Heart Valve Replacement/Repair

Heart Valve Replacement/Repair

Valve replacement surgery is a safe and effective way to treat patients with diseased or non-functional heart valves. In the last 40 years, new surgical and valve technologies have provided a wide array of durable valves and improved surgical techniques, and patients are doing better than ever before.

Treatment

There are three primary treatment options for patients with heart valve disease:

  • medication
  • surgical valve repair
  • surgical valve replacement

The cardiologist and cardiothoracic surgeon consider a variety of factors in selecting the right approach for your treatment. You are encouraged to discuss treatment options with your physician.

Medications are generally used to improve the heart's pumping ability, which in turn can improve the symptoms of valve disease. Cardiothoracic surgeons can repair damaged heart valves. In many cases, a simple device called an annuloplasty ring is used to support the newly repaired valve. For most patients, however, repair is not possible, or would only result in short-term benefit. In these cases, the surgeon chooses to replace the valve.

Surgical approaches

Advances in surgical techniques and medical instrumentation have led to new, minimally invasive surgery. You may wish to discuss the opportunity for minimally invasive surgery with their surgeon.

The difference between minimally invasive and conventional surgical procedures lies in the location and size of the incision that the surgeon must make in order to reach the valve. A smaller, minimally invasive procedure may reduce the chance for infection, speed healing and be less painful during recovery. It is also cosmetically appealing because it leaves a smaller scar. It is important to note, however, that a small incision is not appropriate for every patient. The surgeon will discuss which approach is best for you.

Regardless of the surgical approach used to reach the valve, the procedure will require the use of a heart-lung machine (also called cardio-pulmonary bypass), that takes over the function of your heart during the operation.

The Procedure

The typical valve replacement procedure will last a minimum of two hours, and is often longer. You will be asleep throughout the entire operation (general anesthesia).

After surgery

After the operation, you will be taken from the operating room to the intensive care unit (ICU), where you may remain for a few hours or overnight. When constant monitoring is no longer necessary, you will be moved to a "step-down" or other unit in the hospital. Many patients report feeling surprised at how quickly they feel better, and are often walking 2-3 hours after the operation. Your total hospital stay may be as short as one day, or as long as seven days.

Recovery

Having valve replacement surgery does not necessarily mean you will need to change their lifestyle dramatically after surgery. In fact, most patients feel much better, physically, after the operation because the symptoms of valve disease have been eliminated. Most symptoms will improve gradually in the first few weeks after the operation, with more changes weeks and months into recovery.

Following your surgery, you will be prescribed an exercise regimen and recommended diet. You should ask your doctor for guidance on resuming normal activities including household tasks, exercise, driving and returning to work.

You may also experience unexpected feelings after the operation. They may include:

  • depression, which could last as long as a few weeks
  • elation
  • loss of appetite
  • disturbed vision
  • disturbed sleep
  • swollen legs

Being aware of these feelings before the operation can ease concerns that you are the only one experiencing these feelings.