Your heart is an amazing pump. Inside this pump are four parts that act like doors. We call these "valves." Every time your heart beats, these doors open and close, keeping blood flowing in the same direction. But sometimes when these valves become diseased or don't work properly, the blood flow becomes blocked. Sometimes blood flows backward, or the valve becomes blocked and blood can't flow forward. That's when doctors talk about "heart valve surgery." It's normal to feel a little scared when you hear these words, but this is to help your heart work properly again. When your heart works well, you feel good too.
What are the valves in the heart?
Our heart has four main chambers. There are four main types of valves that control the flow of blood between these chambers. Let's take a look at what they are.
| Valve Name | Location |
|---|---|
| Tricuspid valve | Between the upper and lower chambers on the right. |
| Pulmonary valve | Between the right lower chamber and the artery that carries blood to the lungs. |
| Mitral valve | Between the upper and lower chambers on the left. |
| Aortic valve | Between the left lower chamber and the main artery that carries blood to the body (Aorta). |
What types of surgeries are there?
The type of surgery you need will depend on several factors. Your doctor will consider the following:
- The structure of your heart.
- your age.
- Other illnesses you have.
- Your lifestyle.
After the tests, the doctor will determine what the problem is with your valve and how severe it is. Then, he will choose the surgery that is best for you. Sometimes, this valve surgery can be done together with other heart surgery. For example, it can be done together with bypass surgery or surgery for atrial fibrillation .
There are two main types of surgery.
1. Heart valve repair surgery
This involves repairing the defect while preserving your own valve as much as possible. It's like repairing something that's broken. This method is most often used for problems with the mitral valve. But it can be done for other valves as well.
2. Heart valve replacement surgery
In this procedure, your diseased valve is completely removed and a new valve is inserted in its place. This new valve can be biological (made from pig, cow, or human tissue) or mechanical ( made from metal or carbon). No matter which type is inserted, your body will not reject it.
Keep in mind that a heart valve problem cannot be completely cured with medication alone. While medication can temporarily control symptoms, surgery is the permanent solution.
When is surgery necessary?
When the medications given for valve disease no longer work, meaning you continue to have symptoms like these, you may need to consider surgery.
- Chest pain.
- Difficulty breathing.
- To put a seal.
You don't have to wait until your symptoms get worse. Sometimes doctors decide it's best to perform surgery before symptoms even begin. This is a decision you, your cardiologist, and your surgeon should make together.
How do you prepare before surgery?
You will need to have several tests the day before the surgery.
- Chest X-ray.
- Echocardiogram.
- Electrocardiogram (EKG).
- CT scan.
- Cardiac catheterization.
- Blood tests.
Do not eat or drink anything after midnight the night before surgery. Talk to your doctor about the medications you are taking and find out exactly what you can and should stop taking before surgery.
On the day of surgery, wear loose, comfortable clothing. Leave your valuables with the person who will accompany you. Before surgery, the hospital staff will clean the surgical area and remove any hair, if necessary.
What happens during the surgery?
You won't feel anything during the surgery because you will be given a sedative through a vein.
The surgeon will try to perform the surgery through as small an incision as possible. During the surgery, the function of your heart and lungs is transferred to an artificial machine (heart-lung machine). The valve is then repaired or replaced. When the work is done, your heart is restarted and your chest is closed.
There are several ways to perform the surgery:
- Traditional open-heart surgery: A 6-8 inch incision is made in the middle of the chest.
- Minimally invasive surgery: This is done through a 3-4 inch or smaller incision. This can be done endoscopically or robotically-assisted.
- Transcatheter: This method does not involve an incision in the chest. A catheter is inserted through a large blood vessel in the groin and into the heart to replace the valve. An example of this is a procedure called TAVR .
This surgery can usually take between two and five hours.
What happens after surgery and recovery time
After the surgery, you will be admitted to the Intensive Care Unit (ICU). There, your condition will be monitored very closely. After a few days, you will be transferred to a regular ward. You will stay in the hospital for between 5 and 7 days.
You may have tubes inserted in your chest to remove excess fluid from your body. You may be connected to machines to monitor your blood pressure and heart rate.
Doctors will encourage you to start walking as soon as possible. You can start by walking around the room and then gradually increase the distance. You may also be referred to cardiac rehab, which is a supervised exercise program.
It usually takes between 4 and 8 weeks to fully heal. However, if you had minimally invasive surgery, your recovery time may be shorter.
How do you take care of yourself after you get home?
- Follow your doctor's instructions exactly. Go to the clinics on the scheduled days.
- Rest. You will feel tired quickly in the first three weeks. Don't go to work that you can't handle.
- Do not drive for a few weeks.
- Do not lift more than 5-7 kg for the first 6-8 weeks.
- Ask your doctor when you can go back to work.
What are the risks and benefits of surgery?
As with any surgery, there are some risks, but the benefits of having the surgery far outweigh the risks of not having it.
| Benefits | Risks |
|---|---|
|
|
These risks vary depending on your age, other medical conditions, and the complexity of the surgery. Your doctor will explain this to you in detail.
Especially after valve surgery, you have a small risk of developing a heart infection called infective endocarditis . So be very careful about the health of your teeth and gums. Talk to your doctor before undergoing any dental treatment.
When do you need to see a doctor?
If you experience any of these symptoms after returning home from surgery, call your doctor immediately.
- If you experience pain in the chest or around the incision .
- If you feel severe anxiety or depression ( this can happen after surgery).
- If you have a fever (this could be a sign of an infection).
- If your body weight increases by about 2-3 kilos at once (this means that water is accumulating in the body).
Some frequently asked questions
How long does a new valve last?
It depends on your age, the type of surgery you had, and the type of valve you had. Mechanical valves last a long time, but biological valves may need to be replaced every 10-20 years, especially if they are placed in a young person.
Do I need to continue taking anticoagulants after surgery?
- If you were given a mechanical valve , yes, you will have to take blood thinners for the rest of your life.
- If you had a valve repair or a biological valve , you may only need to take this medication for a few weeks, or you may not need it at all.
Can I live a normal life after the surgery?
Yes! Most people can return to doing the things they did before surgery. Your recovery will also depend on your overall health. It's normal to feel scared when you hear about heart valve surgery. But remember, this is something you're doing to change your life for the better. Talk to your family and friends about it. It's a great support system to have someone to support you during your recovery.
Take-Home Message
- Heart valve surgery is not something to be afraid of, it's something that helps your heart work healthily again.
- There are two main types of surgery: valve repair and total valve replacement. Your doctor will decide which is best for you.
- It will take several weeks to fully recover. It is very important to get plenty of rest and follow medical advice during this time.
- Report any unusual symptoms to your doctor immediately after surgery.
- You are not alone on this journey. Your medical team and family are there to support you. Talk openly with them.
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