What Is Heart Valve Repair or Replacement Surgery?
When heart valves become damaged or diseased, they may not function
properly. Conditions which may cause heart valve dysfunction are
valvular stenosis and valvular insufficiency (regurgitation).
When one (or more) valve(s) becomes stenotic (stiff), the heart
muscle must work harder to pump the blood through the valve. Some
reasons why heart valves become stenotic include infection (such as
rheumatic fever or staphylococcus infections) and aging.
If one or more valves become insufficient (leaky), blood leaks
backwards, which means that less blood is pumped in the proper
direction. The physician may decide that the diseased valve(s) needs
to be surgically repaired or replaced.
Traditionally, repair or replacement of heart valves has involved
open-heart surgery, which means that the chest is opened in the
operating room and the heart stopped for a time so that the surgeon
may repair or replace the valve(s). In order to open the chest, the
breastbone, or sternum, is cut in half and spread apart.
Once the heart is exposed, large tubes are inserted into the heart
so that the blood could be pumped through the body during the surgery
by a cardiopulmonary bypass machine (heart-lung machine). The bypass
machine is necessary to pump blood because the heart is stopped and
kept still while the surgeon performs the valve repair or replacement procedure.
Newer, less invasive techniques have been developed to replace or
repair heart valves. Minimally-invasive procedures in which the
incision is much smaller often mean less pain post-operatively and
shorter hospital stays. Valvuloplasty is another method that may be
used to treat valve stenosis in some cases.
The diseased valve may be repaired using a ring to support a
person's own valve, or the entire valve may be removed and replaced by
an artificial valve. Artificial valves may be mechanical (made of
metal or plastic) or tissue (made from animal valves or human valves
taken from cadavers).
Other related procedures that may be used to assess the heart include:
