Heart Valve Repair and Heart Valve Replacement
Heart valve surgery is used to repair or replace diseased heart valves. Healthy valves are important to keep blood flowing between the chambers of the heart, and out of your heart into the large arteries. Heart valve repair and replacement can reduce symptoms such as weakness and shorntess of breath, and can help prolong life.
The two most common types of valve disease are
- Stenosis: A narrowing of the valve which obstructs blood flow and causes the heart to work harder
- Regurgitation: A valve that doesn’t close tightly and allows blood to flow back into the heart.
Depending on the type of valve disease you have and your age and overall condition, you may be a candidate for valve repair or valve replacement.
Types of Vave Repair
Balloon valvotomy for stenosis
In balloon valvotomy, a catheter is inserted through an artery in the groin or arm and threaded into the heart. When the tube reaches the narrowed mitral valve, a balloon located on the tip of the catheter is quickly inflated. The balloon presses against the narrowed valve, stretching it to allow more blood to flow through the heart. Balloon valvotomy does not require open-heart surgery, so recovery is easier.
Open commissurotomy for stenosis
Open commissurotomy is performed using open surgery. In this procedure, the heart surgeon removes calcium deposits and other scar tissue from the mitral valve leaflets, which in turn opens the valve. Open commissurotomy is used for patients with severe narrowing of the valve who are not good candidates for balloon valvotomy.
Valvuloplasty for regurgitation
Valvuplasty is an open surgery procedure in which a heart surgeon modifies the diseased valve by removing excess tissue or reconnecting the valve leaflets so the valve closes properly.
Annuloplasty for regurgitation
In annuloplasty, a heart surgeon uses open surgery to either tighten or replace the ring around the valve (the annulus) so the valve closes properly.
Types of Valve Replacement
When a diseased heart valve cannot be repaired, it must be replaced. Valve replacement can be done as an open-heart surgery or a minimally invasive procedure, depending on the individual patient and the procedure.
There are two types of replacement valves:
Mechanical heart valve
A mechanical heart valve is made from plastic or metal. These valves are extremely durable and can last a lifetime. However, they are more likely than tissue valves to cause blood clots in the heart that can travel to the brain and cause a stroke. Because of this danger, people who have a mechanical heart valve must take an anticoagulant medicine, generally Coumadin, for the rest of their lives. This drug increases the risk of bleeding.
Bioprosthetic heart valve
A bioprosthetic heart valve is made from tissue, generally from a pig or cow. Tissue valves are not as durable as mechanical valves, generally lasting 8 to 15 years and requiring replacement when they wear out. However, in most patients, tissue valves offer the advantage of not requiring medicine to prevent blood clots.
Determining the best option for heart valve replacement is an important decision that should be made in consultation with a heart surgeon, who can explain the options in more detail and offer advice on lifestyle changes that should be considered with each option.
About Heart Valve Replacement Surgery
Heart valve surgery is generally performed as open surgery, with the heart surgeon making an incision along the length of the breastbone to expose the heart. The patient's heart is hooked up to a heart-lung machine, and blood flow is directed to this machine. The surgeon will then remove the damaged valve and replace it with the new one.
Most valve replacement surgeries take an average of 3 to 5 hours and involve a long recovery time. Our skilled surgeons are often able to perform these surgeries with minimally invasive and robotically-assisted techniques.
Aortic Valve Replacement
UC San Diego surgeons are researching advanced techniques such as percutaneous aortic valve replacement (AVR). This new valve replacement technique uses a catheter, rather than open heart surgery, to replace the valve. It can be used in some patients with aortic stenosis (narrowing of the aortic valve opening).