Who performs a heart valve replacement?

A cardiac surgeon performs a heart valve replacement. Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. A cardiac surgeon may also be known as a cardiothoracic surgeon.

A subspecialist called a congenital cardiac surgeon may perform the surgery on a heart valve with a congenital defect (a defect present at birth).

How is a heart valve replacement performed?

Your heart valve replacement  will be performed in a hospital using one of the following approaches:

  • Minimally invasive surgery involves inserting special instruments and an endoscope through a three to four inch incision in the chest. The endoscope is a small, thin camera that sends pictures of the inside of your body to a video screen. Your surgeon views the surgical area on the video screen while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your surgeon will make a small incision instead of a large one used in open surgery. Surgical tools are threaded around structures, such as the breastbone and muscles, instead of cutting through or displacing them as in open heart surgery. Minimally invasive surgery may also include the use of a surgical robot or special imaging technologies (computer-assisted surgery) to help your surgeon view the area and perform the surgery.
  • Open heart surgery involves making a six to eight inch incision in chest through the breastbone (sternum). Open surgery allows your surgeon to view and access the heart directly. Open heart surgery allows your doctor to directly see and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open heart surgery may be a safer or more effective method for certain patients.
  • Catheter surgery may be an option for patients who are not candidates for other types of valve replacement surgeries. Catheter surgery involves inserting a catheter (a long, thin tube) through a blood vessel in your groin. Your surgeon will thread the catheter up and into the heart until it reaches the diseased valve. The catheter tip contains a deflated replacement valve that expands once the catheter is in place. This type of heart valve replacement is an emerging technology that is only available at certain medical centers.

Surgeons sometimes combine minimally invasive techniques with an open procedure. Your surgeon may also decide after beginning a minimally invasive technique that you require an open surgery to safely and effectively complete your surgery. 

Your surgeon will advise you on which procedure is best for you and how long you need to stay in the hospital based on your diagnosis, age, medical history, general health, and possibly your personal preference. Learn about the different heart valve repair procedures and ask why your surgeon will use a particular type for you.

Types of anesthesia that may be used

Your surgeon will perform your heart valve replacement using either general or regional anesthesia, depending on the specific procedure. General anesthesia is more common for these procedures.

  • General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. You may also receive a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will have sedation with regional anesthesia to keep you relaxed and comfortable.