Surgical Heart Valve Replacement Procedure
In most cases, heart valve replacement is an open-heart operation. This means the surgeon opens your chest and heart to remove the damaged valve. In some cases, the valve can be replaced through a small incision near the breastbone or under your right chest muscle. This is called minimally invasive surgery.
To help you prepare for the procedure, your doctor may suggest:
- Talking with different members of the surgical team, such as the anesthesiologist, surgeon, cardiologist, respiratory therapist, and nurses
- Discussing the details of the operation with family members
- Visiting the intensive care unit where you may be sent for postoperative recovery
Who Is In Theater For Open Heart Surgery
A team of doctors and other health professionals work together in the operating theater during open heart surgery.
The team is likely to include:
- the lead surgeon who will direct others surgeons who will assist during the operation
- the anesthesiologist, who is in charge of giving and anesthesia and monitoring vital signs
- the pump team, also known as perfusionists, operate the heart-lung machine and other technical equipment that supports open heart surgery
- nurses and technicians, who assist the surgical team and prepare the operating theater for surgery
Recovery After Heart Surgery
Although your heart itself is resilient there’s not much it can’t handle the type of incision used by your HonorHealth heart specialist for your heart surgery will dictate how soon you return to your usual exercise routine.
Even with traditional heart surgery, when the breastbone is broken to repair the heart, you can be exercising strenuously in two to three weeks. Just keep in mind that you’re recovering not only from surgery, but also from heart disease.
Types of heart surgeries, from least to most invasive are:
- Transcatheter procedures, such as transcatheter aortic or mitral valve replacement. The cardiologist and a team of specialists thread a catheter through a small incision at the top of your leg or in an artery in your chest, guiding the catheter and the valve inside it to the heart to replace the faulty valve.
- Minimally invasive surgery is another option if you need a heart valve repair. HonorHealth is one of the few health systems in the country to offer this type of surgery to repair a heart valve. The surgery has no age limit heart specialists operate on patients from age 18 to 90 and even older.
Aortic valve surgery involves a two-inch incision between the ribs above the breastbone. Mitral valve surgery involves a two-inch incision between the breastbone and the armpit.
- Traditional open-heart surgery, in which the chest is opened by breaking the breastbone. Recovery from this type of surgery involves time to allow the bones to mend back together.
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What Happens Before Heart Valve Replacement
Your healthcare provider may take a chest X-ray and do an electrocardiogram a day before your operation.
Avoid eating or drinking anything during the night before or the day of your surgery.
Follow your providers instructions about which medications to take or stop taking before your operation.
Take comfortable clothes with you to the hospital, along with shoes you can slip into instead of tie. Your relative or friend who drove you to your appointment can hold your belongings for you during surgery.
Your provider will prepare your incision site by shaving and cleaning it.
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 .
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Recovery After Mitral Valve Replacement
Some people need a valve replacement rather than repair. Even if you require a replacement valve, your heart function should be much improved after you recover from surgery, unless other health factors are involved. Recovery from valve replacement is similar to that of valve repair: several days in the ICU, followed by a gradual increase in activity as directed by your doctor when you return home. You may receive a valve made from biological tissue or a mechanical valve. A tissue valve can last as long as 15 years, and a mechanical valve as long as 25 years. Either way, you should be able to resume most of your normal activities after about 6 to 8 weeks.
If you have a mechanical valve, you will need to take blood thinners on an ongoing basis to avoid developing blood clots in your heart. You may hear a clicking sound, which is normal. Its important that you follow your doctors guidance on monitoring your heart function following the procedure.
If you had symptoms before your mitral valve surgery, such as fatigue or shortness of breath, you may feel better very quickly after the operation. Even if it takes a little while to feel better, mitral valve surgery is a common procedure with a high success rate and, in many cases, can get you back to your regular routine.
Patient Realities About Open Heart Surgery Recovery Time
In creating this website and writing my book, I decided to find out if I was alone in these thoughts. That said, I ran an extensive survey. I asked hundreds patients about their recovery experience.
As I learned during this research, most heart valve surgery patients surveyed suggested that heart valve surgery recovery was “more difficult than expected”. The patients surveyed also suggested that their cardiologists and surgeons could have better prepared them for their recovery.
My research suggested that the recovery time from heart surgery has a significant range. When answering the question, “How long did it take you to return to work?”, some patients stated they felt recovered in 2 to 3 weeks. Others responsed that it took over 15 weeks to recover from heart surgery.
I also wanted to get surgeon feedback. So, at the Heart Valve Summit, I filmed this interview with Dr. David Adams, the Surgeon-in-Chief at Mount Sinai Health System in New York City, New York. It was interesting to hear Dr. Adams’ research and clinical experience as he has treated thousands of patients during his 20+ year career.
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In This Video Learn Reasons Doctors Use Open
Heart surgery is one of the marvels of modern healthcare. Doctors of the 1800s initially believed surgery on the heart was impossible and were hesitant to even try. Starting in the 1950s, thanks to determined and brilliant surgeons, open-heart surgeries became increasingly safer, more common, and more effective.
Despite the medical progress, patients and their loved ones are understandably anxious about their surgery dateand what their life will be like in the weeks and months following the procedure.
Open-heart surgery is actually a group of procedures. We can do surgery on the heart for many different reasons, says Michelle Weisfelner Bloom, MD, cardiologist at Stony Brook University Medical Center. The most common surgery is coronary artery bypass grafting, or CABG.
When Is Open-Heart Surgery Beneficial?
Patients might benefit from open-heart surgery for one of a few reasons, according to Dr. Weisfelner Bloom.
What to Expect After Open-Heart Surgery
After waking up from your surgery, you will likely feel confused and tired. You will be hooked up to wires and tubes and will be in the Intensive Care Unit with highly trained healthcare professionals. Your wrists may be gently strapped down to prevent you from accidentally pulling out any of the tubes.
Recovering from Open-Heart Surgery
What Medications Are Needed After Open-Heart Surgery?
Preparing For The Operation
To make sure youâre healthy enough for surgery, youâll get:
- Blood and urine tests
- Drugs you buy âover the counterâ
- Prescription medicines
You may need to stop taking certain ones before surgery.
Also tell your doctor about any illnesses you have, even a simple cold. It might seem minor, but it could affect your recovery.
If you smoke, youâll need to stop 2 weeks before surgery to help prevent blood clots and problems breathing.
The night before surgery, youâll likely need to wash with a special soap that your doctor provides to kill germs. And in most cases, you wonât be allowed to eat or drink anything after midnight.
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Reasons To Call Your Doctor
If you feel any of these symptoms, report them to your doctor or nurse:
- Palpitations or a heart rate greater than 120 beats per minute when you are at rest, or a change from a regular to an irregular pulse.
- Increased fatigue or shortness of breath at rest.
- Temperature greater than 101 degrees more than one time, or chills for 24 hours.
- Excessive redness, swelling, soreness or drainage from any wound site.
- Swelling in your ankles and hands with a weight gain of two or more pounds in one day or five pounds in one week.
- Abnormal pain or other symptoms that do not go away with your medication.
- Pain in the calf of your leg.
How Long Do You Live After Heart Valve Replacement
Your life expectancy after a heart valve replacement depends on several factors, such as:
- How old you were when you received your heart valve replacement.
- What other health issues you have.
One study found that people considered low-risk lived anywhere from six to 16 years after a surgical aortic valve replacement. People aged 85 had shorter survival times, while those aged 60 to 64 lived longer.
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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.
How Long Does It Take To Recover From Heart Valve Replacement Surgery
Recovery after heart valve replacement surgery requires a relatively long time i.e. about a few months. During this period, a patient has to put limit on his activities, while simultaneously the patient experiences a few common emotional and physical changes.
Moreover, in some cases, patients deal with difficulty in sleeping or experience chest pain. In addition, during this phase, the patients of heart valve replacement surgery require the necessary medicines, proper physical exercise and good amount of nutrition.
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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?
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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Why Might I Need An Open Aortic Valve Replacement
When your aortic valve is working poorly such as in aortic valve stenosis or aortic valve regurgitation, you may need this procedure.
- In aortic stenosis, your valve is unable to open fully, and less blood is able to exit your heart.
- In aortic regurgitation, your valve is leaky. Some blood leaks backward through the valve instead of moving out to the rest of your body.
In both of these cases, you may need to have your aortic valve replaced. A poorly working aortic valve may lead to symptoms, such as:
- Shortness of breath
- An unpleasant awareness of your heartbeat
If these symptoms get worse, surgery may be needed. Your doctor may recommend the surgery even if you dont have significant symptoms, since surgery is most effective if symptoms are not too advanced.
Both aortic stenosis and aortic regurgitation can result from general aging of the valve. Other causes of aortic valve disease include:
- Heart birth defects
- Bacterial infection of the heart valve
- A tear in the aorta
- Aortic aneurysm
- Certain genetic conditions
Your Eating Habits May Change
You may notice that youve lost your appetite or you just feel too tired to eat. This is common, so be patient. Your appetite will soon be back to normal.
We suggest you try eating frequent, small meals throughout the day. You need proper nutrition to enable your body to heal and get stronger.
We recommend a diet low in fat, cholesterol and sodium and high in protein. Good sources of protein include fish, eggs, dairy, beans and nuts. Limit the amount of salt in your diet to 2,000 milligrams a day. Foods known to be high in salt include restaurant food, soups, pizza, bacon and other processed meats.
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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.
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.
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What Happens After Heart Valve Replacement
Youll start your hospital stay in an intensive care unit so your healthcare provider can keep a close eye on you. Next, youll move to a regular room. Your hospital stay may last five to seven days.
You can expect to have machines checking your blood pressure and heart rate.
There could be tubes draining fluid from your chest.
You can drink, eat and walk as soon as youre able to after your operation. Take a few steps around your room and then down the hallway with help from your healthcare provider.
After you go home, you may go to a cardiac rehab program to help you get stronger.
During The Surgical Heart Valve Replacement Procedure
During the procedure, the surgeon opens your chest to get to your heart and the diseased valve. The procedure varies from patient to patient, lasting a minimum of two hours and often longer. During this time, you are asleep under general anesthesia.
The surgeon will remove any tissue and calcium deposits that are interfering with the normal function of the valve. Your damaged valve may be completely removed. Then, the new valve will be sewn into the space where your own valve used to be. After the surgeon makes sure your valve is working properly, blood flow will be restored to your heart and the incisions will be closed. Your surgery is performed while the function of your heart is taken over by a heart-lung machine called cardiopulmonary bypass or CPB.
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