Heart Valve Surgery - Valve Repair, Valve Replacement

Heart Valve Surgery

Heart Valve Surgery 

Heart valve surgery is performed for replacing or repairing a valve in the heart. The valve that is not working properly due to valvular heart disease (heart valve disease) is repaired or replaced. This surgery is also known as open-heart surgery and is a major operation that may last around two hours or even longer. Its recovery usually takes a few weeks. 

Types of Heart Valve Surgery

Heart valve surgery offers two options:

Valve Repair Surgery:

• Aimed at fixing a damaged or faulty valve while preserving a significant portion of the person's own tissue.
• Commonly applied to the mitral valve, but applicable to the aortic and tricuspid valves as well.

Valve Replacement Surgery:

• Involves the removal of the defective valve, replaced by either biological (from pig, cow, or human tissue) or mechanical (made of metal or carbon) valves.
• All valve replacements are biocompatible, ensuring compatibility with the immune system to prevent rejection.

Prior to surgery, various tests are conducted to identify the location, type, and extent of valve disease, aiding in the selection of the most suitable procedure.

Additional considerations include:

• Assessment of the heart's structure.
• Consideration of the patient's age.
• Evaluation of other existing medical conditions.
• Understanding the patient's lifestyle.

Cardiac surgeons may integrate valve surgery with other heart procedures, such as those involving multiple valves or combining valve surgery with:

• Bypass surgery.
• Aortic aneurysm surgery.
• Procedures addressing atrial fibrillation.

What are the advantages of Heart Valve Surgery?

Heart valve surgery has the potential to alleviate symptoms, enhance life expectancy, and reduce the risk of mortality.

When comparing heart valve repair to valve replacement, the potential advantages are as follows:

• Reduced Risk of Infection:
  • Lower likelihood of developing infections after the surgery.
• Decreased Need for Lifelong Anticoagulant Medication:
  • A diminished requirement for long-term blood-thinning medication.

Both valve repair and valve replacement, which are the most frequently performed minimally invasive procedures, offer several benefits:

• Lower Infection Risk:
  • The procedure carries a reduced risk of post-surgical infections.
• Minimized Bleeding and Trauma:
  • Less bleeding and trauma are associated with the surgery.
• Shorter Hospital Stay:
  • Patients experience a shorter duration of hospitalization.
• Faster Recovery:
  • The recovery period is shorter following minimally invasive valve surgeries.

Risks of heart valve surgery

Every surgery carries inherent risks, and heart valve surgery is no exception. Potential risks associated with heart valve surgery include:

• Heart Attack: The occurrence of a heart attack during or after the surgery.
• Heart Failure: The possibility of heart failure as a complication.
• Abnormal Heart Rhythm: The potential need for a pacemaker due to irregular heart rhythms.
• Stroke: The risk of a stroke during or after the procedure.
• Infection: The likelihood of infection at the surgical site.
• Bleeding: The possibility of excessive bleeding during or after surgery.

Risk factors influencing these potential complications include:

• Age: The impact of age on the overall risk profile.
• Existing Medical Conditions: The presence of other health issues affecting the overall surgical risk.
• Number of Procedures in a Single Operation: The risk associated with multiple procedures performed in a single operation.

Before undergoing surgery, your cardiologist and surgeon will thoroughly discuss these risks with you. It is essential to be aware of the potential complications and make informed decisions regarding the procedure.

If you have undergone valve repair or replacement, there may be an increased risk of developing infective endocarditis. Although this risk is present in both repaired and faulty valves, your healthcare provider might prescribe antibiotics in certain situations, such as after dental work, to prevent endocarditis. Taking good care of your teeth can also contribute to reducing the risk of endocarditis.

When do the CARE Hospitals doctors decide to perform heart valve surgery? 

In a healthy heart condition, valves are responsible for controlling the blood flow and moving it in a single direction via the body and heart. If a valve does not work appropriately, blood flow is clogged within the blood vessels that are responsible for carrying oxygen. 

When your value has a minor problem, doctors may recommend some medications to treat the symptoms. If the condition of a patient is more severe, then valve repair or replacement is done via heart valve surgery to prevent further damage to the heart valve. 

How do CARE Hospitals perform heart valve surgery - valve repair and valve replacement? 

Heart valve repair in Hyderabad: The following are the various procedures used to repair heart valves depending on the patient's condition:

• Valvotomy - It is a non-surgical procedure that is performed to enlarge heart valves that have become narrow. It is considered to be a less invasive procedure as it is done with the help of a catheter. We also perform it with the help of a balloon. It is also referred to as valvuloplasty or balloon valvuloplasty.
• Annuloplasty - This is done when a patient has a leaky valve. At the base of the heart valve which is also known as the annulus, a fibrous ring is present. For repairing the annulus which has enlarged, sewing of sutures is done around the ring for making its opening small. A ring-resembling device is also connected around outside the opening of the valve to aid the value so that it is closed more tightly. 
• Commissurotomy - It is a treatment that our doctors recommend for valve tightening. The leaflets/flaps of the valve are cut for loosening the valve (only slightly). And it allows the blood to circulate smoothly. 

Heart valve replacement

When a heart valve is damaged, it requires surgery to replace it with a biological or mechanical valve. Age remains a deciding factor to opt for the type of valves. For older people, biological valves are preferred. Our doctors take this decision with your consent after discussing all the circumstances with you. 

Mechanical valves 

• The prime advantage of a mechanical valve is its durability, as it lasts longer. 

• Heart tissue is sewn to the value using a fabric ring. 

• Mechanical valves can result in blood clotting that may lead to stroke or heart attack. For preventing these clots, people opting for mechanical valves are recommended anticoagulants (blood-thinning medicines) for a lifetime.

• Childbearing women or people with a bleeding history may have big implications, so our doctors examine all the factors in advance. The people who are suggested blood thinners may also need routine blood-testing for measuring blood clotting tendency. 

• Biological valve replacement is also known as bioprosthetic or tissue valves that are made of animals or human donors. 

• Animal source valves, especially pigs or cows, are considered the same as the human heart. These are adjusted well, and these are minimal or not likely to build blood clots as compared to mechanical valves.

• Homograft or allograft are those human heart valves that are used from a donated heart and these are considered to be well-tolerated. These last longer as compared to animal valves. However, the use of a human valve is not so common. 

• Autografts are also valves that are taken from the own tissue of a human. A well-working pulmonary valve is used for replacing a damaged aortic valve. Further, replacement of the pulmonary valve is done with a donated valve. 

• Patients opting for biological valves are recommended for blood thinners for a short duration. For older patients, these are considered durable for the aortic position. 

Transcatheter aortic valve implantation (TAVI) is also known as transcatheter aortic valve replacement (TAVR). This is a minimally invasive surgical valve replacement process that is performed for treating symptomatic aortic valve stenosis. It is different from conventional valve replacement surgery. 

• A catheter is inserted by our surgeons with a collapsible and new aortic valve via small incisions in the chest or groin. 

• With the use of chest x-rays and ultrasound, the catheter is used for correcting heart position, and a fresh valve is expanded and implanted. 

• Once the fresh valve is placed perfectly, it quickly starts controlling blood circulation. 

• People opting for TAVI get the faster recovery and short stays at hospitals. It is recommended for those who have complications from open-heart surgery. 

Why choose CARE Hospitals in India?

At CARE Hospitals, patients are privy to state-of-the-art infrastructure and skilled doctors who guide the patients not only through the Heart Valve Replacement in Hyderabad but also regarding lifestyle changes, exercise regime, and food habits,  improving the quality of their life.