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What is Heart valve replacement surgery?

Heart valve replacement surgery is a procedure aimed at replacing a damaged heart valve that is either too narrow (stenosis) or fails to close properly (regurgitation), disrupting the normal flow of blood through the heart and body.

The human heart has four main valves: mitral, aortic, tricuspid, and pulmonary. When one or more valves fail to function correctly and medications are no longer effective, surgical or catheter-based repair or replacement becomes necessary. (1)

Indications

The surgery treats heart valve diseases, which typically fall into two categories: (2)

  1. Valve Stenosis: Narrowing of the valve, restricting blood flow.
  2. Valve Regurgitation: Leakage of blood backward due to incomplete closure.

Symptoms of valve dysfunction include: (1)

  • Dizziness or loss of balance.
  • Chest pain due to insufficient blood flow to the heart.
  • Breathing difficulties, such as shortness of breath during activity or even rest.
  • Palpitations or irregular heartbeats.
  • Fluid retention in the legs, ankles, or abdomen.
  • Rapid weight gain due to fluid buildup.

When Is Surgery Necessary?

  • Mild Symptoms: Medication and lifestyle changes may manage symptoms temporarily.
  • If no Symptoms: Surgery might still be advised, if another heart surgery is planned, allowing the valve issue to be addressed simultaneously.
  • The choice of surgery (repair or replacement) depends on factors like the patient's age, overall health, and the type and severity of valve disease. 
  • Replacement becomes necessary when the valve cannot be repaired or if other treatments prove ineffective. (1)

How Is It Performed?

Surgical Approaches: 

  1. Open-Heart Surgery:some text
    • Involves a large incision in the chest and cutting through the breastbone (sternum) to access the heart.
    • The traditional method, best suited for complex cases.
  2. Minimally Invasive Surgery:some text
    • Utilizes small incisions with modern tools.
    • Techniques include:some text
      • Endoscopic or video-assisted surgery 
      • robotic-assisted surgery.
  3. Transcatheter: A catheter is inserted through a large artery (e.g., femoral artery in the thigh) to replace the valve without opening the chest. (2)

Advantages of less invasive Procedures:

  • Shorter hospital stay.
  • Faster recovery.
  • Less post-surgical pain.
  • Lower risk of infection.
  • Reduced time in the ICU.
  • Decreased likelihood of arrhythmias.

Surgery Steps:

Valve replacement surgery steps include: (3)

  1. The surgeon temporarily stops the heart and uses a heart-lung bypass machine to maintain blood flow.
  2. The heart is injected with a cooling solution to stop it.
  3. The damaged valve is removed and replaced with an artificial valve.
  4. The heart is restarted with small electrical shocks.
  5. The bypass machine is removed, and the surgeon ensures the valve and heart function properly. 

Types of Replacement Valves

  1. Mechanical Valves:  some text
    • Made from durable materials like titanium or carbon.
    • Long-lasting but require lifelong blood-thinning medications to prevent clots.
  2. Biological Valves:some text
    • Made from animal (e.g., cow) or human tissue.
    • Don’t typically require long-term blood thinners.
    • May need replacement over time. (2)

Success Rates 

Heart valve replacement surgeries have high success rates, allowing patients to live for many years with a functional artificial valve. (4)

  • 5-Year Survival Rates:some text
    • Aortic Valve Replacement: 94%
    • Mitral Valve Replacement: 64%
    • Pulmonary Valve Replacement: 96%
    • Tricuspid Valve Replacement: 79%
  • Mortality Risk: Ranges from 0.1% to 10%, depending on the patient's health and the complexity of the surgery. Studies show that physically active patients during the first year after surgery have lower mortality rates. Participation in a cardiac rehabilitation program with tailored exercises is highly recommended. (2)

Risks

While advancements in medical technology have reduced risks, complications can still occur, such as: (3)

  • Bleeding.
  • Infection.
  • Irregular heart rhythms (arrhythmias).
  • Issues with the replacement valve.
  • Heart attack.
  • Stroke.

Post Surgery: Recovery and Lifestyle

After heart valve surgery, recovery is a gradual process. Your doctor will guide you on when you can return to your usual activities while emphasizing specific care and lifestyle adjustments to ensure optimal recovery. (1)

Follow-Up and Continuous Care

  1. Regular Appointments: Attend follow-up visits to monitor heart health and valve function.
  2. Routine Tests: Periodic tests will be necessary to confirm the heart is working properly.
  3. Restrictions on Activities:some text
    • Avoid driving for several weeks after surgery.
    • Refrain from lifting objects heavier than 7 kilograms for 6–8 weeks post-surgery.
  4. Returning to Work: Discuss with your doctor when it’s safe to resume work, typically 6–12 weeks after the operation.

Lifestyle Changes for Long-Term Heart Health

To maintain and improve heart health after surgery, adopt the following habits:

  1. Healthy Diet:some text
    • Focus on heart-friendly foods, including:some text
      • Fruits and vegetables.
      • Whole grains.
      • Healthy fats like olive oil and nuts.
    • Limit salt, sugar, and processed foods.
  2. Regular Exercise:some text
    • Choose activities that match your energy levels, such as walking or light aerobics.
    • Consult your doctor about safe options as you recover.
  3. Stress Management:some text
    • Practice relaxation techniques like meditation or deep breathing exercises to reduce stress.
  4. Quit Smoking:some text
    • Stop all forms of smoking, as it negatively affects heart and blood vessel health.

Cardiac Rehabilitation

Your doctor may recommend a cardiac rehabilitation program to support recovery. This program typically includes:

  • Education about heart health and warning signs. 
  • Exercise Guidance: activities tailored to your abilities.

Key Takeaway

Heart valve replacement is a life-saving procedure with a high success rate and significant benefits for long-term health. With proper follow-up care and adherence to rehabilitation programs, most patients can return to normal life with improved heart function.

Consult Cardiologists at Dr. Soliman Fakeeh Hospital

If you are experiencing heart valve issues or seeking specialized medical advice about your heart health, visit our Cardiology Department at Dr. Soliman Fakeeh Hospital. Ensure the best diagnosis and treatment by contacting us today.

References

  1. Heart valve surgery - Mayo Clinic
  2. Heart Valve Surgery: Replacement & Repair
  3. Heart Valve Repair or Replacement Surgery | Johns Hopkins Medicine
  4. Survival Rate of Heart Valve Replacement Surgery

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