What Are Heart Valve Replacements Made Of
There are two types of heart valve replacements:
Mechanical heart valves. These valves are created from man-made materials, which can be plastic or metal. Because they are considered to be the most durable, these valves are often used for younger patients. People who have a mechanical valve must take blood-thinning medications such as warfarin. They are also at higher risk for thrombosis . Though this is rare, it is a serious complication that is more likely to occur with a mechanical valve.
Tissue valves. While a tissue valve does not require long-term use of blood-thinners , and they are less likely to be associated with thrombosis, they are also less durable. Most will need to be replaced in 10 to 20 years. The tissue can be taken from animals or cadavers. A third option is the Ross procedure, a surgery that replaces a defective aortic valve with the patients own pulmonary valve.
Alternatives To An Aortic Valve Replacement
An aortic valve replacement is the most effective treatment for aortic valve conditions.
Alternative procedures are usually only used if open heart surgery is too risky.
Possible alternatives include:
- transcatheter aortic valve implantation the replacement valve is guided into place through the blood vessels, rather than through a large incision in the chest
- aortic valve balloon valvuloplasty the valve is widened using a balloon
- sutureless aortic valve replacement the valve is not secured using stitches to minimise the time spent on a heart-lung machine
Page last reviewed: 23 December 2021 Next review due: 23 December 2024
Survival Rate Of Heart Valve Replacement Surgery
The survival rate for a heart valve replacement surgery depends on which valve is involved. This was analyzed in a large study in which the lifespan of a large population, who went ahead with the surgery, is observed for a specific timeframe.
The 5-year survival rate means what percentage of people lived for at least 5 years after the surgery. Similarly, the 10-year survival rate means what percentage of people lived for at least 10 years after the surgery.
For example, the 5-year survival rates for aortic valve replacement surgery is 94%. This means 94 out of 100 people who underwent AVR surgery could live at least 5 years.
Table 1: The Survival Rates as Per the Type of Valve in Heart Valve Replacement Surgeries
Survival rates for heart valve replacement surgery are often used as predictors of how long patients can live beyond a certain number of years after the surgery. However, these may vary for you depending on your age, your overall health, and the current status of your heart function. Discuss with your doctor about these factors to know about your life expectancy after the surgery.
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Patients & Heart Valve Experts Say
“This website is an amazing educational resource for anyone needing or researching heart valve surgery. The patient community is so supportive and inspiring. I learned a lot and met great people.” – Laura Harrington, patient
“HeartValveSurgery.com is the best resource Ive seen for patients who want to find expert care for their heart valve disease and a supportive community.” – Dr. Joanna Chikwe, Chair of Cardiac Surgery, Cedars-Sinai Medical Center
“I was lost until I found HeartValveSurgery.com. At the website, I was able to learn about my valve disease, find my surgeon and get helpful tips from doctors and patients who already had surgery.” – Ana Brusso, patient
“HeartValveSurgery.com provides compassion and reassurance among patients. This website is a huge contribution to the welfare of patients everywhere.” – Dr. Marc Gillinov, Chairman of Cardiac Surgery, Cleveland Clinic
Robotic And Minimally Invasive
Our cardiovascular surgeons specialize in robotic-assisted and minimally invasive cardiac surgeries to treat heart valve disease. We offer:
Transcatheter aortic valve replacement
Your physician places an expandable replacement valve into the heart via a catheter inserted through the femoral artery. AHN is a national leader in TAVR procedures.
MitraClipâ¢ mitral valve repair
This innovative device stops valve regurgitation by closing leaky valve leaflets. During minimally invasive heart surgery, your physician implants the device via a catheter inserted through the femoral artery in the groin.
Robotic-assisted mitral valve repair
Your physician repairs a leaky mitral valve using a small camera and instruments inserted through small incisions between the ribs. Learn more about robotic heart surgery for mitral valve repair.
During this minimally invasive procedure for valve stenosis , your physician inserts a catheter tipped with a balloon through a blood vessel in the leg or arm. After inflating and deflating the balloon to stretch the valve opening, your physician removes the catheter and balloon.
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What Happens After Heart Valve Surgery
After surgery, your healthcare team may move you to an intensive care unit where they can monitor you closely. After that, youll be in a regular room. You may be in the hospital for five to seven days.
Machines connected to you will monitor your blood pressure and heart rate. You may have tubes coming out of your chest to drain fluids.
Your provider will encourage you to eat, drink and walk as soon as you can after surgery. You can start with short walks around your room or down the hall and increase your distance little by little.
Your provider may sign you up for cardiac rehab, a carefully monitored exercise program.
Is Surgery Better For Me Than Medication Alone
Medications often help during the first stages of valve disease, but they don’t work as well as the disease gets worse. You dont need to wait until your symptoms become unbearable before you have surgery. In some cases, its best to have surgery before symptoms start. The decision to have surgery is a major one thats based on your individual needs. It involves input from you, your cardiologist and your surgeon.
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Yales Approach To Aortic Root Surgery Has Led To Excellent Outcomes
Dr. Vallabhajosyula routinely follows up with patients who have had this surgery at Yale, and he says all have done well. We havent had any mortality or stroke. Patients dont need blood thinnersin fact, they need no medicine at all related to the aorta, and their valve should potentially last for the rest of their life, he says.
Part of this is because when the surgery is elective, patients are chosen carefully based on such factors as healthif the surgeon thinks there could be serious complications, he or she may decide its better for that patient to have a valve replacement.
Yale surgeons also have standardized the preoperative, intraoperative, and postoperative care for these patients, and routinely employ the same surgical techniques. They also work with a dedicated multidisciplinary team. This has enabled us to maintain and achieve excellent outcomes so far, says Dr. Vallabhajosyula. But that does not mean we are complacent. As a team, we are constantly discussing how we can improve the care we provide to our aortic patients and their families, he says.
Yale surgeons also maintain an active database of all the aortic root surgeries they perform, with information on root dimensions and characteristics of the valve before and after the operation. This will help to add to the body of literature on this medical problem, the doctors say. We want to continue to learn from this process, says Dr. Assi.
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Why Is Mitral Valve Repair Done
Mitral valve repair fixes problems with your valve so you can lower your risk of serious complications down the road.
Your mitral valve is the door that connects your left atrium and left ventricle. These are the two chambers of your heart that hold oxygen-rich blood. Your left atrium receives this blood from your lungs. The blood travels through your mitral valve to enter your left ventricle. Then, your left ventricle pumps it out to the rest of your body through your aorta.
Mitral valve disease makes it harder for your valve to do its job. Over time, this can lead to heart and lung damage. Repair through open-heart surgery can help you avoid or delay such problems.
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Treatment Techniques For Repairing Heart Valves
The treatment of complex valve disease requires a tailored approach that takes into account the patient’s physical condition, age, type of valve disease, and other medical problems. Aided by Montefiore’s advanced cardiac imaging capabilities, Heart Valve Repair Program surgeons and cardiologists collaborate to develop a treatment plan that is personalized to the patient. Heart Valve Repair Program physicians are experienced in several different techniques to repair diseased heart valves, including:
How Do I Prepare
Your surgery could be scheduled weeks in advance, and it’s a good idea to go into your surgery as healthy as you can. Focus on eating well and getting enough sleep and exercise. Try to keep your stress under control.
Your doctor will need information about your health. They’ll want to know what medications or supplements you take. You should also let them know if you smoke, have any allergies, could be pregnant, or have a pacemaker.
They also may want to do a blood test or other tests to make sure you’re healthy enough for surgery.
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Will I Need To Take Blood
The need for anticoagulant medication after surgery depends on the type of surgery you have. The medication prevents blood clots from forming and causing problems with your heart valve. Currently, warfarin is the only approved blood thinner for mechanical heart valves.
If you have a mechanical heart valve, youll need to take this medication for the rest of your life.
If you have valve repair or a biological valve replacement, you may need to take this medication for several weeks after surgery, or maybe not at all.
You may need to take an anticoagulant for a condition not related to your heart valves. This medication also treats:
- An irregular heartbeat.
When Should I See My Healthcare Provider
Your provider will let you know how often you need to return for follow-ups. Be sure to keep all your follow-up appointments and tell your provider how youre feeling.
As you recover, pay attention to how you feel. Everyone has some discomfort, and your provider will prescribe pain medication. But call your provider if you have signs of complications. These include:
- Signs of infection around your incision, like oozing or redness.
- Slurred speech or other signs of a stroke.
Your provider will tell you if there are other signs you should look out for. For instance, if youre taking blood thinners, you should call your provider if you:
- Have excessive bleeding in any area of your body .
- Have many bruises on your skin.
It may be hard to know when a symptom is a normal part of recovery, or when its a sign of a complication. When in doubt, pick up the phone and call your care team. Its better to get checked out and learn nothings wrong than to ignore a problem that needs medical care.
A note from Cleveland Clinic
Mitral valve repair surgery can give you back the energy and strength youve been missing. Like all heart surgeries, it can come with risks. But advances in technology make mitral valve repair safer and more durable with each passing year. Back in the 1920s, surgeons pioneered mitral valve repair. Their technique? Using the surgeons finger to open up a narrowed valve! From the surgeons finger to advanced surgical methods, weve come a long way.
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Valve Repair Procedure Recovery
In the intensive care unit , the staff will keep a close watch on your heart rate, temperature, blood pressure, and other vital body signs. You may feel a little uncomfortable because of all the monitoring equipment attached to you. The nurses will try to keep you as comfortable as possible. Friends and family are usually welcome to visit you.
When intensive care monitoring is no longer needed, you’ll be moved to a regular hospital room. Typically, you will be in the hospital for 3 to 10 days, depending on how quickly you recover. Many patients are amazed at how much better they feel and how soon they can resume normal activities.
What Is The Outlook For People Who Have Mitral Valve Repair
Mitral valve repair is a durable solution for treating mitral valve disease. Most people can go at least 10 years without needing another surgery. Almost as many can go 20 years. Most people dont need another mitral valve surgery after a successful repair.
Youll need an echocardiogram each year so your provider can check on your valve function. You may also need antibiotics before certain procedures to prevent endocarditis . Talk with your provider about all measures you need to take in the years following your surgery.
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Heart Valve Replacement And Repair
In valve replacement surgery, the surgeon removes the diseased valve and replaces it with a new one made from plastic, metal or tissue. In valve repair surgery, also called valvuloplasty, the surgeon repairs the defective valve by sewing the edges together. For many patients, heart valve repair is preferable to replacement because the individuals own tissues are used. When a valve is severely damaged or malformed, replacement may be necessary.
Balloon valvuloplasty is a nonsurgical, minimally invasive option for some patients who have stenosis of a valve. This procedure involves a physician threading a catheter containing a balloon into the patients groin and up to the heart. The balloon is inserted into the valve and stretches it opened. The balloon and catheter are then removed.
What Happens Before Heart Valve Surgery
- A healthcare provider will shave and clean the area where your surgeon will be working.
- Dont eat or drink anything after midnight the day of your surgery.
- Check with your healthcare provider about which medications you can take before surgery.
Bring loose, comfortable clothes and shoes that are easy to put on. If you wear a bra, you may want to bring one thats easy to put on without raising your arms. The person who brought you to the hospital can hold on to these items for you during surgery.
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Will I Need A Pacemaker After Mitral Valve Replacement
Some people do receive mitral valve replacement surgery and need a pacemaker at a later time, but this isnt common. For most people, mitral valve replacement surgery improves their quality of life and eliminates symptoms, such as a racing heart that might be associated with the need for a pacemaker. Talk to your doctor if you are concerned you might need a pacemaker in the future.
Why The Procedure Is Performed
You may need surgery if your mitral valve does not work properly because:
- You have mitral regurgitation — When a mitral valve does not close all the way and allows blood to leak back into the left atria.
- You have mitral stenosis — When a mitral valve does not open fully and restricts blood flow.
- Your valve has developed an infection .
- You have severe mitral valve prolapse that is not controlled with medicine.
Minimally invasive surgery may be done for these reasons:
- Changes in your mitral valve are causing major heart symptoms, such as shortness of breath, leg swelling, or heart failure.
- Tests show that the changes in your mitral valve are beginning to harm your heart function.
- Damage to your heart valve from infection .
A minimally invasive procedure has many benefits. There is less pain, blood loss, and risk of infection. You will also recover faster than you would from open heart surgery. However, some people may not be able to have this type of procedure.
Percutaneous valvuloplasty can only be done in people who are too sick to have anesthesia. The results of this procedure are not long-lasting.
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Recovering From An Aortic Valve Replacement
You’ll usually need to stay in hospital for about a week after an aortic valve replacement, although it may be 2 to 3 months before you fully recover.
You should take things easy when you first get home, but you can start to gradually return to your normal activities over the next few weeks.
You’ll be given specific advice about any side effects you can expect while you recover and any activities you should avoid.
You won’t usually be able to drive for around 6 weeks and you’ll probably need 6 to 12 weeks off work, depending on your job.
Read more about recovering from an aortic valve replacement.
Why Ohio State Is The Best Hospital For Heart Valve Replacement Or Repair
We have a team approach to heart valve surgery, which means both a cardiologist and a cardiac surgeon evaluate a patient. When appropriate, other clinicians become involved, such as an imaging specialist, an interventional cardiologist and an anesthesiologist. This integrated approach means that each patients heart valve disease is treated individually, with that particular patients needs and physical condition in mind.
In addition, we offer both minimally invasive surgery and robotic heart surgery, which result in smaller incisions, reduced hospital stays and shorter recovery times. Open-heart surgery is also available if that is determined to be the best treatment option.
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