and you are stable, you may start to drink liquids. You can start eating more solid foods as soon as you can tolerate them.
When your healthcare provider decides that you are ready, you will be moved from the ICU to a surgical unit or acute care unit. Your recovery will continue there. Your activity will be gradually increased as you get out of bed and walk around for longer periods. A member of your healthcare team will arrange for you to go home and schedule a follow-up visit with your healthcare provider.
Once you are home, it will be important to keep the surgical area clean and dry. You will be given specific bathing instructions. Your doctor will remove the sutures or surgical staples during a follow-up office visit, if they were not removed before leaving the hospital.
Do not drive until your healthcare provider tells you it's OK. Other activity restrictions may apply.
Tell your healthcare provider right away if you have any of these:
Your healthcare provider may give you other instructions after the procedure, depending on your situation.
Before you agree to the test or the procedure make sure you know: