Heart Valve Disease Surgery

The heart contains four valves that regulate blood flow through the heart. They prevent blood from flowing in the wrong direction.

There are four chambers in the heart: two upper atria and two lower ventricles. Each ventricle contains two valves:

1. One-way input valve
2. One-way outflow valve

The four valves of the heart include:

1. Tricuspid valve: The input valve in the right ventricle receives blood from the right atrium and sends it to the pulmonary arteries.
2. Pulmonary valve:
   • The output valve of the right ventricle.
   • The right ventricle sends blood to the lungs through the pulmonary arteries.
3. Mitral valve: The intake valve of the left ventricle receives oxygenated blood from the left atrium and pumps it out for circulation in the body.
4. Aortic valve:
   • The output valve opens into the aorta.
   • The blood pumped by the left ventricle goes into the aorta for circulation through the aortic valve.

If one or more heart valves are dysfunctional, the condition is called heart valve disease. 

Dysfunctional valves lose the ability to prevent the backflow of blood, leading to reduced output and other circulatory disorders. A valve replacement or valve repair must be done to treat the condition.

Various types of heart valve disease are:

• Aortic stenosis: Narrowing of the aortic valve. One of the most common reasons for valve replacement.
• Mitral stenosis: Narrowing of the mitral valve.
• Aortic regurgitation or insufficiency: The blood flows back into the heart from the aortic valve, restricting forward flow to the body.
• Mitral regurgitation:
  • The mitral valve causes blood to flow backward into the lungs instead of through the heart as it should.
  • You may have trouble breathing, an irregular pulse, and chest discomfort.

Valve replacement surgery

• Traditional heart valve surgery requires the person to be sedated.
• An intravenous line is inserted into their arm, with other catheters placed in their neck and wrist to monitor their heart and blood pressure.
• Throughout the process, the doctor monitors the person’s heart rate, blood pressure, breathing, and blood oxygen level.
• The surgery site is well-sanitized before making an incision through the center of the chest to cut the breastbone in two and expose the heart.
• The heart is stopped from beating during the surgery. An external circulation machine is set up to supply oxygenated blood to the body.
• The surgeon replaces the abnormal valve with an artificial one made from animal tissue or a mechanic valve made from carbon and metal.
• The natural circulation in the body is restored, and the heart beats normally. The external circulation machine is taken off.
• The cardiac surgeon examines the function of the replaced valves.
• The procedure usually takes two hours, but it may take longer depending on the number of heart valves that need to be replaced or mended.

Risks associated with heart valve replacement surgery

• Swelling or bruising at the location of the incision
• Infections
• High blood pressure
• Formation of blood clots
• Bleeding
• Stroke
• Malfunctioning of the replaced valves

Valve repair surgery

The same procedure is done for a valve repair, but instead of replacing the complete valve, the cause is eliminated through:

• Reconstruction and reshaping of the valve leaflets
• Separation of the fused leaflets
• Removal of calcium deposits on the leaflets
• The transfer chordal within the leaflets of a valve
• Widening the narrow valves

Following heart valve surgery, you will usually spend a few days in the intensive care unit, where a medical team can monitor your recovery and look for symptoms of infection.

• You will be transferred to a progressive care unit to finish your in-hospital rehabilitation.
• Your health and the type of surgery you went through will determine the length of your hospital stay.
• Your doctor will give you guidelines to follow during the recovery phase, such as
  • Activities to avoid
  • Drugs to be taken
  • How to look for indications of infection

Your doctor may advise you on a few lifestyle adjustments to improve your cardiovascular health, such as eating a balanced diet and quitting tobacco and alcohol.