What Are The Risks Associated With Heart Valve Repair And Replacement Surgery
Like all types of surgeries, there are several risks associated with heart valve repair and replacement surgeries. Besides, the risks are higher in this case because the heart is involved and flaps of the valves play a crucial role in managing the entire process of blood purification.
So, before you agree to the surgery, you must be aware of the risks associated with this surgery.
1. Infection at the sight of surgery is one of the most common risks, especially if the process involves open heart surgery.
2. You should be aware of the intramuscular bleeding at the location of the stitches. Although it is not a fatal condition, doctors usually monitor the stitches and the surgical wound to prevent any clotting.
3. The stitches can get ruptured, causing profuse bleeding. It can even lead to heart attacks or strokes.
4. The replacement valves sometimes fail to function as they are expected to. As a result, the patient may suffer from critical medical conditions.
5. Irregular heart patterns or pulse rate is another risk involved with heart valve repair and replacement surgeries.
How Is An Aortic Valve Replacement Carried Out
An aortic valve replacement is carried out under general anaesthetic.
This means you’ll be asleep during the operation and won’t feel any pain while it’s carried out.
During the procedure:
- a large cut about 25cm long is made in your chest to access your heart although sometimes a smaller cut may be made
- your heart is stopped and a heart-lung machine is used to take over the job of your heart during the operation
- the damaged or faulty valve is removed and replaced with the new one
- your heart is restarted and the opening in your chest is closed
The operation usually takes a few hours.
You’ll have a discussion with your doctor or surgeon before the procedure to decide whether a synthetic or animal tissue replacement valve is most suitable for you.
Heart Valve Replacement Without Cardiac Surgery
Being a 75-year-old, I thought that I have been keeping myself in quite a good health. But about few months ago, I started to feel tired more easily and short of breath when doing my regular walking exercise. My doctor discovered that I had severe aortic stenosis a very narrowed heart valve through which my heart bumped the blood out. Without treatment, my quality of life would remain poor, and the chances of getting heart failure or dying was about 50% within a year.
Even though my health has otherwise been good, just the thought of undergoing an open-heart surgery at 75 could be a major undertaking, let alone if there would be any complication that might cause a major setback of my life.
I was referred to the cardiac team in Royal Columbian Hospital, and after undergoing various tests, the physicians offered me the option of the transcatheter aortic valve implantation , in which the doctor can insert a small tube into my groin artery and then deliver a new stent valve to replace the old valve without splitting my chest open.
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Replacing An Aortic Valve Without Open
Cardiologists expect wider use of the less-invasive techniqueknown as TAVRin the near future.
The one-way valve inside your aorta opens to allow blood to surge from the heart to the rest of your body. But as you age, the valve’s leaflets may stiffen and become clogged with calcium deposits, restricting blood flow. About 12% of people ages 75 or older have this condition, known as aortic stenosis. Symptoms include feeling dizzy, faint, tired, and breathless. Unless the valve is replaced, half of people with symptoms from aortic stenosis die within two years.
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Who Is A Candidate For Minimally Invasive Heart Valve Surgery
Although there are rare cases in which I would recommend traditional surgery, most people are eligible for a minimally invasive surgery.Its common for people to hear that theyre too old, sick, or frail to have heart valve surgery. They may not be physically able to handle a long procedure or recovery period. If they have bad knees or hips and rely on their arms to stabilize themselves, it can be even more difficult to allow the breastbone to heal following traditional heart valve surgery.This is not a problem with the minimally invasive procedure. The surgery is much shorter, which eliminates some potential complications from being under general anesthesia for a long time. And because we dont divide the breastbone, we don’t need to wait for it to heal before my patients return to their normal activities.Minimally invasive surgery also is preferable for patients who need to return to work to pay the bills. Instead of waiting a month or more, they will be back to work much quicker.
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Why The Procedure Is Performed
Aortic valve surgery is done when the valve does not work properly. Surgery may be done for these reasons:
- Changes in your aortic valve are causing major heart symptoms, such as chest pain, shortness of breath, fainting spells, or heart failure.
- Tests show that changes in your aortic valve are harming the work of your heart.
- Damage to your heart valve from infection .
A minimally invasive procedure can have many benefits. There is less pain, blood loss, and risk for infection. You will also recover faster than you would from open heart surgery.
Percutaneous valvuloplasty and catheter-based valve replacement such as TAVR are done only in people who are too sick or at very high risk for major heart surgery. The results of percutaneous valvuloplasty are not long-lasting.
Minimally Invasive Procedure Using Mitraclip Device Does The Job
Its the most common type of heart valve disease: mitral regurgitation, also known as a leaky mitral heart valve. While this condition can lead to serious health problems, it is treatable even more so these days due to a minimally invasive procedure using the MitraClip. This FDA-approved device allows physicians to fix faulty heart valves without doing open heart surgery.
In this episode of San Diego Health, Matthew Price, MD, an interventional cardiologist at Scripps Clinic John R. Anderson V Medical Pavilion in La Jolla, joins host Susan Taylor to discuss mitral valve disease and the catheter-based procedure used to correct the problem.
Its one of the miracles of modern medicine, Dr. Price says. With the MitraClip procedure, patients go home the next day.
What is heart valve disease?
Heart valve disease can be congenital or acquired during ones lifetime.
The four valves in the heart are supposed to keep blood flowing freely in a forward direction and prevent backward leakage. Heart valve disease occurs when the hearts valves fail to work the way they should and put a strain on the heart.
If you have a leaky mitral valve, what happens is when your heart squeezes, instead of blood going forward to your brain and your muscles, the blood goes backward toward the lungs, Dr. Price says.
What does the MitraClip do?
The benefits and side effects of the MitraClip
Who is a candidate for MitraClip?
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Newer Heart Valve Surgery Options
One important reason to track any possible valve disease-related symptoms and get regular check-ups especially as we age is to ensure any developing valve problems can be identified and treated as soon as possible.
Medications can be prescribed to increase the hearts ability to pump blood which may help compensate for a valve that isnt working correctly. However, a diseased heart valve is a mechanical problem that cant be fixed with medication alone. Surgery is often needed to repair or replace the damaged valve. Untreated valve disease may lead to decreased heart function and limit future treatment options. Its important to discuss any symptoms with your health care provider.
Can A Heart Valve Replacement Surgery Be Done Without Open Heart Surgery
Yes, of course, heart valve replacement surgery can be done without open heart surgery. Minimal invasive surgeries are an alternative option to open heart surgeries. The risk of complications is less in minimally invasive heart replacement surgery. The stay in the hospital is also less if you go for minimally invasive heart replacement surgery. Apart from this Robotic Heart Valve Replacement is now an advanced technique in this field and is being accepted by most cardiac surgeons. The recovery rate of robotic heart surgery is faster than open heart surgery. The risk of infection, blood loss, and post-surgery complications are also minimal if compared with open heart valve replacement surgery.
But the options for robotic surgery are very limited. Robotic heart surgery options are not available in all states or cities. You will have to find out an expert doctor and a minimally invasive robotic cardiac surgery setup.
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What Are The Risks Of Minimally Invasive Aortic Valve Replacement
There are certain risks with any type of surgery. Your risks will vary based on your medical condition, your age, and other factors. Be sure to talk with your healthcare provider about any concerns that you have.
Most people who have minimally invasive aortic valve replacement will have a successful outcome. However, there are some possible risks. These include:
Why Choose Georgia Heart Institute For Valve Surgery
There are numerous differentiators Georgia Heart Institute offers when it comes to valve surgery, namely outstanding clinical quality delivered consistently. Recognized by the Society for Thoracic Surgeons, the surgeons of Northeast Georgia Physicians Group ensure excellent clinical outcomes as compared to national benchmarks.
Even more impressive, our cardiothoracic surgeons have received the highest rating of three stars for mitral valve surgical quality. Ultimately, this means that our patients experience fewer complications, have better outcomes and are discharged to home faster than patients who receive valve surgery at other hospitals throughout the country.
Minimally-invasive valve surgery is an extremely innovative procedure thats not readily available through most heart and vascular programs. At Georgia Heart Institute, we have an experienced team that specializes in performing minimally-invasive valve procedures. This ensures they utilize the most advanced techniques and approaches to care, while delivering the highest clinical quality.
Even after the procedure, patients continue receiving exceptional and personalized care through our state-of-the-art cardiovascular intensive care unit , the Ronnie Green Heart Center. While cardiac patients who underwent minimally-invasive surgery have a faster and easier recovery than open heart patients, specialized treatment and education during recovery plays a crucial role in long-term wellness.
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Why Its Better To Have Your Mitral Valve Repaired Than Replaced
Having your mitral valve repaired before symptoms become severe can increase your longevity. Heres one patients story.
When Thomas Kimble discovered he would need to have his mitral valve repaired, he was happy to get a recommendation from his Florida cardiologist for a surgeon highly skilled in minimally invasive procedures.
This eased the decision for the Florida resident to move forward, even though, like many individuals, he wasnt experiencing symptoms of his mitral valve regurgitation, which may include fatigue, shortness of breath, chest pain and an irregular heartbeat.
In fact, just prior to his November 2020 surgery with Michigan Medicine Frankel Cardiovascular Center surgeon Gorav Ailawadi, M.D., the 68-year-old was hiking at 11,000 feet in Breckinridge, Colorado. I may have felt a little fatigued, but I attributed it to my age, he says.
A Trend Toward Less Invasive Procedures
We can repair mitral valves using different treatment methods, including open-heart, minimally invasive and transcatheter procedures, says Ailawadi, noting that more and more minimally invasive and transcatheter procedures are being performed at Michigan Medicine over open-heart surgeries.
A minimally invasive mitral valve procedure involves small incisions between the ribs on a patients right side to access and repair or replace the valve.
In a transcatheter procedure, the heart valve is accessed via a catheter through a patients blood vessel, typically the femoral vein.
Kimble was happy to know he would avoid the need for open-heart surgery.
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The patient had severe mitral regurgitation and his heart was starting to dilate, says Ailawadi, but his valve and chordae, which had ruptured, could be repaired without the need to open his breastbone. Chordae are thin, cordlike tendons that support the mitral valve leaflets as they open and close. When they become stretched or broken, as in Kimbles case, the valve cannot close properly.
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Minimally Invasive Redo Mitral Valve Surgery Without Aortic Crossclamp
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CO2: Carbon dioxide
The use of sternotomy for mitral valve surgeries has led to an increase in long-term survival and acceptable rates of morbidity and mortality, which is why it is the treatment of choice in cases of severe mitral valve disease. Alternatives to sternotomy have been put forward in order to reduce morbidity and mortality, provide faster recovery, and offer better aesthetic results. These alternatives include: partial sternotomy, mini right anterolateral thoracotomy performed under direct vision or video-assisted as well as robotic mitral valve surgery. These procedures can be performed either using longer common instruments coupled with small retractors or with the help of complex, expensive instruments. Myocardial protection can be achieved through the use of endovascular clamp, aortic clamping with the placement of the clamp via parallel access, or through surgeries performed without aortic clamping and with the patient under hypothermia with ventricular fibrillation.
The goal of this study is to describe the immediate results of tem patients who underwent video-assisted minimally invasive mitral valve reoperation, under hypothermic ventricular fibrillation and without aortic clamping.
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What Happens During Heart Valve Repair Or Replacement Surgery
Heart valve repair or replacement surgery requires a stay in a hospital.Procedures may vary depending on your condition and your healthcareproviders practice.
Generally, open-heart valve repair or replacement follows this process:
You will be asked to remove any jewelry or other objects that may interfere with the procedure.
You will change into a hospital gown and empty your bladder.
The surgical team will position you on the operating table, lying on your back.
A healthcare professional will start an intravenous line in your arm or hand for injection of medicine and to give IV fluids. More catheters will be put in blood vessels your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples.
The anesthesiologist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
Your doctor will put a breathing tube through your mouth into your lungs and connect you to a ventilator, a machine that will breathe for you during the surgery.
Your doctor will place a transesophageal echocardiogram probe into your esophagus so he or she can monitor the function of the valves.
A soft, flexible tube will be put into your bladder to drain urine.
A tube will be put through your mouth or nose into your stomach to drain stomach fluids.
Someone on the surgical team will clean the skin over your chest with an antiseptic solution. If there is a lot of hair at the surgical site, it may be shaved off.
What Is Heart Valve Repair And Replacement Surgery
Heart valves can easily malfunction owing to an array of reasons. They can quickly repair the issue in the early stages and ensure the doors start functioning normally. For example, if the flaps are not closing due to fat deposition, doctors will remove them and ensure the flaps start closing right on time.
But when it comes to conditions where the repair is impossible, doctors repair the original valves with artificial ones and ensure they work properly. There are two options for replacing the valves:
1. Mechanical valves: These are artificial and function just like mechanical doors. If the doctor uses this valve, the patient must take blood-thinning medications to prevent blood clotting, heart stroke, or myocardial infarction.
2. Biological tissue valve: In this, the tissues of cows, pigs, or the human cardiac muscles are used to make the flaps of the valves. You do not need to take thinning blood medicines for this case. However, the replacements can wear down due to tissue degeneration and require replacement.
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Repair Procedure: Balloon Valvuloplasty
View an animation of valvuloplasty.
For many people, valve tightness can be relieved during a procedure called balloon valvuloplasty. It’s done as part of a cardiac catheterization, which is less invasive than general surgery or open heart surgery. Balloon valvuloplasty is more often performed for mitral stenosis and aortic stenosis.
In a balloon valvuloplasty, a small catheter holding an expandable balloon is threaded into the heart and placed into the tightened valve. Next, the balloon is expanded to stretch open the valve and separate the leaflets.
In some cases the valve cannot be successfully treated by balloon valvuloplasty, and a different surgical treatment is needed to open the valve and allow better blood flow.
Treatment results can vary depending on the experience and training of your medical care teams. Hospitals can become very proficient at managing care around certain conditions. When a valve problem is complex, it is very important to choose anexperienced team to do the repair.