Heart Valve Replacement Surgery

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Heart valve replacement surgery is a surgery that is used to treat heart valve disease. Heart valve disease affects any of the four heart valves and inhibits their proper functioning, which is the regulation of blood flow in the right direction through the heart. The heart’s four valves are the aortic, tricuspid, mitral, and pulmonary valves. Read More

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Heart Valve Replacement Surgery

Heart valve replacement surgery is a surgery that is used to treat heart valve disease. Heart valve disease affects any of the four heart valves and inhibits their proper functioning, which is the regulation of blood flow in the right direction through the heart. The heart’s four valves are the aortic, tricuspid, mitral, and pulmonary valves. Each of these valves has flaps that open and close during every heartbeat. Failure of these valves to open or close properly due to disease leads to the disruption of blood flow through the heart. Heart valve replacement surgery is a procedure aimed at replacing one of the hearts valve with a biological, mechanical valve. The type of heart valve replacement used is dependent on various factors like the age of the individual, the general health, the level of seriousness of the valve disease, and the valve affected.

What is heart valve replacement surgery
Picture courtesy: bismaristantr.com

What are the reasons for heart valve replacements

The valves of the heart are supposed to open to allow the flow of blood and close completely after the flow. Diseased heart valves do not properly perform this task. Faulty valves may allow the backflow of blood (regurgitation); the signs of valvular heart disease include:

  • Fatigue
  • Lightheadedness
  • Chest pain
  • Dizziness
  • Cyanosis
  • Oedema, especially in the lower limbs

Health valve repair in some people may require the total replacement of the valves as the damage is too severe for repair.

What are the types of heart valve replacements?

The types of heart valve replacements that exist include:

  • Biological valves – these are also called tissue valves or bioprosthetic valves. They are usually made of cow tissue, pig tissue, or human tissue (allograft or homografts). Biological valves may also possess some artificial parts to give them some extra support and make them easier to put in place.
  • Homograft valves – these are valves that are gotten from human beings; they may be gotten from a donor after their death. They are usually used in the replacement of a diseased aortic valve in individuals whose aortic valves have been destroyed because of disease or infections. They can also be used to replace the pulmonary valve when it is diseased.
  • Mechanical valves – mechanical valves are made of metal or carbon and are designed to function just like normal valves. The bileaflet valve is the most common type of mechanical valve used. Mechanical valves are quite durable, and they are also well tolerated and designed to last throughout the life of the individual.

What are the types of heart valve replacement surgery?

The types of heart valve replacement surgery include:

  • Aortic valve replacement – the aortic valve is on the left side of the heart and functions as an outflow valve. It allows the outflow of blood from the left ventricle and also closes after to prevent the backflow of blood. Surgery of the aortic valve may be needed if there is a congenital disease or defect or an infection that causes a stenosis or backflow of blood.
  • Mitral valve replacement – Mitral valve is located on the left side of one’s heart. It helps in the inflow of blood, and it allows the blood from the left atrium to flow into the left ventricle. Surgery may be required when the valve is narrow or doesn’t close completely to prevent backflow. This can be due to some congenital defect, disease, or infection.
mitral valve replacement
Anterior view of male chest showing sternal incision. Top view of heart showing mitral valve repair with a ring.
Picture courtesy: Standford Children’s Health
  • Double valve replacement – this is the replacement of both the aortic and the mitral valve, this type of surgery is not as common, and the mortality rate is higher than the other types of heart valve replacement surgery.
  • Pulmonary valve replacement – the pulmonary valve demarcates the pulmonary artery from the right ventricle. It allows the blood to flow from the heart to the lungs through the pulmonary artery. Pulmonary valve replacement can be due to stenosis, which restricts blood flow. A congenital defect, infection, or carcinoid syndrome may cause stenosis.

What are some of the surgical techniques used in heart valve replacement?

The decision to repair or replace a damaged valve is dependent on many factors, including:

  • The stage of the valvular disease
  • The age and general health of the individual
  • The type of valve repair that is required

The method used can be minimally invasive, open heart surgery, or the procedure can be done through a blood vessel.

Transcatheter aortic valve replacement: This is a treatment option for individuals with severe aortic stenosis. The individual may also have this surgery if they are high risk, though individuals at any risk level may still be eligible for the procedure. In this procedure, a catheter is used to replace the diseased valve. The catheter is placed through an artery in the groin or a cut in the chest. The new valve is put within the valve that was previously used. 

Transcatheter aortic valve replacement
Picture courtesy: Mayo Clinic

Ross procedure: this procedure is a very complex procedure where the pulmonary valve is switched to the aortic valve, and a pulmonary homograft is placed in its position.

What is the procedure of the surgery?

Heart valve replacement surgery is done under general anesthesia, and the techniques may be invasive or minimally invasive. The invasive or conventional surgery requires an incision that runs from the neck to the navel. A minimally invasive surgery has a shorter incision length which also massively reduces the risk of infection. A bypass machine that helps in circulating blood is used during the surgery because the heart is usually still and inactive. This is to enable the surgeon to access the heart and valves. The surgeon makes an incision through the aorta to access the valves to be replaced or removed.


After the surgery, most patients will remain in the hospital for 5-7 days. The patients who had a less invasive surgery can go home earlier than the ones who had a more invasive surgery. The patients are attended to by the medical personnel who administer medication for pain and against infection. The medical staff also monitors their vitals, like blood pressure, heart function, and breathing rate, during the first few days after a heart valve replacement. Full recovery may take a few weeks to several months, depending on the type of surgery done, the recovery rate of the individual, and their general health. Infection is the primary risk after surgery, so the surgical site must be aseptic. It is also important to contact the health care provider at the onset of any of these symptoms, including:

  • Fever
  • Chills
  • Swelling or tenderness at the surgery site
  • Increased drainage at the surgery site

Follow-up appointments are very important. They help inform the health care provider on the state of recovery of the individual and whether they are well enough to resume their normal activities.

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