What Is The Success Rate Of Heart Valve Replacement Surgery
The success rate of heart valve surgery usually depends on various factors like the patients overall health, age and so on. Damage in the heart valve is primarily a serious condition and should be treated without much delay. Replacement surgery of the heart valve definitely increases the life expectancy of the patient, improving quality of life. Due to the advances in the medical field and use of latest technologies and heart care facilities, doctors have reported a success rate of around 94 to 97 percent of such a surgery. The mortality rate due to the heart valve replacement surgery has also decreased over the years of advancement.
What Is Cardiac Surgery
Cardiac surgery is any surgery that involves your heart or the blood vessels connected to your heart. Its also called cardiovascular surgery or simply heart surgery. Heart surgery is complex and requires the specialized expertise of cardiac surgeons. Its a major event that can improve heart function and circulation and give you a whole new lease on life.
Heart surgery can correct issues you were born with . It can also repair issues that develop later in life. The type of heart surgery you have depends on the underlying problem or combination of problems.
How Does Atrial Fibrillation Occur
Atrial fibrillation is due to the development of electrical short circuits inside the top chambers of the heart. Usually these short circuits begin in the top chamber on the left . They are usually triggered by abnormal electrical activity located within the veins that drain blood from the lungs back to the heart .
These rapid short circuits have several consequences:
1. The short circuits drive the pumping chambers rapidly and erratically. This produces palpitations, shortness of breath, and tiredness. In some people it can also cause dizzyness and chest pain. It usually reduces your exercise or physical capacity. It is NOT however a life-threatening rhythm disturbance.
2. The short circuits result in ineffective pumping of the upper chambers. This leads to slow blood flow in both of these upper chambers . This can rarely cause blood clots and possibly stroke. For this reason many patients with atrial fibrillation will require a blood thinner. This may be aspirin, warfarin or one of the newer medications .
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Survival Rate Of Heart Valve Replacement Surgery
The survival rate for a heart valve replacement surgery depends on which valve is involved. This was analyzed in a large study in which the lifespan of a large population, who went ahead with the surgery, is observed for a specific timeframe.
The 5-year survival rate means what percentage of people lived for at least 5 years after the surgery. Similarly, the 10-year survival rate means what percentage of people lived for at least 10 years after the surgery.
For example, the 5-year survival rates for aortic valve replacement surgery is 94%. This means 94 out of 100 people who underwent AVR surgery could live at least 5 years.
Table 1: The Survival Rates as Per the Type of Valve in Heart Valve Replacement Surgeries
Survival rates for heart valve replacement surgery are often used as predictors of how long patients can live beyond a certain number of years after the surgery. However, these may vary for you depending on your age, your overall health, and the current status of your heart function. Discuss with your doctor about these factors to know about your life expectancy after the surgery.
Risk Adjustment And Benchmarking
For the benchmarking procedure, risk adjustment was performed using the logistic EuroSCORE. This model is the most commonly used risk-adjustment method in Europe and its definitions are used in the NVT database. The logistic EuroSCORE was calculated for each patient. Subsequently, benchmarking was performed using each early mortality measure. A random effects model was fitted with one of the mortality measures as the outcome variable and including the logistic EuroSCORE as covariate. A random effects model accounts for within-hospital variability and between-hospital variability and is the preferred type of regression model used for comparison between centres . This regression model thus assumes that mortality is partly explained by patient characteristics and partly by a centre effect, which is specific to each centre and can be compared across centres .
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Cardiac Surgery Survival By Procedure
Cardiac surgery programs can also report survival rates by each specific operation. These are called benchmark operations, and they are one of the ways surgical centers can compare outcomes. Note that these data do not include a patients specific risk factors prior to surgery.
In the table below, we report the total number of benchmark operations at Childrens Colorado, as well as the survival rates here compared to the national average.
What we measure:
Index case survival shows the percentage of patients who received a specific operation and were alive 30 days after their operation. It also includes patients who needed to be in the hospital longer than 30 days who were alive and successfully able to go home.
Index case survival
What it means:
For the majority of the open-heart surgeries listed above, our survival rates are higher than the national average.
It is challenging to compare outcomes by procedure alone. The procedure-alone data does not include important health-related factors such as age, other health conditions , and genetic conditions that can make procedures riskier. This is why pediatric heart surgery programs should report a wide range of outcomes, including how well patients do when they are at higher risk due to other health conditions.
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How Often Is Sts Data Updated
Childrens Colorado and other centers submit data to the STS twice per year. The STS then verifies the data and generates reports that allow us to compare our results with our peers.
We publish our outcomes data on this website as soon as possible following the STS data release, also twice per year.
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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.
What Does A Heart
Operating on a heart safely while it is beating is difficult. A heart-lung machine takes over the function of maintaining the circulation of blood and oxygen throughout the body so that the surgeon can work on a still heart. This process is called perfusion, and it is managed by perfusionists. These machines can take over the hearts pumping action for hours.
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Why Is This Important
The research team says one of their aims in this project was to empower patients. Parents said it helped to know they were not alone in facing complications, that clinical teams had seen the complications before and knew how to deal with them.
Over the course of the project, the researchers kept in close contact with the organisation that monitors the outcomes of childrens heart surgery, called the National Congenital Heart Diseases Audit , and with those responsible for designing specialist health services. These groups now use the same definitions when talking about the complications of childrens heart surgery, and hospitals across the UK now use the list when recording what happens to children after their surgery.
Testing A Diagnostic Tool
As many as 40% of Americans older than 60 experience some narrowing of their coronary arteries caused by the buildup up of plaque in the walls of the blood vessels, according to the American Heart Association. Most cases arent serious enough to limit oxygen supply to the heart and can be treated with statins or aspirin. But significant blockages can cause chest pain and increase the risk of heart attack or death.
For years, clinicians relied exclusively on angiograms an X-ray of the coronary arteries to determine whether the vessels were sufficiently narrowed to warrant intervention. But angiograms can be misleading, showing a tight space within a vessel when none exists, Fearon said.
A better diagnostic tool, known as fractional flow reserve, or FFR, can measure whether blood flow has been reduced to a dangerous level. Doctors thread a wire with a small sensor on the tip into the artery to measure the pressure of the flow. In a significantly narrowed vessel, the blood pressure will drop in that segment of the vessel beyond the narrowing, signaling the need for intervention.
In the FAME 1 study, whose results were published in 2009, Fearon and his colleague found that use of FFR led to fewer stent placements and fewer complications when compared with stenting based on angiogram images alone. Among patients with FFR-guided stents, the rates of death, heart attack and the need for repeat procedures were significantly less, they found.
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How Is Yale Medicine Unique In Its Approach To Cardiac Surgery
Yale Medicine Cardiac Surgery has a team of world-class heart surgeons who are highly skilled in treating the full range of cardiac diseases and conditions, using a variety of approaches and techniques, from minimally invasive robotic surgeries to complex open surgeries. Yale New Haven Hospitals Heart & Vascular Center is one of the few cardiac centers in the country where cardiac surgery outcomes for procedures such as CABG and mitral and aortic valve replacement consistently exceed national and regional norms.
Yale is a major referral center for a number of cardiac surgeries. Yale Medicine has the largest volume of aortic cases in Connecticut and is in the top 3 percent of aortic surgical volume nationally.
We are one of the highest volume centers in New England for mitral valve repairs, which our surgeons can often perform with a minimally invasive approach that may include use of a highly advanced robotic surgical tool. We also are nationally recognized for excellence in TAVR and are a designated training center for this technique.
How Is A Heart Valve Replacement Surgery Performed
Heart valve replacement surgery can be performed via any of the two approaches:
- Open-heart surgery: Traditional method of heart surgery in which a large incision is made in the chest the heart is stopped for a time so that the surgeon can repair or replace the valve.
- Minimally invasive heart surgery: These are the newer techniques in which the doctors make smaller incisions over the chest to replace the heart valves.
The diseased valves may be replaced by any of the artificial valves that include:
- Manufactured mechanical valve: Made up of carbon-coated plastic, the mechanical valve is the most durable type of valve that will usually last for your entire lifetime.
- Donors valve: This is an actual human valve taken from a donor and implanted in your heart . It usually lasts for anywhere between 10 to 20 years.
- Tissue valve: Created from animal valves or tissues, this type of heart valve is expected to stay healthy for 10 to 20 years after the surgery.
Your doctor will discuss the benefits and risks of the available surgical options as well as of the types of valves.
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Routinely Performed Coronary Artery Bypass Surgeries
Youll Play A Key Role In Managing Your Pain
Post-surgical pain is unavoidable but can be managed in a variety of ways. Because of recent national legislation changes, physicians can prescribe no more than a seven-day supply of opioids to patients at the time of their hospital discharge.
Weaning yourself off opioids as soon as possible is important. You may need less than a seven-day supply, depending on your condition. Some patients do not require any opioids for pain management.
Other options for pain management include:
Oral and topical analgesics such as acetaminophen and Salonpas patches
Applying a warm cloth to the area, using caution near the incision because nerve sensitivity may be decreased, causing the skin to burn
Relaxation techniques such as meditation and guided imagery
If you are on long-term opioids, you should meet with your prescribing physician to begin to wean down to the lowest dose possible before surgery.
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What Happens During Heart Surgery
What happens during your surgery depends on the type youre having. It also depends on the method your surgeon uses to perform the operation.
Surgeons use different methods for operating on your heart. These include open-heart surgery, off-pump bypass surgery and minimally invasive heart surgery. Your care team will discuss which method is best for you, and why.
Open-heart surgery is what most people think of when they hear someone say heart surgery. Your surgeon makes a 6-to 8-inch long incision in the middle of your chest and spreads your ribcage to reach your heart. Youll be connected to a heart-lung bypass machine, so your heart wont be beating during the surgery.
The length of traditional open-heart surgery varies based on whats being fixed. CABG surgery takes about three to six hours.
Off-pump bypass surgery
Off-pump bypass surgery is also called beating heart surgery. Its similar to traditional open-heart surgery, but you wont be on a heart-lung bypass machine. This method can only be used for CABG surgery. And its most suitable when only one or two coronary arteries need to be bypassed.
Minimally invasive surgery
Minimally invasive heart surgery is also called a keyhole surgery. This means your surgeon makes smaller incisions to access your heart.
A partial sternotomy involves a 3- to 4-inch incision through part of your sternum . A mini-thoracotomy avoids your breastbone and instead uses small cuts between your ribs.
What Is The Survival Rate Of Heart Surgery
Heart surgery survival rates vary based on the type of surgery and how many problems are repaired during the operation. Survival rates are:
- Mitral valve repair for mitral valve prolapse: 100%.
- Aortic valve replacement: 98.1%.
- Coronary artery bypass surgery : 97.8%.
Heart surgery is generally riskier for people who are very ill or have other medical conditions.
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What Happens After The Procedure
After the procedure you will wake up in a hospital ward called the recovery area. When you are completely awake you will be transferred to the normal hospital ward. You will have to lie flat for approximately 4- 6 hours after the procedure. During this time, it is important to keep your legs straight and your head relaxed on the pillow. You will have a compression clamp on the groin area which stays in place for 4-6 hours. You will need to stay in hospital overnight after the procedure connected to the heart monitor. You will be reviewed by the Arrhythmia team the following day prior to your discharge.
Whilst in hospital you will either continue your blood thinning medications or commence blood thinning injections.
It is common to have a sore throat and some mild chest discomfort after the procedure. You will also have some discomfort and bruising in the groin after the procedure. This should usually improve over several days. Because it takes several weeks for the areas of ablation to heal and form scars, it is not uncommon to experience abnormal or irregular heart beat or rhythm for up to 4 weeks after the procedure.It is important that you monitor your groin for signs of bleeding and have adequate rest at home to help recover.
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Care Of Your Incisions
As you heal, your incision will look better and the soreness will go away. Changes in the weather, too much or too little activity and sleeping in one position too long may cause increased soreness. You may also feel numbness or itching or see redness or swelling, which will also stop with time. To care for your incisions, we suggest:
- Wash gently with mild soap during your daily shower. Dry carefully with a towel. Pat it dry Do not rub the incision.
- If you have small pieces of white tape over your incision, you must remove them after you have been home for seven days. If the strips come off on their own, you may leave them off.
- If your incisions are puffy, have areas of redness, are oozing, or begin to open slightly, call your surgeon.
- Women should wear a bra. A good support bra will reduce the tension placed on the incision. If the bra bothers you, you may put a small piece of gauze under the bra for added comfort.
- For discomfort or soreness, you may use a heating pad. Apply it four or five times per day on the low setting for about 20 minutes each time. If needed, take pain medication prescribed by your doctor.
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