How To Prepare For Heart Valve Surgery
Before your surgical date, make sure to arrange for assistance or support for when you return home and are still in recovery. Talk to your family about what you might need and have a plan in place. You’ll also want to discuss any post-surgery questions with your doctor beforehand, such as foods to avoid and what medications you’ll be taking.
Your doctor may recommend that you pack a bag with a few items for the duration of your hospital stay, such as:
- Eyeglasses, dentures, or hearing aids.
- Comfortable clothing.
- Items for entertainment, like a book, tablet, or music player.
- Personal items, such as a toothbrush or shaving kit.
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.
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.
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Preparing For Your Procedure
Prior to your heart valve surgery, youll meet with your physician to discuss your medical history, medications you take and any questions you have. Tests you may have before heart valve surgery include:
- Chest X-ray a radiograph or picture of the heart and lungs including blood vessels, ribs and bones of the spine
- Blood tests studies to detect enzymes that leak into the blood when the heart has been damaged and to detect infection and antibodies
- Electrocardiogram a test that records the electrical activity of the heart
If you use tobacco, youll be instructed to quit at least two weeks before surgery. Tobacco use can interfere with the bloods ability to clot properly. Your physician can prescribe a nicotine-replacement product to help you stop tobacco use.
As in the case of most surgeries, your physician will ask you not to eat or drink a certain number of hours beforehand, often nothing after midnight the night before.
The area where your incision will be made is shaved and cleaned prior to surgery to reduce risk of infection. Youll be given anesthesia.
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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What Are The Advantages Of Heart Valve Surgery
Heart valve surgery can ease your symptoms, improve your life expectancy and help prevent death.
The potential advantages of heart valve repair vs. valve replacement are:
- Lower risk of infection.
- Less need for lifelong anticoagulant medication.
Valve surgeries, including valve repair and valve replacement, are the most common minimally invasive procedure.
The benefits of minimally invasive surgery include:
- Lower risk of infection.
- Other medical conditions you have.
- How many procedures you have in a single operation.
Your cardiologist and surgeon will talk to you about these risks before your surgery.
If youve had a valve fixed or replaced, you may be at a higher risk of getting infective endocarditis. But this can also happen with a faulty valve that isnt repaired. In certain cases, your healthcare provider may prescribe antibiotics to keep you from getting endocarditis from some types of dental work. You can reduce the risk of endocarditis yourself by taking good care of your teeth.
What Can Heart Valve Repair Accomplish
Heart valve repair can restore proper blood flow and circulation to your body, giving you more energy. It can also:
- Reduce or eliminate heart murmurs or palpitations
- Reduce or eliminate swelling in feet and legs
- Reduce or eliminate chest discomfort or pain
- Enable you to be more physically active without experiencing fatigue or shortness of breath
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Cracked Cylinder Head Repairs In Richmond Hill
Cracked Cylinder Head?
When a cylinder head comes into Central Ontario Cylinder Head for repair and reconditioning, it may be cracked and warped due to overheating. The cylinder head could be leaking internally or the valve guides and seals may just be worn out. Therefore the first thing we do is diagnose the problem.
We start by thoroughly cleaning the head and then follow with a visual inspection. We then pressure test for cracks. If the head cannot be pressure tested, we will magnaflux instead. Sometimes both procedures are used if it is warranted. If the head checks out OK then it can be repaired and reconditioned. If the head is cracked, it may need to be welded. If the head cant be repaired, the customer is informed and we source a new head for the job. If the head can be repaired, the guides may have to be changed. If the guides are changed, the seats have to be machined. The cylinder head is then resurfaced to manufacturers specifications and all components are cleaned for final assembly. The valve springs are tested for pressures and the head is then reassembled with new valve seals.
Heart Valve Replacement And Repair
In valve replacement surgery, the surgeon removes the diseased valve and replaces it with a new one made from plastic, metal or tissue. In valve repair surgery, also called valvuloplasty, the surgeon repairs the defective valve by sewing the edges together. For many patients, heart valve repair is preferable to replacement because the individuals own tissues are used. When a valve is severely damaged or malformed, replacement may be necessary.
Balloon valvuloplasty is a nonsurgical, minimally invasive option for some patients who have stenosis of a valve. This procedure involves a physician threading a catheter containing a balloon into the patients groin and up to the heart. The balloon is inserted into the valve and stretches it opened. The balloon and catheter are then removed.
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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.
Is Surgery Better For Me Than Medication Alone
Medications often help during the first stages of valve disease, but they don’t work as well as the disease gets worse. You dont need to wait until your symptoms become unbearable before you have surgery. In some cases, its best to have surgery before symptoms start. The decision to have surgery is a major one thats based on your individual needs. It involves input from you, your cardiologist and your surgeon.
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Transcatheter Valve Clip Procedure
This procedure is most commonly used on patients with mitral valve regurgitation who are too old or weak to undergo other surgical options. A catheter tipped with a small clip is threaded through your arm or groin to the valve that needs to be repaired. The clip is then placed on the valve, reshaping it so it closes properly.
Types Of Replacement Valves
Mechanical and biologic valves are used to replace faulty valves. Mechanical valves are artificial components that have the same purpose as a natural heart valve. Theyre created from carbon and polyester materials that the human body tolerates well. They can last between 10 and 20 years. However, one of the risks associated with mechanical valves is blood clots. If you receive a mechanical heart valve, youll need to take blood thinners for the rest of your life to reduce your risk of stroke.
Biologic valves, also called bioprosthetic valves, are created from human or animal tissue. There are three types of biologic heart valves:
- An Allograft or homograft is made of tissue taken from a human donors heart.
- A porcine valve is made from pig tissue. This valve can be implanted with or without a frame called a stent.
- A bovine valve is made from cow tissue. It connects to your heart with silicone rubber.
Biologic valves dont increase your risk of developing blood clots. This means you most likely wont need to commit to a lifetime of anti-clotting medication. A bioprosthetic doesnt last as long as a mechanical valve and may require replacement at a future date.
Your doctor will recommend which type of heart valve you get based on:
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What Is A Heart Valve Replacement
Heart valve replacement is a procedure to replace one of your hearts valves with a biological or mechanical valve.
Sometimes, a valve doesnt form right when youre born. Some people may have a valve that gets too narrow, stiff or leaky. In these cases, your blood cant move through your heart efficiently.
You have four valves that control where your blood goes in your heart. Normally, your hearts valves are all opening and closing completely when your heart beats. This allows blood to move in an organized way.
Your blood moves:
- From one part of your heart to the next.
- To your lungs to get oxygen.
- To your aorta, which sends your oxygen-rich blood out to the rest of your body.
Like a sink drain that doesnt hold all the water or completely drain it, a diseased valve keeps some of your blood from going where its supposed to go.
If one of your valves isnt working right, you may need to take medicine or have your valve repaired. If these treatments dont work, you may need a heart valve replacement.
Types of Heart Valves
Biological valves are made of:
In general, theres no difference in durability between the types of biological valves. Biological valves may have some artificial parts to give the valve support and make it easier to put in place.
Homograft Valves
A homograft is:
Mechanical Valves
Mechanical valves are:
- Designed to last a lifetime.
Heart valve replacement: mechanical vs. tissue
Biological valves
Mechanical valves
Types of Heart Valve Replacement Surgery
How Do I Prepare
Your surgery could be scheduled weeks in advance, and it’s a good idea to go into your surgery as healthy as you can. Focus on eating well and getting enough sleep and exercise. Try to keep your stress under control.
Your doctor will need information about your health. They’ll want to know what medications or supplements you take. You should also let them know if you smoke, have any allergies, could be pregnant, or have a pacemaker.
They also may want to do a blood test or other tests to make sure you’re healthy enough for surgery.
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Recovery After Your Heart Valve Replacement
If you have traditional heart valve surgery, you may remain in the hospital for as long as a week or two.
Your medical team will help you get up and about one or two days after surgery. You may feel stiff and sore, but its important to breathe deeply and cough to clear fluids from your lungs. Youll be allowed to eat normally in most cases.
If you have valve replacement surgery, you may need to take medication to prevent blood clots from forming on the new valve. You also may hear a mechanical valve clicking in your chest. This is normal.
If your job involves primarily sitting at a desk, you usually can return to work in four to six weeks.
How Is Repair Of A Mitral Valve Accomplished
There are several ways to repair a damaged mitral valve. If your valve is judged to be repairable, the three primary matters your surgeon will consider are whether one or both of the tissue flaps that make up your mitral valve need repair, what kind of repair is most advisable, and which surgical approach will work best.
Sometimes just one of the two tissue flaps that make up your mitral valve needs repair, but sometimes both do. The flaps are also known as cusps or leaflets the mitral valve has a posterior leaflet and an anterior leaflet . The valve’s name comes from the fact that the shape of the flaps looks somewhat like a miter, the ceremonial headdress worn by a bishop. Our cardiac surgeons have considerable experience in repairing one or both flaps:
- Single leaflet repair involves repairing just the posterior leaflet or just the anterior leaflet. Some surgeons elsewhere have experience repairing only posterior leaflets.
- Bileaflet repair involves repairing both leaflets at the same time. Some surgeons elsewhere are not experienced in bileaflet repair.
There are three primary ways of performing the actual repair of a damaged mitral valve these procedures are sometimes performed separately but are often used in combination:
- Annuloplasty involves repairing the ring of tissue to which the flaps are attached , by attaching a ring of tissue, cloth or metal to it.
- Resection involves trimming and/or reshaping the flaps themselves.
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Alternatives To An Aortic Valve Replacement
An aortic valve replacement is the most effective treatment for aortic valve conditions.
Alternative procedures are usually only used if open heart surgery is too risky.
Possible alternatives include:
- transcatheter aortic valve implantation the replacement valve is guided into place through the blood vessels, rather than through a large incision in the chest
- aortic valve balloon valvuloplasty the valve is widened using a balloon
- sutureless aortic valve replacement the valve is not secured using stitches to minimise the time spent on a heart-lung machine
Page last reviewed: 23 December 2021 Next review due: 23 December 2024
Replacing A Leaky Valve:
Aortic regurgitation is another common valve problem that may require valve replacement. Regurgitation means that the valve allows blood to return backward through the valve and into the heart instead of moving it forward and out to the body. Aortic regurgitation can eventually lead to heart failure.
Mitral regurgitation may also require a valve replacement. In this condition, the mitral valve allows oxygenated blood to flow backward into the lungs instead of continuing through the heart as it should. People with this condition may experience shortness of breath, irregular heartbeats and chest pain.
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Heart Valve Surgery Types
If your doctor determines that you need heart valve surgery, you may have:
- Balloon valvuloplasty This is a surgical procedure that opens a narrowed heart valve, without need for open heart surgery.
- Mitral valve repair This surgery repairs a diseased or defective mitral valve. The surgery may be open heart or minimally invasive, depending on your age, health condition and other factors.
- Mitral valve replacement This procedure involves removing your mitral valve and replacing it with a mechanical valve or a tissue valve.
- Aortic valve replacement This procedure involves removing your aortic valve and replacing it with a mechanical valve or a tissue valve.
- Transcatheter aortic valve replacement This is a less invasive valve replacement option for some qualified patients.
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:
-
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.
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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.