Are you having trouble breathing, chest pain, or feeling very tired even when doing normal activities? Your doctor may have told you that this is due to a problem with a heart valve. He may also have told you that you need to have surgery to replace that valve (Heart Valve Replacement Surgery). It is very normal to feel a little scared and anxious when you hear something like this. That is why we thought we would talk about this in a simple way that you can understand.
Why does the heart need valves? What does this mean?
Simply put, our heart is like a pump with four chambers. Between these chambers are four doors that help keep blood flowing in only one direction. Those doors are what we call heart valves .
Because these valves open and close properly, blood flows in an orderly manner.
- From one part of the heart to the other.
- The lungs get oxygen.
- The main blood vessel (Aorta) sends oxygen-rich blood to the entire body.
Imagine that the water in our sink is not draining properly. The water gets stuck, or it keeps flowing. That's what happens when there is a diseased valve. The blood flow is obstructed, or the blood leaks backward (regurgitation). This causes the heart to work harder.
In this situation, the doctor will first try to control it with medication. But if that doesn't work, the valve may need to be repaired or completely replaced.
What types of valves are used for switching?
There are two main types of valves. Your surgeon will decide which type is best for you, taking into account factors such as your age, health, and lifestyle.
1. Biological Valves
These are valves made of tissue. They are also called tissue valves or bioprosthetic valves .
- Bovine tissue: From the membrane covering the heart of a cow.
- Porcine tissue: From a pig's heart valve.
- Homograft: A human heart valve taken from a deceased donor. These are often used in younger people or those whose valves have been damaged by infection.
2. Mechanical Valves
These are valves made of durable materials like carbon and titanium. They are designed to function like your own valves. They are extremely durable and last a lifetime.
When you install some mechanical valves, you may hear a slight "click" sound as it opens and closes. This is normal and nothing to worry about.
Biological or mechanical? How do you choose?
This decision is very important. So talk to your doctor about it carefully. The table below will give you a good idea of the difference between the two.
| Feature | Biological Valve | Mechanical Valve |
|---|---|---|
| Durability | It usually lasts 15-20 years. Reoperation may be necessary. | Very durable. Designed to last a lifetime. |
| Blood thinners | Most people do not need to take these medications (e.g., Warfarin) for the rest of their lives. | It is mandatory to take blood-thinning medications (such as Warfarin) for the rest of your life . |
| Who is it suitable for? | It is most suitable for people over the age of 60-65, those who do not want to take blood-thinning medications, and women who are planning to become pregnant. | It is best suited for younger, active people (e.g., under 50 years old for Aortic valve, under 65 years old for Mitral valve). |
| Disadvantages | Over time, it may wear out and need to be replaced. | Lifelong medication and frequent blood tests are required. There is a risk of bleeding. |
What are the methods of performing the surgery?
There are now several methods for performing valve replacement surgery.
1. Open-Heart Surgery: This is the traditional method. This surgery is performed through a large incision in the middle of the chest bone.
2. Minimally Invasive Surgery: This involves making a small incision in the chest. This results in less recovery time, less blood loss, and a lower risk of infection.
3. Transcatheter Aortic Valve Replacement (TAVR): This is a newer and more advanced procedure. The chest is not opened. A catheter (thin tube) is passed through a blood vessel into the heart through a small incision in the groin or chest, and the new valve is inserted into the old valve and fixed. This procedure is very suitable for those who cannot bear the risks of open surgery.
What happens after the surgery? How long does it take to recover?
After the surgery, you will be kept in the intensive care unit (ICU) for observation for one or two days. Then you will be transferred to a general ward. The entire hospital stay may take about 5-7 days.
Recovery Time:
- It can take a month or two to fully heal. If minimally invasive surgery was performed, the recovery time is much shorter.
- You will feel tired quickly in the first few weeks. That's normal. You will gradually regain your strength.
- Do not lift more than 10 pounds (4.5 kg) for 6-8 weeks.
- Do not drive for a few weeks. Ask your doctor for advice on this.
After you go home from the hospital, you may be referred to a cardiac rehabilitation program, which will greatly help you recover quickly.
When to see your doctor immediately
If you have one or more of the following symptoms, see your doctor or go to the hospital without delay:
- Fever.
- The surgical wound is swollen, red, or oozing pus.
- Severe chest pain.
- Weight gain of 2-3 kg in a few days (may be a sign of water retention).
- Severe difficulty breathing.
- Severe mental stress or depression.
Take-Home Message
- Heart valve replacement surgery is now a very successful, life-saving treatment, so don't be unnecessarily afraid of it.
- The type of valve (biological or mechanical) and surgical procedure that is right for you will be determined by your doctor, taking into account factors such as your age and health condition.
- If a mechanical valve is inserted, you will need to take anticoagulant medications and undergo regular medical tests for the rest of your life.
- It takes time to fully recover after surgery. It is very important to follow your doctor's instructions exactly.
- If you have any questions about the surgery or any complications that may arise after it, don't hesitate to ask your doctor.
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