valvular surgery

Heart valve surgery is a procedure to treat heart valve disease. Heart valve disease happens when at least one of the four heart valves is not working properly. Heart valves keep blood flowing in the correct direction through the heart.

The four heart valves are the mitral valve, the tricuspid valve, the pulmonary valve and the aortic valve. Each valve has flaps — called leaflets for the mitral and tricuspid valves and cusps for the aortic and pulmonary valves. These flaps should open and close once during each heartbeat. Valves that don't open and close properly change blood flow through the heart to the body.

In heart valve surgery, a surgeon repairs or replaces the damaged or diseased heart valve or valves. Methods to do this may include open-heart surgery or minimally invasive heart surgery.

The type of heart valve surgery needed depends on age, overall health, and the type and severity of heart valve disease.

Why it's done

Heart valve surgery is done to treat heart valve disease. There are two basic types of heart valve disease:

  • A narrowing of a valve, called stenosis.
  • A leak in a valve that allows blood to flow backward, called regurgitation.

You might need heart valve surgery if you have heart valve disease that affects your heart's ability to pump blood.

If you don't have symptoms or if your condition is mild, your healthcare team might suggest regular health checkups. Lifestyle changes and medicines might help manage symptoms.

Heart Valve Repair

Heart doctors recommend heart valve repair when possible. It saves the heart valve and avoids the need of a replacement heart valve. It also can help save heart function. During heart valve repair, a surgeon might:

  • Patch holes in a valve.
  • Reconstruct valve flaps, also called leaflets or cusps.
  • Remove excess valve tissue so that the leaflets or cusps can close tightly.
  • Replace or remove pieces of tissue called cords that are diseased and no longer support the valve.
  • Separate valve flaps that have fused.
  • Tighten or reinforce the ring around the valve, called the annulus.

Some heart valve repair procedures are done using a long, thin tube called a catheter and clips, plugs or other devices.

Doctors might treat a valve with a narrowed valve opening using a catheter procedure called balloon valvuloplasty. A catheter with a balloon on the tip is placed into an artery in the arm or groin. Then it is guided to the diseased or damaged valve.

The balloon is inflated, which widens the opening of the heart valve. Then it is deflated, and the catheter and balloon are removed.

Heart valve replacement

If your heart valve can't be repaired and other treatments aren't an option, the valve might need to be replaced. To replace a heart valve, a surgeon removes the heart valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue. Valves made from living tissue are called biological tissue valves.

Biological valves often need to be replaced eventually, as they tend to wear out over time. If you have a mechanical valve, you'll need to take blood-thinning medicines for life to prevent blood clots. Mechanical valves usually do not wear out over time. Your healthcare team likely will talk with you about the benefits and risks of each type of valve.

Valve Material Used Benefits Challenges
Tissue Specially treated animal or human valves
  • They are silent (no clicking sound).
  • You do not need to take "blood thinners (anticoagulants) for a long time).
  • Does not last long as a mechanical valve.
Mechanical Very strong metal, carbon or other man-made mateial
  • Last for long time
  • Often hear "clicking" sound of the valve (may go away with time).
  • Patients must take "blood thinners" (anticoagulants) for the rest of their life.