The decision to have surgery is something that most of us don’t take lightly. Even relatively minor or common surgeries may be emotionally stressful.
Unfortunately, sometimes the surgery you need may not be minor. Such surgeries may in fact be necessary to correct a serious health condition, improve quality of life, and in some cases, to save your life.
One type of surgery that may be particularly stressful and cause much anxiety for the patient is the need for any type of open heart surgery. One of the common types of surgical procedures performed on cardiac patients is heart valve surgery.
Here, we’ll take a closer look at heart valves and why heart valve surgery might be necessary in some cases.
What are heart valves? What do they do?
All of us have four heart valves. They are aortic, mitral, tricuspid, and pulmonary.
The valves operate in much the same way as a gate at a dam might work. When there is too much water in the lake, gates are opened allowing the excess water to flow downstream.
Imagine the downstream flooding that would occur if the gate never closed! Conversely, imagine the flooding on the lake side if the gate were unable to open at the proper time and allow the excess water to flow where it needed to go.
Heart valves function in much the same manner. Think of a heart valve as a gate that opens, allowing blood to flow into or out of the different chambers of your heart or heart arteries.
As long as your heart valves are opening and closing at the proper time, the blood flow continues just as it’s supposed to.
On the other hand, when one of your heart valves fails to open or close at the proper time, serious heart problems can occur.
What causes a heart valve to quit functioning properly?
There are several reasons why a heart valve might fail to function as designed. Sometimes, defective heart valves are the result of a congenital, or birth, defect. In other cases, aortic valve disease may be the culprit, leading to a damaged heart valve.
Conditions such as rheumatic fever, a complication of strep throat, have been linked to damaged aortic valves.
Two common types of a heart valve disease are aortic regurgitation and aortic stenosis.
In aortic regurgitation, the heart valve fails to close properly causing the blood to back up. In aortic stenosis, the opening to the heart valve has become too narrow which makes it difficult for the right amount of blood to flow through the opening.
My doctor says I have a problem with one of my heart valves. Will I have to have it replaced?
That depends on how damaged or diseased your heart valve has become. Sometimes, the heart valve can be repaired.
If this is the case, then your physician may perform a valve repair or a ring annuloplasty.
A valve repair involves trimming up or reshaping the flap that opens and closes the valve so it functions properly. These flaps are called leaflets.
A ring annuloplasty focuses on repairing the ring part of the valve. In this procedure, the physician sews some type of tissue, cloth, or plastic around the valve ring to repair it.
If your valve is so damaged or diseased that it can’t be repaired, you’ll need valve replacement surgery. In this procedure, the surgeon must remove the damaged valve and replace it with a new heart valve.
Both mechanical (man-made) and biological (made from human or animal tissue, such as pig or bovine valves) are currently available. Each type of replacement valve has advantages and disadvantages.
Mechanical heart valves generally have a longer life. However, recipients must take a blood thinner such as warfarin or Coumadin for the rest of their lives.
Biological replacement valves have a shorter life -- between 12 to 15 years -- after which they’ll need to be replaced again. However, many recipients of biological valves don’t need to take blood thinners.
Some patients who need an aortic valve replaced may elect to have a Ross Procedure. In a Ross procedure, the surgeon replaces the damaged aortic valve with one of your pulmonary valves.
The pulmonary valve is then replaced with a new valve. Most people who have this procedure do not need to take blood thinners.
Why do I need heart valve surgery?
As mentioned above, sometimes valves do not work properly and may need to be repaired, as in valve stenosis or valve regurgitation.
Over time, a damaged heart valve may begin to affect your heart function or cause other serious problems such as chest pain or angina, heart failure, fainting spells, or shortness of breath.
If you’ve already previously had heart replacement surgery, the valve may cease to function properly and simply need to be replaced.
In addition, if you have any of the following conditions, your physician may recommend heart valve surgery. Congenital heart valve disease, aortic insufficiency, or stenosis, which includes aortic stenosis, mitral stenosis, or pulmonary valve stenosis may necessitate heart valve surgery. Other conditions that might indicate that surgery is necessary are regurgitation, which includes acute and chronic mitral regurgitation, tricuspid regurgitation and mitral valve prolapse.
Are there any risks to heart valve surgery?
No surgery is risk free and heart valve surgery is no exception. Common risks include adverse reactions to medications, excessive bleeding, infection, blood clots, stroke and kidney failure. Other dangers are arrhythmia, post-pericadiotomy syndrome, heart attack, confusion and death.
You should discuss all concerns about risks with your physician before surgery.
Sources:
Heart Valve Surgery. MedLine Plus, a service of the US National Library of Medicine, National Institutes of Health. 06 May 2011.
http://www.nlm.nih.gov/medlineplus/ency/article/002954.htm
Aortic Valve Stenosis. The Mayo Clinic. 13 Jul 2012.
http://www.mayoclinic.com/health/aortic-valve-stenosis/DS00418
Aortic Valve Disease. The Mayo Clinic. 2012.
http://www.mayoclinic.org/aortic-valve-disease
Reviewed July 30, 2012
by Michele Blacksberg RN
Edited by Jody Smith