The heart has four valves: the tricuspid, aortic, mitral and the pulmonary (or pulmonic). Valves regulate blood flow between the four chambers of the heart, and between the heart and the aorta and pulmonary artery. Problems with these valves can interfere with the heart's ability to function properly, and severe valve problems can lead to heart damage and even death. Heart valve replacement is an option for some people whose heart valve problems cannot be managed with medications, stents or other-less invasive methods. About 225,000 heart valve replacements are performed throughout the world each year.
Types
Replacement heart valves can come from human organ donors (cadaver valve, allograft or homograft) or from a pig (porcine valve or tissue valve) or it can be an artificial valve (mechanical valve). Although a pig valve may sound strange, pig hearts are very similar to human hearts, and pig valves work well in people. Your physician will decide which type of heart valve is best for you.
Valves from a human donor are often preferred for children and pregnant women, because they do not require long-term therapy with anti-clotting medications. These valves have a high success rate, but the supply is limited since there must be an appropriate organ donor.
Porcine valves are chemically treated to make them ready for use in a human patient. The valve may or may not have a stent attached to it; a stent is a sort of frame that supports the valve. The surgeon sews a thin cuff made of polyester mesh around the outside of the valve to make it easier to implant.
Mechanical valves are designed to function like natural heart valves. They have a ring that supports the valve and flaps that open and close. People who receive an artificial heart valve need to take anticoagulant medication every day to prevent blood clots from forming around the valve, and need to have their medication levels tested regularly.
Process
Heart valve surgery usually takes three to five hours. The surgeon will use general anesthetic, so you will be completely asleep during the procedure. The surgeon will use a heart-lung machine to keep your blood flowing while your heart is being worked on. The surgeon will usually make two incisions: one down the middle of the breastbone and one near the aorta. The breastbone will be wired back together after the surgery.
Heart valve replacement patients will be in the intensive care unit (ICU) after the surgery, and will be moved to a regular hospital room when ready. The patient will be sore from the incision and will need to do breathing exercises after the surgery to clear the fluids from his lungs. He should be able to sit up and move around within a couple of days after the surgery.
Afterwards
The patient may need to take anticoagulants or other medications following surgery. He may need to take antibiotics before and after he goes go to the dentist in order to prevent infection that may damage the new valve. The heart valve will probably not set off metal detectors, but your physician can give you a patient ID card to show at security checkpoints just in case. The patient should wear a medical alert bracelet that identifies him as someone with a heart valve replacement, in case of emergency. Tell your clinician that you have had a heart valve replacement before any medical tests such as an MRI, so that they can make sure the test is safe. Some people notice a soft clicking noise coming from their chest after their heart valve replacement; this is normal and most people get used to it quickly.
Artificial heart valves are built to last, and will usually last the rest of your lifetime unless there are complications. Tissue valves or allografts may not last as long as a mechanical valve, and symptoms of valve failure may be similar to your symptoms before surgery and may include dizziness, shortness of breath, fatigue, fluid retention and chest pain.
Risks
Although most heart valve replacements are completed without complications, possible risks include bleeding, infection, heart attack or stroke. Talk to your physician about any concerns you have before surgery.
Considerations
It is important to follow a heart-healthy diet following your . See the "Resources" link for diet information.
Be sure to continue regular follow-up appointments with your physician, and tell him about any symptoms you are having. If you develop new symptoms, call your physician.
Warning
If you suddenly develop symptoms like chest pain, shortness of breath or other possible heart attack symptoms, call 911 immediately.
Tags: heart valve, after surgery, heart valve replacement, heart valves, need take, surgeon will, valve replacement
