Heart Valve Replacement Surgery

Muscle tissue makes up the heart. There are four chambers in the heart: two upper chambers called atria, and two lower chambers, called ventricles. Each heart’s pumping chamber has a valve that keeps blood flowing forward.
If one or more heart valves are damaged or diseased and aren’t functioning properly, they may need to be repaired or replaced. Heart valve replacement surgery is performed when one or more valves are severely damaged beyond repair. The surgery will involve replacing faulty valves with biological or mechanical valves.

Types of Heart  Valves

Tricuspid:

 Located between the right atrium and right ventricle, this valve allows deoxygenated blood to move from the right atrium to the right ventricle.

Mitral:

 Located between the left ventricle and the left atrium, the heart valve moves oxygen-rich blood coming from the lungs from the left atrium to the left ventricle.

Pulmonary:

 The valve allows deoxygenated blood to move to the pulmonary artery.

Aortic:

 The valve moves the oxygen-rich blood from the left ventricle to the aorta, which supplies blood to the whole body.

When a heart valve is not working normally, some of the blood may flow backward, or when the valve becomes narrow, it may prevent blood from moving to the other chamber.

Reasons for Heart Valve Replacement Surgery

A heart valve replacement surgery may be required when one or more of the heart valves are damaged or diseased and cannot be repaired. Conditions that can cause the dysfunctioning of a valve are valve regurgitation (leaky valve) or valve stenosis (stiff valve).
Valve stenosis is a valvular heart disease in which the valve becomes stiff and doesn’t open fully, causing reduced or blocked blood flow to the heart. This causes the heart to work harder to pump enough blood through the damaged valve. Valves can become stiff or narrow from aging or infections like staph or rheumatic fever.
Valve regurgitation is a heart valve disease in which the valve doesn’t close completely, and the blood leaks backward. The causes of heart valve regurgitation include abnormal heart muscle, congenital heart conditions, enlarged heart, pulmonary hypertension, mitral valve prolapse, and complications from infections like rheumatic fever and endocarditis.

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What Causes Damage to Heart Valves?

Damage to the heart valves can be congenital or acquired. Some common causes of heart valve damage include

Congenital Heart Valve Disease:

 The disease is usually related to the aortic or pulmonary valves. Leaflets of the heart valve are not correctly attached.

Bicuspid Aortic Valve Disease:

 A normal aortic valve has three leaflets, but in bicuspid aortic valve disease, there are only two leaflets. With one less leaflet, the valve doesn’t open or close properly. Bicuspid aortic valve disease is the most common congenital heart valve abnormality affecting 0.5% to 1.4% of the population.

Acquired Valve Disease:

 This involves heart valve diseases acquired later in life and includes changes in the structure of the valve due to a disease or infection.

Other conditions like coronary artery disease, heart attack, syphilis, hypertension, connective tissue diseases, and dilation of the valve’s annulus can also cause damage to the valves.

Types of Heart Valve Replacement Surgeries

Aortic Valve Replacement Surgery

The aortic valve allows the blood to flow from the left ventricle to the aorta, the largest artery in the body. When closed, the valve prevents blood from moving back to the heart. Aortic valve replacement surgery is required when a congenital valve defect or disease causes valve regurgitation or stenosis.

Mitral Valve Replacement Surgery

The valve allows oxygen-rich blood to flow to the left ventricle. When the valve is not working properly, the blood can flow back and cause pressure to the lungs. The damage to the valve can be due to congenital disease, infection, or a degenerative disease. A defective mitral valve must be replaced with a biological or metal artificial valve.

Pulmonary Valve Replacement

The pulmonary valve allows the blood to flow from the right ventricle to the lungs. Damage to the valve will make it difficult for the heart to pass enough blood to the lungs. Pulmonary valve replacement surgery will be required when the valve gets stiff due to stenosis and restricts the blood flow.

Tricuspid Valve Replacement Surgery

The surgery is performed to replace the heart’s tricuspid valve. The valve separates the heart’s upper right and lower right chambers. The damage to the valve can be due to tricuspid atresia, tricuspid valve stenosis, or regurgitation.

Double Valve Replacement Surgery

The surgery replaces the aortic and mitral valves or the entire left side of the heart. The surgery is performed when both aortic and mitral valves are damaged beyond repair.

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Types of Replacement Valves

Biological or artificial valves are used to replace damaged heart valves.

Mechanical Valves

Mechanical valves are made of carbon, metal, polyester, and ceramic materials that the human body tolerates well. The mechanical or artificial valves are durable and can last for over 20 years. However, the use of mechanical valves involves a high risk of the formation of blood clots. To reduce the risk of stroke, a person receiving a mechanical valve will need to take anticoagulants or blood thinners on a regular basis.

Biological Valves

Biological Valves Biological valves, also known as bioprosthetic valves, are made of human or animal tissues. The valves have a lifespan of 10-15 years and may require replacement in the future. There are three types of biological heart valves:

• • Homograft or Allograft: The valve is made from the tissue taken from the heart of a human donor. The valve is tolerated well by the body and may last longer than other types of biological valves.
  • Porcine Valve: The valve is made from pig tissue. The tissue is treated before replacement to avoid rejection from the body. The valve is less likely to calcify and is the most preferred choice for valve replacement.
  • Bovine: The valve is crafted from the tissue surrounding the cow’s heart. The tissue is highly flexible and strong. It is treated to avoid a negative immune response.

Bioprosthetic valves don’t require the patient to take blood thinners regularly. The heart surgeon will recommend the type of heart valve replacement depending on the following factors:

• Age
• Overall health
• The person’s ability to take blood thinners

Procedure

Heart valves can be replaced through minimally invasive or open-heart surgical procedures. Open heart surgery will require a large incision from the neck to the navel, while less invasive procedures require a small incision to reach the heart.
To replace the damaged heart valve, the surgeon will stop the heart, and a heart-lung bypass machine will be used to keep the blood circulation in the body. The damaged valve is then replaced with an artificial or biological valve.

In some cases, minimally invasive procedures like transcatheter aortic valve replacement (TAVR) are used to replace the damaged valve. A thin, flexible tube is inserted by making a small opening in the leg and directed to the heart to place the new valve.

Patiala Heart Institute is the best option if you seek the best medical assistance for your heart valve or other cardiovascular diseases. We have highly qualified cardiologists and heart surgeons with years of experience who can provide you with the best treatment with utmost care.

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