What you can expect
If you have heart valve disease, you may eventually need heart valve repair or heart valve replacement to treat your condition. Doctors will discuss with you whether valve repair or replacement is appropriate for your condition.
During the procedure
You'll receive anesthetics, and you may be unconscious during the procedure. You'll be connected to a heart-lung bypass machine, which keeps blood moving through your body during the procedure.
Heart valve surgery may be performed during open-heart surgery, which involves a cut (incision) in the chest. Doctors may sometimes perform minimally invasive heart surgery, which involves the use of smaller incisions than those used in open-heart surgery.
Minimally invasive heart surgery includes surgery performed using long instruments inserted through one or more small incisions in the chest (thoracoscopic surgery), surgery performed through a small incision in the chest, or surgery performed by a surgeon using robotic arms (robot-assisted heart surgery).
Minimally invasive heart surgery may involve a shorter hospital stay, quicker recovery and less pain than open-heart surgery. Minimally invasive heart surgery generally should be performed at medical centers with a medical team experienced in performing these types of procedures.
Heart valve repair
Your doctor may often recommend heart valve repair when possible, as it preserves your heart valve and may preserve heart function. Heart valve repair surgery may include:
- Patching holes in a valve
- Reconnecting valve flaps (leaflets or cusps)
- Removing excess valve tissue so that the leaflets or cusps can close tightly
- Replacing cords that support the valve to repair the structural support
- Separating valve flaps that have fused
- Tightening or reinforcing the ring around the valve (annulus)
Some heart valve repair procedures may be performed using a long, thin tube (catheter) and clips, plugs or other devices, but the majority of these remain investigational.
Doctors may treat a valve with a narrowed opening with a catheter procedure called a balloon valvuloplasty. In this procedure, a doctor inserts a catheter with a balloon on the tip into an artery in your arm or groin and guides it to the affected valve. The balloon is then inflated, which expands the opening of the heart valve. Doctors then deflate the balloon and remove the catheter and balloon.
Heart valve replacement
If your heart valve can't be repaired, your doctor may recommend heart valve replacement. To replace a heart valve, your doctor removes the heart valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).
Biological valves often eventually need to be replaced, as they degenerate over time. If you have a mechanical valve, you'll need to take blood-thinning medications for the rest of your life to prevent blood clots. Doctors will discuss with you the risks and benefits of each type of valve and discuss which valve may be appropriate for you.
A minimally invasive catheter procedure may be conducted to replace certain heart valves. For example, a catheter procedure may be performed to insert a replacement valve into a biological replacement valve in the heart that is no longer working properly.
After the procedure
After your heart valve surgery, you'll generally spend a day or more in the intensive care unit (ICU). You'll be given fluids, nutrition and medications through intravenous (IV) lines. Other tubes will drain urine from your bladder and drain fluid and blood from your heart and chest. You may be given oxygen.
After the ICU, you'll be moved to a regular hospital room for several days. The time you spend in the ICU and hospital can vary, depending on your condition and surgery.
Your treatment team may monitor your condition and watch for signs of infection in your incision sites. Your team will check your blood pressure, breathing and heart rate. Your treatment team will also work with you to manage pain you may experience after surgery.
Your treatment team will instruct you to walk regularly to gradually increase your activity and to do breathing exercises as you recover.
Your doctor will give you instructions to follow during your recovery, such as watching for signs of infection in your incisions, properly caring for incisions, taking medications, and managing pain and other side effects after your surgery.