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.
What Makes The Mitral Valve Such An Important Component Of A Healthy Heart
A properly functioning mitral valve, situated between the left atrium and left ventricle, opens as the left atrium fills with blood. As the heart expands, blood flows into the hearts main pumping chamber, the left ventricle. The mitral valve then closes as the heart contracts, pushing oxygenated blood into the bodys largest artery, the aorta.
When the mitral valve doesnt work as it should, however, your heart might not pump enough of the oxygen-rich blood to your body. Mitral valve regurgitation, the most common heart-valve disorder, is a leaky valve that allows blood to flow backward into the left atrium. A diseased valve can cause shortness of breath, dizziness, fatigue, chest discomfort, migraines and many other symptoms.
At Hartford HealthCares Heart & Vascular Institute, our goal is to repair — whenever possible — your own living valve. Our results, and multiple studies, confirm that repair is better than replacement, with a reduced risk of complications, no blood thinners , better quality of life and greatly enhanced chances of a longer life.
But not every patient is a candidate for mitral valve repair. Patients too ill for either repair or replacement now have a nonsurgical option: the MitraClip, a mesh clip delivered through a catheter that reinforces the mitral valve and prevents blood backflow.
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.
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Survival Time In Relation To Surgical Risk
The 30-day mortality for the entire cohort was 2.0% , 1.2% for low-risk, 4.1% for intermediate-risk, and 8.3% for high-risk patients .
Low-risk patients had a median survival time of 10.9 years , intermediate-risk patients of 7.3 years , and high-risk patients of 5.8 years . The continuous survival time for the 3 risk groups is illustrated in . The cumulative 5-year mortality of patients classified as low risk was 16.5% , for those classified as intermediate-risk, 30.7% , and for patients classified as high-risk, 43.0% . The 10-year cumulative mortality is depicted in . The sensitivity analysis, with imputed EuroSCORE values for patients with missing risk assessment, confirmed the results of the primary analysis .
Smoothed Line Plot of Survival Time Based on Age at Operation
The median survival time as a function of age for low-, intermediate-, and high-risk patients. As is illustrated, older age had a substantial impact on median survival for patients in the low-risk group but the impact was attenuated for intermediate- and high-risk patients.
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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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What Happens Before Heart Valve Surgery
- 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.
What Is The Outlook After Mitral Valve Replacement
Mitral valve repair can help people with mitral valve disease improve their quality of life. It can reduce symptoms and help you feel much better than you did before surgery.
Your surgery might be followed by attending a program called cardiac rehabilitation. Cardiac rehab programs are designed to help you recover from your surgery and will teach you exercises and other tips to make the most of your new mitral valve.
Its important to adopt a healthy lifestyle when you have a replacement mitral valve. Your doctor can help you develop exactly what that means for you, but common parts of a healthy lifestyle include:
- getting enough sleep
- managing your stress levels
Additionally, you might have changes to your medications after a mitral valve replacement. For instance, If you received a mechanical valve replacement, youll need to take blood thinners daily.
Youll have regular checkups to make sure your replacement valve is working. If you received a biological valve, it may eventually need to be replaced again.
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Heart Valve Surgery Without Cracking Open The Chest
May 2, 2022
The man sitting across from me had traveled a long way from Saudi Arabia. He needed heart valve surgery. He could have had traditional surgery at home, but he wanted to know if we could fix his valve without the pain of breaking his breastbone. I told him we could with minimally invasive heart valve surgery.
Unfortunately, way too many people dont know about minimally invasive heart valve surgery. This is, in part, for two reasons: these procedures are fairly uncommon in most centers, so only a few doctors perform them, and they are highly complex surgeries that are only performed at a handful of centers across the country. This approach is so rare that fewer than 1% of aortic valve surgeries worldwide are performed this way, as well as fewer than 20% of mitral valve surgeries.
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.
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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 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.
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.
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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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.
Mitral Valve Repair Versus Replacement In Elderly Patients: A Systematic Review And Meta
Xiaoke Shang1*, Rong Lu2*, Mei Liu2, Shuna Xiao3, Nianguo Dong1
1Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , 2Department of Intensive Care Unit, Wuhan No. 1 Hospital Hubei Maternal and Child Health Hospital , , China
Contributions: Conception and design: N Dong Administrative support: N Dong Provision of study materials or patients: X Shang, R Lu Collection and assembly of data: X Shang, R Lu Data analysis and interpretation: X Shang, R Lu Manuscript writing: All authors Final approval of manuscript: All authors.
*These authors contributed equally to this work.
Background: Although mitral valve repair is generally accepted as the standard treatment for mitral valve disease, in older patients, there is increasing debate about whether MVP is superior to mitral valve replacement . We, therefore, performed a meta-analysis to compare MVP vs. MVR in the elderly population.
Methods: We systematically searched PubMed, the Cochrane Library, and Scopus up to February 2017 and scrutinized the references of relevant literatures. Only studies of MVP vs. MVR in the elderly patients that were published after 2000 were included.
The present meta-analysis indicates that elderly patients who receive MVP have better early and late outcomes than those undergoing MVR. MVP may be the preferred strategy for mitral valve surgery in the elderly population.
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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.
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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What Is Heart Valve Disease
There are several types of heart valve disease that can decrease or damage the functioning of your heart. They include:
- Aortic stenosis: narrowing of the aortic valve, one of the most common conditions requiring valve replacement.
- Mitral stenosis: another condition that sometimes requires valve surgery.
- Aortic regurgitation: when the valve allows blood to return back into the heart preventing forward flow out to the body. Also known as aortic insufficiency.
- Mitral regurgitation: when the mitral valve allows blood to flow backwards into the lungs instead of continuing through the heart as it should. You may experience difficulty breathing, irregular heartbeat and chest pain.
Learn more about valve disorders.
What Are The Signs And Symptoms Of A Valve Problem
The primary sign that you have a valve problem is a heart murmur, or unusual heartbeat, that a doctor can hear when he or she listens to your heart with a stethoscope. However, having a heart murmur doesnt necessarily mean you have a valve problem.
Other symptoms of heart valve disease include fatigue, dizziness, fainting, shortness of breath, sudden weight gain, and swelling in the ankles, neck veins, and other areas of the body.
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Surgical Options For Valve Replacement Include:
- Mechanical valve a long-lasting valve made of durable materials
- Ross ProcedureBorrowing your healthy valve and moving it into the position of the damaged valve aortic valve and replacing the borrowed valve with a new valve.
- TAVI/TAVR procedureTranscatheter aortic valve implantation/transcatheter aortic valve replacement
The procedure chosen will depend on the valve that needs replacement, the severity of symptoms and the risk of surgery. Some procedures may require long-term medication to guard against blood clots.
*Age is not the only factor in making a decision on treatment. It is critical to talk to your care team to weigh the risks and benefits of each approach and take into account your values and preferences.
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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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.
Symptoms Of Aortic Valve Disease
Sometimes, if you have a problem with your aortic valve, you may not experience any symptoms until later on in the disease process. Any symptoms you feel occur because your heart cannot pump blood around your body efficiently. Symptoms you may have include:
- chest pain brought on by physical activity this is caused by your heart having to work harder due to restricted blood flow through your aortic valve
- shortness of breath at first you may notice this only when you exercise, but later you may experience this even when resting
- dizziness or light-headedness this is caused by the obstruction of the flow of blood from your heart to the rest of your body
- loss of consciousness this is also a result of reduced blood flow caused by the obstruction in your heart
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