What is Valve Surgery and Why Do I Need it? -

What Are Heart Valves?
Your heart has four compartments, two on the right and two on the left. The compartments on the right side of your heart pump blood to the lungs. The compartments on the left side pump blood to your body. Each of these compartments has a "gate," or valve, that keeps blood flowing in the right direction.

On the right side are the tricuspid and pulmonic valves. On the left are the mitral and aortic valves. As the heart muscle pumps, blood flows from compartment to compartment. The valves open, allowing blood to flow into the next compartment and then they close in order to prevent blood from going back the wrong way.

Problems With Heart Valves
Problems with one of these valves may disrupt blood flow not only through the heart but also through the lungs and body. There are many possible causes for problems with valves. A valve defect may be present at birth. Certain diseases can cause damage or destruction of the valves. Normal aging can also cause valves to weaken or to get too hard.

A valve may have become so stiff (or hard) that instead of opening easily it makes it harder for blood to flow forward. This is called stenosis. The valve may also have become weakened or stretched so that instead of closing, blood is able to flow backwards. This is called regurgitation.

In either case, your heart has to work a lot harder to pump the same amount of blood to the body. Whether or not you need surgery depends on how badly your valve is damaged and how ill you are.

Correcting Heart Valve Problems
Depending on the type of problem, the valve may either be repaired or replaced:

Repairs
A stiff (stenotic) valve may be repaired by separating the stiff parts of the valve to make it open more easily.

A leaky (regurgitant) valve may need some strengthening or tightening up.

Replacement
Your valve may be replaced with either a mechanical valve or tissue valve.

A mechanical valve is made from artificial materials. If you have a mechanical valve placed, you will need to take daily medicine to prevent clots.

A tissue valve is a valve taken from either human donors or one that is made from animal tissue. Tissue valves do not last as long as mechanical valves, but may not require daily medicine to prevent clots.

Discuss with your doctor what type of valve is recommended for you. Be sure to ask any questions you may have about it.

Valve Surgery
During valve surgery, an incision is made down the middle of your breastbone (sternum). Once your chest is open, your heart is cooled and stopped. During this time, the normal work of the heart and lungs is taken over by the heart-lung bypass machine.

Your valve is then replaced or repaired. After the surgeon is sure the new valve is working, your heart will be restarted and you will be removed from the heart-lung bypass machine. Your chest will then be closed using wire to close the bone and regular stitches to close your skin.

The surgery usually takes about three to five hours.

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