Heart Valve Surgery: What to Expect

A healthy human heart is made up of four valves that help keep blood flowing in the proper direction. Each of these valves has flaps, which open and close for every heartbeat.

When these valves don’t open or close properly, the flow of blood through the heart and to the body is disrupted. To fix this, your doctor might recommend heart valve surgery—this is a surgery in which your surgeon either repairs or replaces the damaged valves.

Why It’s Done

Heart valve surgery can be done if your condition is severe, worsening or if you’re experiencing symptoms of valve dysfunction. Here’s what you can expect when discussing heart valve concerns with your doctor:

•Your doctor will evaluate you to determine the most effective treatment for your condition, which might just be monitoring over time if the condition is mild.
•Your doctor may recommend simple lifestyle changes or prescribe medications.
•Even if you’re not experiencing symptoms, your doctor may recommend a heart valve surgery. S/he may conduct surgery to replace or repair this valve during surgery for another heart condition.
•Doctors often recommend heart valve repair if possible—it preserves the valve, and possibly heart function. In some cases, though, a full replacement might be needed.
•You may also be a candidate for minimally invasive heart surgery, depending on your case.

Preparation

Your doctor will explain what to expect before, during and after surgery, and will discuss any concerns you may have. A few tips to prepare include:

•If advised by your doctor, speak to your family about your hospital stay and discuss help you might need when you return home.
•Talk to your doctor about any food or medication changes you should make in advance.
•Ask your doctor about any items you may need to bring, including loose clothing, personal care items and others. Also ask about items you should avoid, including jewelry, contacts, dentures or others.
•Talk to your doctor about any medication allergies or reactions you may have to medications used

During the Procedure

Most procedures go as follows:

You’ll be given an anesthetic and will be unconscious during the surgery.
You’ll be connected to a heart-lung bypass machine, which keeps blood moving.
Your surgery may be performed during open-heart surgery or can be done using minimally invasive heart surgery, which involves smaller incisions. Minimally invasive surgery might involve a shorter hospital stay, quicker recovery, and less pain.

If it’s possible, your doctor will recommend heart valve repair first, which is less invasive than full replacement and preserves the valve. Heart valve repair might include:

•Patching holes in a valve
•Reconnecting valve flaps
•Removing excess valve tissue to allow flaps to close tightly
•Replacing supportive cords
•Separating valve flaps that have fused together
•Tightening or reinforcing the ring around the valve (annulus)
•Balloon valvuloplasty: When a catheter with a balloon on the tip is inserted, and the balloon is inflated to expand the opening of a narrowed heart valve

If the heart cannot be repaired, valve replacement might be needed. Your doctor will remove the heart valve and replace it with a mechanical valve made from cow, pig or human heart tissue. You may have to take blood-thinning medications after this, possibly for the rest of your life. A minimally invasive catheter can be used here when possible.

Post-Surgery and Risks

Following heart valve surgery, you’ll generally spend at least a day in the intensive care unit of a hospital. You’ll be monitored and given fluid, nutrition and medications through IV lines. You may be given oxygen. After ICU, you’ll be moved to a regular hospital room for a few days. You’ll be instructed to walk regularly and gradually increase your activity level as you recover. When you leave the hospital, your doctor will give you instructions for recovery.

There are a few potential risks of heart valve surgery: