As you know, our heart is like a pump that works perfectly. Inside this pump, there are small doors that help blood flow in only one direction. We call these heart valves. Sometimes these doors can not close properly and can be slightly open. Then, instead of going forward, blood starts to leak backward. Due to this condition, you can feel tired quickly and have difficulty breathing. So, here is a special surgery that is done to repair such a leaky valve, which we call Annuloplasty.
Simply put, what is Annuloplasty?
Annuloplasty is a surgery to repair or strengthen a valve in the heart. Imagine that the door of your house is a little loose and the door won't close properly. Then what we do is put a frame around the door and tighten it. That's the same thing with this.
During surgery, doctors place a special band, or ring, around the annulus of the heart valve and tighten it. This causes the valve, which was loose and leaking, to close properly again. This stops the blood from flowing backward, and the heart's function returns to normal.
The main goal of this surgery is to stop the backflow of blood (valve regurgitation) and help the heart pump blood throughout the body without any obstruction.
What does this so-called Annuloplasty Ring look like?
This is a special device that is placed around the valve. It can be made of mesh, metal, or plastic. This ring is designed to match the natural movement and flexibility of the heart valve. After surgery, it is something that stays in the body for life. Over time, our heart tissue grows around this ring, and it becomes part of the heart itself. This gives the valve a lot of support to open and close properly.
Who needs this surgery?
This treatment is usually recommended for people with a condition called valve regurgitation. This surgery can be performed on any of the four main valves in our heart.
- Mitral valve annuloplasty: Repair of the mitral valve.
- Aortic valve annuloplasty: Repair of the aortic valve.
- Pulmonary valve annuloplasty: Repair of the pulmonary valve.
- Tricuspid valve annuloplasty: Repair of the tricuspid valve.
What is the difference between Annuloplasty and Valvuloplasty?
Although both of these are treatments for heart valves, they both have two purposes. Look at this table, you can easily understand.
| Treatment | What kind of situation are you in? |
|---|---|
| Annuloplasty | Tighten a leaking valve and make it close properly. |
| Valvuloplasty | To widen a narrowed/stenotic valve and facilitate blood flow. |
Annuloplasty is not the only treatment for valve leakage. In some cases, a clip, such as the MitraClip®, inserted through a small incision, can be used to seal the valve. Your cardiologist will determine which treatment is best for you.
What happens before and during the surgery?
Your doctor will give you all the instructions you need before the surgery. Usually, you will not be allowed to eat or drink anything the night before the surgery (fasting). If you are taking any special medications, such as anticoagulants, you must tell your doctor about it. Depending on your doctor's advice, you may need to temporarily stop taking these medications a few days before the surgery.
The surgery is performed by heart surgeons. You will be given general anesthesia, so you will not feel anything during the surgery. There are two main methods of performing the surgery.
| Surgical method | What is happening? |
|---|---|
| Open-heart surgery | A single large incision is made in the chest area, directly accessing the heart, and the Annuloplasty ring is inserted. The incision is then closed with stitches. |
| Minimally invasive surgery | Several small incisions are made in the chest. A small tube with a camera (endoscope) is inserted through them, and the ring is inserted using special instruments while looking at a monitor. |
How long does it take to recover after surgery?
After the surgery, you will be kept in a recovery area for a few hours before being transferred to the ward. If you had minor surgery, you will likely be able to go home in a day or two. However, if you had open-heart surgery, you may need to stay in the hospital for 5-7 days.
The recovery time after going home depends on the type of surgery you had and your physical health.
- You should completely avoid strenuous work for at least a week .
- You will be able to return to work within a week or two after surgery. However, if your job involves lifting heavy objects or physical exertion, it may take longer.
- Your doctor will give you precise instructions on how long you should rest and when you can resume work.
When to see a doctor immediately
When you go home after surgery, you should take extra care of your body. Be aware of anything unusual. If you experience any of the following symptoms, call your doctor immediately. If your symptoms are severe, go to the Emergency Department (ETU) of the nearest hospital.
| Warning signs to look out for |
|---|
| - Chest pain or tightness (angina) |
| - Dizziness or loss of consciousness (syncope) |
| - Having a fever or chills |
| - Nausea or vomiting |
| - Swelling or persistent pain at the surgical site |
Annuloplasty is a safe and successful procedure in most cases. As with any surgery, there are some minor risks (such as infection and bleeding). But don't worry. Your doctor will clearly explain the risks to you based on your specific situation.
Take-Home Message
- Annuloplasty is a surgery to repair a leaky heart valve.
- In this, a special ring is placed around the valve, adjusting it so that it closes properly.
- This surgery can be performed as open-heart surgery or using small incisions.
- Recovery time and hospital stay depend on the type of surgery you had.
- The annuloplasty ring usually lasts a lifetime and does not need to be replaced.
- If you experience any unusual symptoms after surgery, do not hesitate to inform your doctor immediately.
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