Why Might I Need Heart Valve Repair Or Replacement Surgery
Valve repair or replacement surgery is done to correct the problems causedby one or more diseased heart valves.
If your heart valve becomes damaged or diseased, you may have thefollowing symptoms:
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The repaired or replaced valve doesn’t work correctly
There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your healthcare provider before theprocedure.
Surgical Replacement Of Aortic Valves Offers Good Long
This is a plain English summary of an original research article
People undergoing surgery to replace a narrowed aortic heart valve have only slightly lower life expectancy than people without the condition. Surgery was also associated with a low rate of stroke.
This review gathered data from 93 observational studies that followed long term outcomes for people with severe aortic stenosis who had the valve replaced with a biological or tissue valve.
Following surgery, survival ranged from 16 years on average for people aged 65 or less, to six or seven years for those over 75. Fewer than one in 100 developed a stroke each year.
Ten years after surgery most people still had a good functioning valve. By 20 years the rate of valve deterioration had risen to 48%.
Bioprosthetic valves appear safe and are linked to average lifespan for this population, but there may be a need for monitoring and possible replacement after the first ten years.
What Happens Before Heart Valve Surgery
You may have a chest X-ray, echocardiogram and electrocardiogram the day before your surgery. Other tests may include a CT scan, heart cath and lab tests.
- 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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Complications After Aortic Valve Repair And Valve
Michel Van Dyck1, David Glineur2, Laurent de Kerchove2, Gébrine El Khoury2
1Department of Acute Medicine, Division of Anesthesiology, Cliniques Universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium 2Cardiovascular Department, Division of Cardiothoracic and vascular Surgery, Cliniques Universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium
Corresponding to:
Submitted Nov 10, 2012. Accepted for publication Dec 12, 2012.
doi: 10.3978/j.issn.2225-319X.2012.12.03
How Long Does It Take To Recover
Open heart surgery requires 57 days of hospital stay, while home care continues for 710 days afterward. Minimally invasive procedures generally require less time in the hospital and have quicker recovery periods. However, recovery after a sternotomy, a surgical incision through the sternum, can take several weeks or months.
A range of factors, such as age and other health conditions, can influence healing. A persons doctor will provide guidance on recovery time.
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What Is The Life Expectancy After Heart Valve Replacement
There isnt a hard-and-fast rule for how heart valve replacement will impact your health. The success of any surgical operation depends on your unique case your health going into the operation, the process itself and how you recover afterward. But research trends can tell us a little bit about the immediate and long-term effects of common surgical techniques.
One study published in the Journal of Cardiac Surgery examined the success of heart valve replacement at age 85 and up. It found that open heart surgery can be performed in patients 85 years and older with good results though elderly patients are associated with prolonged hospital stay. However, some risk factors can make this less likely, including having severely weakened heart valves pre-surgery.
Open heart surgery isnt the only way to replace a valve for aortic stenosis patients, theres also transcatheter aortic-valve implantation. This is a less invasive technique that could be more appropriate for older patients. It reaches the heart through a major artery instead of requiring more serious surgery. According to researchers, this technique doubles survival rates within the first year compared to living without valve replacement.
What Did This Study Do
This systematic review identified 93 observational studies including a total 53,884 adults undergoing bioprosthetic aortic valve replacement for severe aortic stenosis. Only studies published after 2006 were included to ensure relevance to current technologies. Patients were enrolled between 1977 and 2013. Average patient age was 53 to 92 years.
The researchers carried out several subgroups analyses to examine the influence of different factors. These included patient age, whether the study also included mechanical valves, and risk of study bias.
Overall the risk of bias was assessed as low in 51 studies, moderate for 21, and high risk for 21 studies.
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What Happens After Heart Valve Repair Or Replacement Surgery
In the hospitalAfter surgery the child will be taken to the cardiovascular intensive care unit to be closely monitored for several days. The child will be connected to monitors that will constantly display his or her electrocardiogram tracing, blood pressure, other pressure readings, breathing rate and oxygen level. Heart valve repair or replacement surgery generally requires an in-hospital stay of several days or longer.
The child will most likely have a tube in his or her throat so that breathing can be assisted with a ventilator until the child is stable enough to breathe on his or her own. As the child wakes up from the anesthesia more and starts to breathe independently, the breathing machine will be adjusted to allow the child to take over more of the breathing. When the child is awake enough to breathe completely by him or herself and is able to cough, the breathing tube will be removed. The stomach tube will also likely be removed at this time.
After the breathing tube is out, a nurse will assist the child to cough and take deep breaths every two hours. This will be uncomfortable due to soreness, but it is extremely important to do this in order to keep mucus from collecting in the lungs and possibly causing pneumonia.
Children experiencing pain are given pain medication. A nurse will show the child how to hug a pillow tightly against their chest while coughing to help ease the discomfort.
Notify the childs physician to report any of the following:
Why You Might Need An Aortic Valve Replacement
Aortic valve replacement is necessary if your aortic valve is:
Conditions that can affect the aortic valve are collectively known as aortic valve diseases.
Aortic valve diseases can be classified as:
- congenital which means that you are born with it
- acquired where the disease develops in later life, usually over many years
Some of the most common reasons why a person develops aortic valve disease are described below.
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What Are The Benefits And Considerations For A Tavi Or Other Minimally Invasive Procedure
Benefits of minimally invasive treatment options may include:
- Lower risk of infection
- Less trauma to the chest and heart muscle tissue
- Reduced length of hospital stay
Of course, everyone wants less pain and a shorter recovery time. But everyone also wants the best possible outcome and the longest, healthiest life as a result. Those factors along with a persons age, health history, type and severity of the valve problem and overall health will factor into selecting the best surgical option for any patient.
What To Expect During Heart Valve Replacement Surgery
For heart valve replacement surgery, you will lie on your back on the surgical table, and your health care team will prepare you for surgery by inserting an IV line into your arm to provide fluids. You may also have catheters inserted into your wrist and neck to monitor your blood pressure and heart.
After you have been given a general anesthetic, your doctor will put you on a ventilator, which will breathe for you throughout the surgery.
An echocardiogram probe will be inserted into your esophagus to monitor the function of your valves, and a tube will be inserted into your mouth to drain any fluid from your stomach.
Your team will prepare you for surgery by sterilizing the skin on your chest and shaving it, if necessary. Your surgeon will then make a long incision in your chest to expose your heart.
You will be connected to a lung bypass machine so that the surgeon can briefly stop your heart. Once it has stopped beating, your surgeon will replace the affected valve.
Once the cardiac surgery has been completed, your surgeon will restart your heart, allow the blood from the bypass machine to reenter your body and make sure the new valve is not leaking.
The surgeon will also insert a tube into your chest to allow for the drainage of fluids around your heart. Your sternum will be rejoined, and the incision will be closed. A sterile bandage will be applied.
You will remain in the hospital for several days so your recovery can be monitored.
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What Happens During Heart Valve Replacement
Your heart valve replacement surgery will take two to five hours.
Your healthcare provider will give you medication to make you sleep and be pain-free.
Depending on which kind of surgery youre having, your provider will make:
- A 6- to 8-inch cut in your breastbone for open-heart surgery.
- A 3- to 4-inch incision for minimally invasive surgery.
- A small incision in your groin and put a catheter through it and all the way to your heart.
Your provider will use a machine to do the work of your heart and lungs during your operation so your heart doesnt move during the operation.
Your provider will remove your diseased valve and replace it with a biological or mechanical valve. For a transcatheter procedure, theyll place your new valve inside your original one.
Theyll close your incisions and start your heart again.
Recovery: What To Expect
Things that can affect your surgery include your age, overall health, and the type of surgery. If you have a minimally invasive surgery you’ll be up and around in a few days.
If you have open heart surgery, your recovery will take longer. Your wound might be sore, swollen, and red. Youâll get tired easily. You might not feel like eating much, and you might find it hard to sleep. Thatâs all to be expected, and it gets better with time.
Your breastbone will take 6-8 weeks to heal, but it might be 3 months or so before you feel back to normal. Your doctor may suggest an exercise program or cardiac rehab to help.
As far as getting back to work, expect it to take 6-8 weeks for a desk job. If your work is more physical, it could take up to 3 months.
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When Is Heart Valve Surgery Necessary
You may have been born with a valve problem or developed a leak, stiffness or narrowing in your valve.
Youll most likely need treatment for heart valve disease if youre having symptoms like:
Note: While medication can help improve your symptoms and quality of life, surgery is the only effective long-term option. Ask your healthcare provider when you should start considering heart valve surgery.
How Surgery Is Performed
An aortic valve replacement is carried out under general anaesthetic. This means you will be asleep during the operation and will feel no pain.
The surgeon will begin the operation by making a large incision down the centre of your breastbone . The incision will be around 25cm long. This is known as a sternotomy and it allows the surgeon access to your heart.
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What To Expect During Minimally Invasive Valve Surgery
We ensure that our minimally invasive valve surgery patients are always the center of the care team. Throughout the process, patients have access to our 24/7 referral line for any questions or concerns. When they call 214-74-VALVE , they reach a registered nurse at any time of the day to answer any questions and address concerns.
Heres some more information on what patients can expect through the process.
Before Surgery
We receive referrals in a number of ways. Patients, their families, and/or referring cardiologists can call our referral line at 214-74-VALVE . Then we obtain the patients medical records, including imaging, such as an echocardiogram and heart catheterization, before the first appointment. At the initial appointment our care team determines if surgery is indicated if so, the surgery can be scheduled during this appointment.
Once a surgery date has been selected, we provide written instructions to the patient detailing their surgery appointment times and a medication schedule to follow before surgery.
During Hospitalization
All our surgeries are performed at William P. Clements, Jr. University Hospital, a state-of-the-art facility designed to enhance the experience of our patients and their families.
Prior to discharge, all follow-up appointments are made and detailed at-home care instructions are provided and reviewed with the patient and their support system.
After Surgery
Tavi For Aortic Stenosis
This minimally invasive procedure is similar to placing a stent inside an artery. A catheter, a thin wire or tube, is threaded through an artery to the diseased valve and a new valve is placed inside the old valve. Some implanted valves are spring-loaded and expand themselves. Others are expanded using a balloon. Once the new valve is expanded, it pushes the old valve leaflets out of the way and the replacement valve takes over the job of regulating blood flow.
The TAVI procedure is performed using one of several approaches, allowing the cardiologist or surgeon to choose the best and safest way to access the valve. The two most common approaches are transfemoral and transapical:
- Transfemoral: enters through the femoral artery , which does not require a surgical incision in the chest, or
- Transapical: uses a minimally invasive surgical approach with a small incision in the chest and enters the heart through the tip of the left ventricle called the apex.
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Benefits And Risks Of Heart Valve Surgery
If youre eligible for heart valve surgery, theres a chance your mitral valve disease or aortic valve disease is at a serious level you cannot ignore the disease when it is this severe, and medication will not be able to manage the damage or the symptoms youre experiencing. Talk to a heart valve surgeon about the surgery and find out if you are a good candidate for it. Find out what type of heart valve surgery is the best for your current condition. Be armed with many questions for your doctor. Surgery is a big deal, and its important to be an informed patient.
Surgery can be scary, but it can also save your life. As with any surgery, there are benefits and risks to both mitral valve and aortic valve surgery . For this article, we want to share with you some of the benefits and risks of this surgery to help you have a better idea of what is involved.
Minimally-Invasive Heart Valve Surgery Benefits
- Quicker, more comfortable surgery compared to open-heart surgery
- Tiny scar, which are usually hidden
- Minimal pain post-op
- Fast turnaround back to normal daily activities
- Restored strength and energy
- Longer durability on repairs over replacements
- Lower risk of stroke and infection
- No need to use blood thinners
- Lifestyle will improve due to a healthier heart
Minimally-Invasive Heart Valve Surgery Risks
Risks Of Surgical Heart Valve Replacement
Surgical aortic and mitral valve replacement risks can include the following:
- Blood clots that develop in the heart or on the replacement valve. These clots may break loose and travel through the bloodstream . This problem may cause a stroke or heart attack.
- Obstruction of blood circulation to the heart resulting in damage to the heart tissue
- Abnormal heartbeat
- Damage to red blood cells that can result in anemia
- Blood leaking around the outside of the prosthetic valve or any problem with the valve that causes leaking of blood after the valve has closed
- Any problem with the prosthetic valve that causes narrowing of the valve opening
- Failure of the valve to open and close properly
- Inflammation of the lining of the heart
The potential risks are shown in the order of severity, from most severe to least severe. This list does not include all risks. For more information regarding valve replacement surgery, talk to your doctor.
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How Long Does Aortic Valve Repair Last
Aortic valve repair can last for many years, but it is important to have regular checkups with your doctor to make sure the valve is functioning properly.
A rupture of the aortic valve is the most common cause of death. Complications from infection, stroke, and blood clots are also possible. According to recent medical studies, heart valve surgery has a one to four-year decrease in life expectancy. When a patient does not have surgery, his or her survival rate is only a few years. The most common complication of valve surgery are aortic ruptures, which can be fatal. Choosing a heart valve surgeon should be done with caution so that they can make an informed decision about the risks and benefits.
Sex After Heart Surgery
Before your operation, symptoms of fatigue or shortness of breath may affect your sex life. After your operation, you may feel like having a more active sex life. You can do so as soon as you feel able to, although avoid strenuous positions and be careful not to put any pressure on your wound until it has fully healed.
Some people find that having a serious illness can cause them to lose interest in sex. In men, the emotional stress can also cause impotence, where it is difficult to get and maintain an erection. If you are worried about your sex life, talk to you partner, a support group or your GP.
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