This is surgery to replace a damaged heart valve. The heart's four valves open and tightly close. The tricuspid and mitral valves allow blood to flow from one chamber to another. The pulmonary and aortic valves allow blood to flow to the large blood vessels. The valves make it so that blood can only flow forward when the heart squeezes. Usually, only one valve is replaced at a time. However, at times, one or more valves may need to be replaced. The new heart valves can be: Mechanical, made of metal and plastic, such as a St. Jude valveMade of tissue—most commonly from a pig or a cow, but they may also be supplied by a human donor or even made from your own tissue
Aortic Valve Replacements: Mechanical vs. Tissue
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This procedure is done to repair a valve that is not functioning properly due to: Congenital defectsNarrowed, stiff valves that obstruct the free flow of bloodLoose, leaky valves that allow blood to flow the wrong way through the heartInfected heart valves
If you are planning to have heart valve replacement, your doctor will review a list of possible complications, which may include: Infection
Blood clots forming around the valve, which can cause a
stroke,, myocardial infarction, kidney damage, or damage to the extremities
New valve does not work properlyBleedingAnesthesia-related problemsDeath
Some factors that may increase the risk of complications include: SmokingPre-existing heart or lung conditionIncreased ageRecent or long-term illnessRecent infection
Your doctor may do the following: Physical examEchocardiogram—a test that uses sound waves to visualize functioning of the heart, including the valves
X-ray—a test that uses radiation to take a picture of structures inside the body
(EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
Cardiac catheterization—the insertion of a tube-like instrument into the heart through an artery to detect problems with the heart and its blood supply. It can also accurately define the valve problem.
Leading up to your procedure:
If you had to stop medicines before the procedure, ask your doctor when you can start again. Medicines often stopped include:
Anti-inflammatory drugsBlood thinnersArrange for a ride to and from the hospital.Arrange for help at home after the surgery.Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV.
The doctor will cut through the skin and breastbone. The chest cavity will be opened. Next, your heart will be connected to a heart-lung machine. This machine will take over the functions of the heart and lungs during the surgery. Next, the heart will be stopped. An incision will be made and the damaged valve will be removed. The new valve will be stitched into place. The doctor will check to make sure the valve opens and closes properly. The incision in the heart will be closed, and the heart will be restarted. After the heart is working fine, you will be removed from the heart-lung machine. The chest will be closed with wires. Lastly, the skin will be closed with sutures.
You will be closely monitored in the intensive care unit (ICU) with the help of the following devices: A heart monitorA breathing tube—until you can breathe on your ownChest tubes—to drain accumulated fluids from the chestA line into an artery in your arm or leg—to measure pressureA tube through your nose and into the stomach—to keep the stomach drained of accumulated fluids and gasAn IV to deliver fluids and medicationsA bladder catheter
3-5 hours—depending on how many valves need to be replaced
You will have pain while recovering. Your doctor will give you pain medicine.
This procedure is done in a hospital setting. The usual length of stay is 2-5 days. The first day is spent in ICU. Your doctor may choose to keep you longer if complications occur.
While you are recovering at the hospital, you may be instructed to: Breathe deeply and cough 10-20 times every hour to help keep your lungs working well.Walk with assistance. You may be encouraged to walk 2-3 days after surgery.Take blood thinners to prevent blood clots from forming around the valve. If you have a tissue valve, you will not need a blood thinner. If you have a mechanical valve, you will have to take the medicine for the rest of your life.
When you return home, do the following to help ensure a smooth recovery: Gradually resume your regular diet.Work with a physical therapist.Ask your doctor about when it is safe to shower, bathe, or soak in water.
Be sure to follow your doctor’s
The surgical site in your breastbone will heal in 4-6 weeks. After the recovery process, you should be able to return to normal activities.
After you leave the hospital, contact your doctor if any of the following occurs: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or discharge from the incision siteNausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospitalPain that you cannot control with the medicines you have been givenCough, shortness of breath, or chest painCoughing up bloodRapid heart rateSudden headache or feeling faintProblems with vision or speakingNumbness or weakness on one side of your bodyInability to urinatePain, burning, urgency, frequency of urination, or persistent bleeding in the urinePain and/or swelling in your feet, calves, or legs
In case of an emergency, call for medical help right away.
Cardiac catheterization. Cleveland Clinic website. Available at:
http://my.clevelandclinic.org/heart/services/tests/invasive/ccath.aspx. Updated February 2011. Accessed May 8, 2013.
Cecil RL, Goldman L, Bennett J.
Cecil Textbook of Medicine.
21st ed. Philadelphia, PA: WB Saunders Company; 2000.
6/2/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.
Am J Med.
Last reviewed March 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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