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How Serious Is Heart Valve Replacement Surgery

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Heart Valve Replacement Survival Rate

Watch a Transcatheter Aortic Valve Replacement (TAVR) Procedure at St. Luke’s in Cedar Rapids, Iowa

by DrCiuffo | Mar 15, 2022 | Aortic Valve Replacement, Blog, Heart Surgery |

Having invasive surgery for a heart valve replacement is sometimes necessary, but it doesnt have to be. Open heart surgery is a major operation and requires a hospital stay of at least a week, with part of that in the intensive care unit in most cases. Depending on your age, general health, and how severely damaged or faulty your heart valves are, invasive surgery may not be necessary. Although studies have shown that the heart valve replacement surgery survival rate is very high, there are other less invasive treatments for valve repair or replacement, such as minimally invasive aortic valve replacement or minimally invasive mitral valve repair.

What Happens After I Leave The Hospital

It can take several weeks after valve replacement for you to feel normal again. Hopefully, youll feel much better than normal, especially if you were previously experiencing fatigue, shortness of breath, and other symptoms associated with a faulty heart valve.

Before you leave the hospital, well take plenty of time to explain what to expect during this portion of your healing process. Youll also receive specific instructions regarding your medications, physical activity, diet, and other crucial details pertaining to valve replacement.

My best medical advice for a successful outcome after heart valve replacement includes:

  • Taking all medications exactly as prescribed, some of which may be new for you, such as blood thinners
  • Following care instructions for surgical incisions
  • Getting plenty of rest
  • Participating in activities as directed, such as walking, but not overdoing
  • Keeping your appointments for labs and doctor visits as scheduled, which may include diagnostic studies to access your new valves function and bloodwork to check medication levels

Even after youve recovered and are, perhaps, feeling like a new person, expect to return for periodic checks of your valve and heart health. Its important to keep these appointments so I can identify any problems early, when theyre usually easiest to treat.

How Much Does Heart Surgery Cost In South Africa

The cost of surgical treatment seems to be lower than that of medical treatment, at least in South Africa.

The total cost of a bypass operation is approximately R100 000, while the total cost of angina medication over a ten-year period exceeds this amount. When can coronary bypass surgery save a life?

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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.

Getting Results With Repairs

Understanding heart surgery.

For example, we commonly see patients who have had a previous valve repair.

Often, the repair appears to be adequate immediately after surgery, but in time the repair fails or does not turn out to be adequate. In many cases, the valve might start to leak or allow blood to flow backwards, which can impair the hearts function.

We can often re-evaluate and repair the valve again to achieve the outcomes that were hoped for in the first surgery.

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How Serious Is Heart Valve Replacement Surgery

Cardiologists recommend for heart valve repair or replacement surgery to patients to deal with various problems taking place because of one or more than one diseased heart valves. If heart valve suffers damage or becomes diseased, individuals mainly have a few common symptoms.

These are chest pain, dizziness, breathing shortness or difficulties in inhale/exhale process, palpitations, swelling of body parts or Edema, rapid gain of body weight because of fluid retention. Besides this, there may be a few other reasons, for which your doctor recommend for heart valve replacement surgery.

Yale’s 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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Risks Of An Aortic Valve Replacement

An aortic valve replacement is a big operation and, like any type of surgery, carries a risk of complications.

Some of the main risks of an aortic valve replacement include:

  • wound, lung, bladder or heart valve infections
  • a temporarily irregular heartbeat
  • reduced kidney function for a few days

The risk of dying from an aortic valve replacement is around 2%, although this risk is much smaller than that of leaving severe aortic valve problems untreated.

Most people who survive surgery have a life expectancy close to normal.

Read more about the risks of aortic valve replacement.

Why Might I Need Heart Valve Repair Or Replacement Surgery

Transcatheter Aortic Valve Implantation (TAVI)

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:

  • Dizziness

  • The repaired or replaced valve doesn’t work correctly

  • Death

There may be other risks depending on your specific medical condition. Besure to discuss any concerns with your healthcare provider before theprocedure.

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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.

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 heart’s 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.

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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.

Will I Need To Take Blood

Heart Valve Replacement Surgery

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.

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What Is Heart Valve Disease

Heart valve disease occurs when an abnormality develops in a heart valve and impairs its ability to work properly.

There are two main problems that affect the heart valves:

  • Regurgitation or leaky valve. A defect in a valve can impair its ability to fully close. This can cause blood to regurgitate, or leak, backwards through the valve.
  • Stenosis. This happens when a valves opening becomes narrowed, reducing the amount of blood that can flow through it.

Regurgitation and stenosis can affect any of the hearts valves, and more than one valve can be affected at the same time. A valve can be simultaneously leaky and narrowed.

Each of these conditions interferes with the hearts ability to pump blood around the body. They make the heart work harder than usual and can cause heart failure and other heart problems.

Better Outcomes At High

Its been shown that patients who have high-risk factors or who undergo second procedures do best at high-volume medical centers like ours where the surgical and support team have a lot of experience.

At a medical center where many of these type of surgeries are performed, the surgeons have experience in dealing with complex problems and re-operations. When you are referred to a high-volume medical center for surgery, you know that your cardiologist or surgeon cared enough to send you to a place where complex situations are handled on a daily basis.

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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.

How Dangerous Is Percutaneous Heart Valve Replacement Surgery

Mitraclip Transcatheter Mitral Valve Repair Procedure Animation

A percutaneous valve replacement is a minimally invasive procedure to replace a diseased heart valve. The native valve is replaced with an artificial valve sewn into a stent. The valve may be made of animal tissue or human tissue from the hearts protective membrane .

Percutaneous valve repair is widely performed and carries the typical surgical risks of a cardiac procedure. Percutaneous heart valve replacement techniques are still evolving. The associated risks are expected to decline with advancements in this field.

Percutaneous pulmonary valve replacement has a reasonably good outcome since it is performed primarily on young patients with congenital heart disease.

Percutaneous aortic valve replacement carries higher risks and the procedure is performed only when open surgery is not feasible. The patients are primarily those who are elderly with already compromised health and have associated risks including:

  • Emergency nature of the procedure
  • Other coexisting conditions

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Minimally Invasive Mitral Valve Repair

Mitral Valve Disease occurs when either one or both of the following malfunctions or deformities occur:

  • Mitral Valve Regurgitation or Insufficiency , which is often a result of Mitral Valve Prolapse
  • Mitral Valve Stenosis

Many times, a defective mitral valve can be repaired, as opposed to replaced. In these cases, there is no need for blood thinners and the chance of embolic events, such as a stroke, are diminished. If mitral valve replacement is necessary, there is a higher risk of embolic events.

As with aortic stenosis, patients with severe symptomatic mitral insufficiency should not delay speaking with a surgeon. It is very possible that the heart will tire out and irreversible damage will occur if mitral valve repair is not performed. This procedure involves minimal pain and a short recovery time. Most patients are able to return home within 2 or 3 days.

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.

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Common Causes Of Aortic Valve Disease

Age-related aortic calcification

Age-related aortic calcification is the most common cause of aortic valve disease. It is a degenerative disease, which means that it occurs as a result of aging. Calcium deposits form on the valve, preventing it from opening and closing properly. In this case, you are most likely to be diagnosed with valve problems when you are in your 70s or 80s.

Bicuspid aortic valve

A bicuspid aortic valve is the most common type of congenital aortic valve disease. It affects around 1 in 50 people. It occurs when the aortic valve has only 2 flaps instead of the usual 3. The valve may function normally for years without you being aware of the problem, often until you reach your 50s or 60s.

Underlying health conditions

Several health conditions can damage the aortic valve, causing aortic valve diseases. These include:

  • rheumatic fever this condition can arise as a complication of a throat infection and causes widespread inflammation throughout the body
  • lupus a condition where the immune system goes wrong and starts attacking healthy tissue
  • giant cell arteritis a condition that causes inflammation of the lining of the bodys medium and large arteries
  • endocarditis a rare but serious condition where the inner lining of the heart becomes inflamed

What Is A Heart Valve Replacement

Outcomes of Transcatheter Aortic Valve Replacement in Patients with ...

A heart valve replacement removes a diseased or damaged heart valve and replaces it with a new heart valve. Heart valves keep blood flowing in one direction through the four chambers of your heart. They open to allow blood to flow forward to the body. They then close tightly so blood does not leak backwards into the heart. Diseased or damaged heart valves can cause a backflow of blood or not allow blood to flow forward normally.

Heart valve replacement is a major surgery with significant risks and potential complications. You may have less invasive treatment options, such as a heart valve repair procedure. Consider getting a second opinion about all your treatment options before having a heart valve replacement.

Types of replacement heart valves

The new valve used in a heart valve replacement is called a prosthesis. The types of heart valve prostheses include:

Other surgical procedures that may be performed

Your doctor may also perform other procedures in addition to a heart valve replacement. These include:

Coronary artery bypass graft uses a graft to make a new route for blood to flow around blocked coronary arteries in the heart. Grafts are made with healthy vessels taken from other places in the body.

Percutaneous coronary intervention involves widening or opening a blocked or narrowed coronary arteries in the heart. A stent is typically placed in the artery to keep it open longer.

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How Long Will My Valve Last

The amount of time your valve repair or replacement lasts depends on several things:

  • Age.
  • 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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