In general, it’s preferable to repair Heart valves while preserving a patient’s heart tissue. When the tissue is severely damaged, a valve may be taken from an animal, another human heart, or a mechanical valve to replace it.
In addition to other heart surgeries, your cardiac surgeon can perform valve surgery. Surgical procedures involve multiple valve procedures along with;
- Surgical omission
- Aortic aneurysm surgery
- Atrial fibrillation surgical procedure
Balloon Valve Surgery:
In many cases, a balloon valvuloplasty surgery can reduce valve tightness. As a component of cardiac catheterization, it is a less invasive procedure than open heart surgery or general surgery. Balloon valvuloplasty is more frequently used for mitral and aortic stenosis. During balloon valvuloplasty, a tiny catheter with an expanding balloon is inserted into the tightened valve of the heart. The balloon is then stretched open, and the leaflets are separated.
If balloon valvuloplasty can’t treat the valve, another surgical procedure may be required to open the valve and improve blood flow.
Depending on the expertise and education of your medical care providers, treatment outcomes may differ. Hospitals can become quite skilled at overseeing the care of specific conditions.
Heart valve surgery
The improper functioning of the heart valve caused by valvular heart disease can be repaired or replaced by heart valve surgery and treatments. Open heart surgery is a very complex procedure that can take several hours to complete, and recuperation frequently lasts for several weeks. Some valvular heart diseases can be treated with newer, less invasive techniques, but only at specific facilities.
Open heart valve repair or replacement
Procedures for heart valve surgery may vary based on your illness and the treatment quality provided by your doctor. Typically, open-heart valve replacement or repair may include;
- Any jewellery or other things obstructing the operation must be removed.
- You’ll urinate first and then put on a hospital gown.
- You will be laid back on the operation table by the surgical team.
- A medical professional will establish an intravenous (IV) line in your arm or hand to get IV fluids and pharmaceutical injections. More catheters will be put into the blood vessels of your neck and wrist to collect blood samples and examine your blood pressure and heart health.
- The anesthesiologist will closely monitor your blood pressure, breathing, and oxygen throughout the procedure.
- A ventilator will be connected to your lungs through your mouth.
- To check the valve functioning, your doctor will insert transesophageal echocardiography (TEE) probe into your esophagus.
- A soft, flexible tube called a Foley catheter will be inserted to drain your bladder.
- Your mouth or nose will be used for the insertion of a tube to drain the contents of your stomach.
- A surgical team will use an antiseptic solution to clean the skin on your chest. Shaving and removing excess hair at the surgery site may be necessary.
- If you have open heart surgery, your surgeon will make an incision (cut) across the middle of your chest.
- The breastbone, or sternum, will be split longitudinally to make your heart visible.
- Your doctor needs to halt your heart to perform the valve replacement or repair. They will insert tubes into the heart to allow a heart-lung bypass machine to pump blood through your body while your heart is halted.
- To stop your heart, your doctor will inject it with a cold solution after diverting the blood to the bypass machine for pumping.
- If you need a valve replacement, your doctor will remove the damaged valve and insert the prosthetic valve. Your doctor may separate fused valve leaflets, replace damaged leaflets, or restructure valve sections to ensure improved operation during a valve repair, depending on your valve issue.
- After the procedure, your surgeon will give shocks to your heart with tiny paddles to restart your heartbeat. The tubes attached to the machine will be removed, allowing blood to resume its path through the bypass device and back into your heart.
- Your doctor will examine your heart once it starts beating normally to ensure no surgical leak is present and assess how effectively the heart and its valves are functioning.
- Your doctor may insert a wire for cardiac pacing. If necessary, during the initial healing period, they can temporarily connect these wires to a pacemaker outside your body to pace your heart.
- Your doctor will reattach the sternum with thin sewing wires.
- To remove the blood and other fluids from your heart’s region, your doctor will introduce tubes into your chest.
- Your doctor will stitch the skin around the sternum together after closing the wound with sutures or surgical staples.
- A surgical team member will apply a clean bandage or dressing.
Heart Valve Replacement:
If the heart valve repair is impossible and a catheter-based treatment cannot be used for any reason, the heart valve may need to be replaced. Your doctor removes the heart valve and replaces it with either a mechanical valve or a valve of cow, pig, or human heart tissue.
Biological valves frequently need to be changed because they degrade with time. While in the case of mechanical valves, you must take blood-thinning drugs for the rest of your life to prevent blood clots.
Some heart valves may be replaced using minimally invasive catheter surgery. If a biological replacement valve in the heart is no longer functioning effectively, a catheter operation could be used to introduce a replacement valve into it.
Surgical Options for Valve Replacement
Replacement valve surgery options include;
- Mechanical valve: A reliable valve constructed of solid materials.
- Body valve, which may consist of human or animal donor tissue.
- The Ross Procedure involves transferring your healthy valve into the injured aortic valve’s place and replacing the “borrowed” valve with a new valve.
- Transcatheter aortic valve implantation/replacement surgery is often called the TAVI/TAVR technique.
- Other modern surgical techniques.
The doctor will select the technique according to the patient’s condition, the severity of the symptoms, surgical resources, and the surgical risk. For some surgeries, long-term blood clot prevention medication may be necessary.
References:
- https://www.heart.org/en/health-topics/heart-valve-problems-and-disease/understanding-your-heart-valve-treatment-options/options-for-heart-valve-repair
- https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/heart-valve-repair-or-replacement-surgery
- https://www.heartandstroke.ca/heart-disease/treatments/surgery-and-other-procedures/heart-valve-surgery
- https://www.mayoclinic.org/tests-procedures/heart-valve-surgery/about/pac-20384901
