What Is The Recovery Time
Heart valve replacement recovery takes about one or two months. You might have a quicker recovery if you had a minimally invasive operation.
For the first three weeks of your recovery, youll probably get tired easily.
Youll need to avoid driving for several weeks after your operation.
During the first six to eight weeks after surgery, dont pick up anything more than 10 pounds.
Not All Minimally Invasive Valve Surgery Is The Same
What is a minimally invasive valve operation ?
Traditional valve operations are done via a 10- to 12-inch incision down the middle of the chest and dividing the breastbone which is also known as the sternum. The biggest limitation of traditional valve surgery is that the breastbone needs to heal after it is divided. Given the inability to place a cast on the breastbone for fixation, patients are required to not use their arms to push, pull, or lift more than 10 or 15 pounds for approximately six or eight weeks. Patients are also required not to drive during this time interval while the bone heals.
Minimally invasive or mini valve operations are designed to speed up the patients recovery and minimize the trauma the patient undergoes during a valve operation.
The two most common valves operated on are the aortic and mitral valves.
What is the difference between a minimally invasive aortic valve operation done at UT Southwestern versus elsewhere?
Most centers that perform minimally invasive valve surgery divide 1/2 to 3/4 of the breastbone via a smaller incision providing no significant benefit other than a more cosmetic operation. The patients recovery is still dictated by the six or eight weeks required for the bone to heal.
What is the difference between a minimally invasive mitral valve operation done at UT Southwestern versus elsewhere?
What makes UT Southwestern the destination of choice for many patients from around the country for mailing base of valve surgery?
Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement is a procedure used to replace the aortic valve without opening the chest. It is used to treat adults who arent healthy enough for regular valve surgery.
The aorta is a large artery that carries blood from your heart to the rest of your body. Blood flows out of your heart and into the aorta through a valve. This valve is called the aortic valve. It opens up so blood can flow out. It then closes, keeping blood from flowing backwards.
An aortic valve that does not open fully will restrict blood flow. This is called aortic stenosis. If there is also a leak, it is called aortic regurgitation. Most aortic valves are replaced because they restrict flow forward through the aorta to the brain and body.
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When Is A Heart Valve Replacement Necessary
A heart valve replacement is necessary when valve repair surgery isnt a treatment option. Valve replacement surgery is most often used to treat people with aortic valve disease, particularly aortic stenosis .
Other conditions that may require a heart valve replacement include:
- Mitral, pulmonary or tricuspid valve stenosis .
How Long Will My Valve Last
The amount of time your valve repair or replacement lasts depends on several things:
- Whether you have heart valve repair or replacement.
- The type of valve you have placed .
Mechanical valves rarely wear out, but they may need replacement if a blood clot, infection or tissue growth keeps them from working right. Biological valves may need to be replaced, especially if youre younger.
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Mitral Valve Clip Procedure
During the procedure, your surgeon and cardiologist will place a catheter in your femoral vein in the groin area. Using a guide wire, he or she will move the catheter to your left atrium , then put the MitraClip® through the catheter. Once inside your heart, your surgeon will put the clip in the leaflet of the mitral valve to reduce the leak. In some cases, the surgeon may need to insert more than one clip.
Do You See Patients From Other States
Actually, we see patients from all over the world! Dallas has two major airports and our hospital is located only two miles from Dallas Love Field Airport. Steva and Nelly our intake coordinators work with out-of-town patients all the time. They take care of coordinating benefits, making sure we have the required tests sent over from your providers, and even offer sound technical support because our first appointment is always conducted via telemedicine.
This makes getting a second opinion for out-of-state patients incredibly easy. Since our patients spend an average of only three days after surgery in the hospital, and because pain management is considerably less challenging due to our small incision, our patients are cleared to travel shortly after leaving the hospital.
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Hear From Our Patients
Greg Denning has never really liked going to the doctor, and for most of his life hes been an active person who was able to avoid significant medical care. That started to change one day when he was building a cabin in Wyoming. He started experiencing physical symptoms, like shortness of breath and fatigue, that made his wife worry, especially as his symptoms worsened over time. Then, during a routine physical, Gregs primary care doctor noticed signs of a heart problem and immediately sent him to a cardiologist. He was eventually diagnosed with a severe mitral valve leak that would require heart surgery.
How Long Does A Mitral Valve Replacement Last
The success rate for replacement surgery is good and has very few risks. The most common risks of this surgery include:
Your body will not usually reject the valve, but over time the valve can wear out. Biologic valves made of human or animal tissue only last for about 10 to 15 years. Synthetic valves can last longer, but have higher risks of blood clotting.
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Heart Valve Repair Or Replacement Surgery
The heart is a pump made of muscle tissue. It has 4 pumping chambers: 2 upper chambers, called atria, and 2 lower chambers, called ventricles. Valves between each of the hearts pumping chambers keep blood flowing forward through the heart.
- Tricuspid valve. Located between the right atrium and the right ventricle
- Pulmonary valve. Located between the right ventricle and the pulmonary artery
- Mitral valve. Located between the left atrium and the left ventricle
- Aortic valve. Located between the left ventricle and the aorta
When valves are damaged or diseased and do not work the way they should they may need to be repaired or replaced. Conditions that may cause heart valve dysfunction are valve stenosis and valve regurgitation .
When one valve becomes stenotic , the heart has to work harder to pump the blood through the valve. Valves can become narrow and stiff from infection and aging. If one or more valves become leaky, blood leaks backwards, which means less blood is pumped in the right direction. Based on your symptoms and the overall condition of your heart, your healthcare provider may decide that the diseased valve needs to be surgically repaired or replaced.
How Is It Performed
This procedure is usually performed as an open surgery. The surgeon will make a long incision down the breastbone, and a rib spreader is used to open the chest and access the heart. Tubes are inserted into the heart and major blood vessels, and are attached to a bypass machine. When this is turned on, blood is diverted into the machine, and away from the heart so that the surgeon can operate without too much blood loss. The defected heart valve is then removed and replaced with a biological or mechanical heart valve.
Materials
The valve used may be a mechanical valve or a biological valve .
Anesthesia
Procedure duration
The Heart Valve Replacement takes 3 to 6 hours.
The procedure duration depends on the extent of the heart disease present and will be discussed with the consultant before surgery.
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What Did It Find
- Pooled data from 85 studies estimated that 89.7% of people survived for two years after surgery, 78.4% at five years, 57.0% at 10 years, 39.7% at 15 years, and 24.7% at 20 years. Subgroup analysis showed that five-year survival declined with increasing patient age .
- The average estimated survival after surgery was 16 years for patients aged 65 or less. This compares to a life expectancy of 22.2 in the comparative general US population. In those aged 65 to 75 median survival was 12 years , seven years in those aged 75 to 85 , and six years in those aged more than 85 .
- Structural valve deterioration was reported in 12 studies, including 7,703 people. There were 418 cases of valve deterioration during a median follow-up of 6.4 years, giving an estimated deterioration rate of 6% by 10 years, 19.3% by 15 years and 48% by 20 years.
- Eight studies reported 64 strokes among 6,702 people. This gives a stroke rate of 0.26 per 100 person years , or less than one per 100 persons each year.
- Two studies reported 21 cases of atrial fibrillation among 177 people. This gives a rate of 2.90 per 100 patient years , or about three per 100 persons each year.
- The average length of hospital stay in these studies was 12 days as reported by seven studies including 6,405 people.
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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The Heart Valve Hotline
My team works closely to ensure that every patient gets the best experience possible. When you call us, our heart valve team, led by Steva Smartt, R.N., answers the phone 24/7. We stay with you throughout the entire process from that first phone call to the first visit, and all the way to your discharge. If at any point you have a question, we are always available to you.
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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Is This The Same As Robotic Surgery
While some centers around the country use a surgical robot to perform mitral valve surgery, my approach is considered traditional surgery. I choose not to use a robot. This means my patients benefit from the same outcomes of traditional surgery, which is supported by decades of research, but they get the added benefit of a minimally invasive approach.
There is no denying robotic surgery has revolutionized many complex procedures, however, when it comes to heart valve surgery the robotic approach requires multiple small incisions and takes longer to complete than a mini-thoracotomy. I have performed more than 3,500 heart valve surgeries during my career, and more than 1,000 of those have taken place at UT Southwestern’s William P. Clements Jr. University Hospital.
This means the same intake team, the same OR team, and the same post-surgery recovery team have taken care of my patients more than 1,000 times.
What To Expect After Heart Valve Replacement
Post procedure care
Patients will be connected to a ventilator after the surgery and brought to the ICU to be closely monitored for between 24 and 48 hours.
After ICU, patients will be moved to the ward to complete the recovery, and continue to have a catheter, chest drains and heart monitors attached.
Patients who have had a mechanical valve fitted will need to take blood thinning medication and undergo regular blood tests for the rest of their life.
Possible discomfort
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William P Clements Jr University Hospital
All heart surgeries take place in UT Southwesterns William P. Clements Jr. University Hospital, ranked the #1 hospital in Dallas-Fort Worth by U.S. News & World Report for six consecutive years.
Clements University Hospital brings together the knowledge, expertise, research, and innovation of a world-class medical institution into one remarkable facility with the patient at the center of it all.
- 24 Surgical Suites
Why Is Open Heart Surgery Performed
Your doctor may recommend open heart surgery to treat a variety of diseases and conditions of the heart. Your doctor may only consider open heart surgery for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on open heart surgery.
Your doctor may recommend open heart surgery for:
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Days And Weeks Following The Heart Surgery
During the phase consists of days and weeks following the heart surgery, people usually expect to regain their energy gradually and return to the regular activity levels. Although, the surgeons and cardiologists recommend the necessary medications and care tips to assure the fastest possible recovery of patients support from family members and friends act as the prime key to faster recovery in them.
Preparing For The Surgery
Preparation for open heart surgery starts the night before. A person should eat an evening meal as usual but must not consume any food or drink after midnight.
It is a good idea to wear loose, comfortable clothing to assist with restricted movement following surgery, but wear whatever is comfortable.
Be sure to have all personal medical information on hand. This might include a list of medications, recent illness, and insurance information.
It is normal to feel anxious before an anesthetic, and people should not hesitate to seek reassurance from the healthcare team.
The doctor may request that the person washes their upper body with antibacterial soap. A member of the healthcare team may need to shave the persons chest area before they can have the anesthetic.
The doctors may also need to run tests before surgery, such as monitoring the heart or taking blood samples. A doctor or nurse might place a line into a vein to enable the delivery of fluids.
After the medical team has completed the preliminary tasks, the anesthesiologist will administer general anesthesia.
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After The Surgical Heart Valve Replacement Procedure
When your heart valve has been replaced and the surgery is completed, your heart will be beating on its own and all incisions will be sewn or stapled closed.
Following the surgery, you’ll spend some time in the ICU, where you will be closely monitored to make sure there are no complications. Family and friends will be able to visit while you are in the ICU.
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What To Expect Of The Day Of Surgery
You should prepare to stay in the hospital for approximately seven days after your surgery. It is helpful to have someone at the hospital for support for some of this time.
After you check-in, you will go to a preoperative area where you will be instructed to change into a hospital gown.
You will meet with a member of the anesthesia team and surgical team to go over the procedure and sign consent forms. You may be asked to provide a urine specimen.
Intravenous access is started in the pre-operative area. This will be used for anesthesia, antibiotics, and blood products.
Transcatheter Mitral Valve Repair With Mitraclip
Transcatheter mitral valve repair is the least invasive mitral repair procedure, but it does come with some limitations on what surgeons and/or cardiologists can do. The only FDA-approved transcatheter mitral valve repair surgery is called MitraClip® . This procedure is for patients who are at higher risk and cannot get open-heart surgery. In most cases, this procedure will not stop a leak, but it can reduce the leak and improve symptoms.
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