Valvular Disease Valve Repair

Heart valve surgery is called for if severe symptoms of valvular heart disease develop. Heart valve repair can sometimes restore function to a defective heart valve. If heart valve repair proves not to be an option, heart valve surgery focuses on the use of mechanical or organic valves for valve replacement surgery.

Whether heart valve repair or valve replacement is employed, most heart valve surgery is open-heart surgery. A surgical incision is made through the breastbone. During heart valve surgery the heart is temporarily shut down, and blood is diverted through a heart-lung machine to continue circulation and ensure proper blood oxygenation.

Heart Valve Repair

When possible, heart valve repair is favored over valve replacement surgery. Heart valve repair avoids the complications associated with mechanical or organic valve replacement. Heart valve repair is not an option for all heart valve surgery, however, and some heart valve repairs must be redone if or when valve dysfunction reoccurs.

Heart valve surgery often uses repair techniques to correct congenital heart defects such as separating fused valve flaps. If calcium deposits are a factor in valvular stenosis, heart valve repair can remove built-up calcium, although should calcium build up again, the surgery will have to be repeated.

One particular heart valve repair technique has the advantage of not being as invasive as open-heart surgery. Balloon valvuloplasty can reverse some cases of valvular stenosis. A balloon-tipped catheter is inserted into a vein, usually through the groin. The surgeon guides the catheter to the defective heart valve. Once in position, the balloon is inflated, widening the heart valve opening.

Balloon valvuloplasty is an effective method of heart valve repair, but as the valve inevitably narrows again in the years after surgery, the procedure often has to be repeated.

Valve Replacement and Heart Valve Surgery

Heart valve repair is not always a viable option, and valve replacement surgery must be used instead. During valve replacement surgery the defective valve is removed and replaced with either a mechanical valve or a valve derived from animal tissue or a human cadaver.

Mechanical valves are the longest-lasting valve replacement option. Barring complications, heart valve surgery does not have to be repeated after a mechanical valve is installed. However, mechanical heart valve replacement does increase the risk of future blood clots, as the replacement valve provides a possible anchoring site for blood clot formation.

To counter the risk of blood clots, recipients of mechanical valve replacement must take anticoagulants for life. This lowers the risk of blood clots after valve replacement, but can cause bleeding and coagulation problems. Individuals unable to tolerate life-long blood-thinning therapy should consider heart valve repair or organic valve replacement as an alternative to mechanical heart valve replacement surgery.

Heart Valve Surgery and Organic Valve Replacement

Organic heart replacement surgery does not require long-term anticoagulant treatment, but organic replacement valves do not last as long as mechanical valves. In general, heart valve surgery to replace worn-out valves is required every ten to fifteen years.

Organic valve replacement uses valves gathered from a number of sources. Replacement valves may come from human cadavers, but are also harvested from pigs and cows. Porcine or bovine valves must be physically modified for heart valve surgery, and secured using synthetic rings.

Whether the replacement valve is derived from animal or human tissue, valve replacement surgery requires that the valves be sterilized prior to heart valve surgery and treated with preservatives to extend the life of the replacement valve for as long as possible.

Complications of Heart Valve Surgery

Heart valve surgery is major surgery, and both valve repair and valve replacement operations can last up to five hours. Like all major surgical procedures, heart valve surgery may have complications during and after the operation, including:

  • bleeding
  • infections
  • post-operative blood clots
  • respiratory failure.

In cases of valve replacement, the valve may fail to function properly, requiring further surgery.

Certain medical conditions increase the likelihood of surgical complications and must be brought to the attention of medical professionals prior to surgery. These include:

  • additional heart conditions
  • chronic illness
  • kidney disorders
  • liver disease
  • lung disorders
  • poor dental hygiene
  • recent infections
  • stroke.