Heart Valve Replacement

What is a heart valve replacement?

A heart valve replacement is the surgical removal of a diseased or damaged heart valve and replacement with a new heart valve. Heart valves keep blood flowing in one direction through the four chambers of your heart. They open to allow blood to flow forward to the body. They then close tightly so blood does not leak backwards into the heart. Diseased or damaged heart valves can cause a backflow of blood or not allow blood to flow forward normally.

Heart valve replacement is a major surgery with significant risks and potential complications. Depending on your condition, you may have less invasive treatment options, such as a heart valve repair procedure. You should consider getting a second opinion about your treatment options before having a heart valve replacement.

Types of heart valve replacement

All heart valve replacement procedures remove damaged heart valves and insert a new valve, called a prosthesis. The types of heart valve prostheses include:

• Animal valve prostheses, also called biological or tissue valves, come from either pigs (porcine) or cows (bovine). Tissue valves may also have some man-made parts attached to them. Tissue valves may last 10 to 15 years before they need replacement. With tissue valves, you do not need to take blood thinners for the rest of your life.
• Human valve prostheses come from human donor hearts. These valves are also called biological or tissue valves. They may also have some man-made parts attached to them and may last 10 to 15 years before they need replacement. You do not need to take blood thinners for the rest of your life.
• Mechanical valve prostheses are man-made valves, created from a form of carbon. Mechanical valves are generally more durable than tissues valves. A mechanical valve is likely to last longer than 15 years. However, you must take blood-thinning medication for the rest of your life if you have a mechanical valve.

Other surgical procedures that may be performed

In addition to a heart valve replacement, your doctor may also recommend one or more additional procedures to treat certain conditions. These include:

• Coronary artery bypass graft (CABG), commonly called heart bypass surgery, is a procedure designed to bypass or provide a new route around diseased coronary arteries with healthy vessels taken from other places in your body.
• Percutaneous coronary intervention, or angioplasty, is widening or opening of a blocked or narrowed artery.

Why is a heart valve replacement performed?

A heart valve replacement is a major surgical procedure that your doctor may recommend when one or more of your heart valves does not open or close correctly. A heart valve does not close all the way leads to regurgitation. Regurgitation lets blood flow backward instead of forward. A heart valve that does not open all the way is called stenosis, which is a narrowing of the valve opening. Stenosis prevents blood from flowing forward effectively.

Your doctor may consider a heart valve replacement for you if your heart valve disease causes serious symptoms. These include fatigue, dizziness, passing out, shortness of breath, and swelling of the ankles. However, in many cases, it is preferable to repair instead of replace the valve if possible. Talk with your doctor about all of your treatment options and consider getting a second opinion.

Reasons for heart valve replacement include:

• Aortic regurgitation or stenosis. The aortic valve opens to allow blood to leave the heart and closes to prevent blood from flowing back into the heart.
• Congenital heart valve disease, a condition that is present at birth
• Mitral valve regurgitation or stenosis. The mitral valve opens to allow blood to leave the left atrium and enter the left ventricle. It closes to prevent blood from flowing back into the left atrium.
• Prosthesis replacement when a previous valve replacement is no longer working or is causing problems
• Pulmonary valve regurgitation or stenosis. The pulmonary valve opens to allow blood to leave the heart and go to the lungs to pick up oxygen. It closes to prevent blood from flowing back into the heart.
• Tricuspid valve regurgitation or stenosis. The tricuspid valve opens to allow blood to leave the right atrium and enter the right ventricle. It closes to prevent blood from flowing back into the right atrium.