AVR MVR Surgery : Top Frequently Asked Questions

1.  Am I a candidate for AVR MVR surgery?

Heart valves that are damaged or not working properly are replaced through cardiac procedures called AVR (aortic valve replacement) and MVR (mitral valve replacement). Here are some general factors to consider:

• Heart Valve Condition: Severe valve stenosis (narrowing) or regurgitation (leakage) are common reasons for valve replacement. These conditions can cause symptoms like exhaustion, shortness of breath, and heart failure.
• Symptoms: Surgery may be considered to improve your prognosis and quality of life if your heart valve disease is causing severe symptoms that aren’t being treated by medicine.
• Assessment: To determine the severity of your valve disease, gauge your overall cardiac function, and find any further underlying heart issues, this examination may involve tests such as echocardiography, cardiac catheterization, electrocardiography (ECG or EKG), and imaging studies.
• Overall Health: Several factors will affect the decision-making process, including your age, the existence of other medical disorders (such as diabetes, hypertension, or kidney disease), and your tolerance for anesthesia and operation.
• Benefits and risks: Although valve replacement surgery can help many patients feel better, there are risks associated with it as well, including the possibility of bleeding, infection, stroke, and anesthesia-related adverse effects.

Ultimately, the choice to have an AVR or MVR is very personal and should be made in consultation with your medical team after a full evaluation of your heart condition, symptoms, and general health.

2. Is AVR MVR done as an open heart or laparoscopic surgery?

Yes, it can be done in both ways. The exact heart disease of the patient, general health, and the surgical team’s experience and preferences all play a role in the surgical approach that is adopted.

Open cardiac surgery: During open heart surgery, the patient’s chest is cut open via a midline incision, exposing the heart and giving the surgeon immediate access to the damaged valve or valves. Complex valve disease, major repairs, combined treatments involving several valves, or other cardiac procedures may need open-heart surgery.

Minimally Invasive Surgery: Smaller incisions and specialized tools are used in minimally invasive techniques like laparoscopic or thoracoscopic surgery to access the heart valves. Small incisions are made in the chest or belly for laparoscopic AVR or MVR surgery, and a camera and surgical instruments are placed through these incisions to access the heart.

3. What are the types of replacement cardiac valves available?

The ideal replacement valve functions smoothly and integrates with the complete circulatory system.

• Mechanical Valve: Strong, long-lasting materials are used to make these valves. They are the most durable type of valve replacement as they are made from titanium, carbon, or other strong materials. Most endure for the whole of a patient’s life. Patients who are fitted with a manufactured valve are likely to have to take blood thinners for the rest of their lives.
• Bioprosthetic Valve: Bioprosthetic valves can be manufactured from synthetic materials coated with biological tissue, or from biological tissues such as human donor valves (homografts or allografts) or animal valves (porcine or bovine xenografts). Since bioprosthetic valves do not require continuous anticoagulation therapy, they are a popular choice among patients, especially those who are elderly or have other medical conditions that prevent the use of anticoagulation.
• Tissue Valve: Animal tissue that is strong and flexible, or the valves from donors, are used to make tissue valves. Tissue valves often don’t need to be taken on a long-term basis for medication, and they can last 10 to 20 years. A young patient who has had a tissue valve replacement may likely require follow-up surgery or another valve replacement in the future.

4. How long do these valves last?

Even though your heart functions better, it might not return to its original functioning. You may still experience cardiac issues even after having your valve replaced if your heart was previously functioning poorly. Mechanical valves generally do not wear out, they typically endure 20 years or longer. The bovine pericardial valve is expected to last for the rest of your life if you are over 60. However, Biological valves usually need replacement after ten years or so. But these valves often work normally for 15 to 20 years or maybe longer.

5. How long is the recovery period after the surgery?

Typically, you’ll have assistance getting out of bed the day following the surgery. Following your procedure, you should anticipate some discomfort, and you will be given painkillers. Although recovery periods vary depending on the type of surgery and the patient’s physiology, many people go home in a week or less.

A full recovery often takes two to three months, though this might vary since each person reacts to treatment differently.

6. How long does the surgery take?

A traditional heart valve replacement surgery usually takes two or more hours to complete.

7. What are the risks and benefits of AVR/MVR surgery?

The following are potential benefits:

• Lengthen your lifespan
• Reduced risk of infection
• Minimized need for long-term anticoagulant (blood-thinning) medications.
• Reduced trauma and bleeding.
• Lower your risk of death

In general, replacing or repairing valves is safe. However, complications may occur with every surgery or procedure. The possible risks are:

• Bleeding during or following medical treatment
• Blood vessel injury
• Blood clots that may result in lung difficulties
• Heart attacks, or strokes
• Infection at the site of the incision
• Endocarditis (an infection in the new valve that is more frequent after valve replacement).
• Pneumonia
• Breathing troubles
• Abnormal cardiac rhythms are known as arrhythmias
• Need for a permanent pacemaker
• Failure of a valve, which is more frequent when replaced
• Adverse anesthetic reaction

8. What are the important precautions that one needs to take after the surgery?

It is essential that you carefully read and understand any instructions that are provided to you while leaving the hospital.

• Drainage and Feeding Tube: A lot of patients are sent home with drains, IV lines, and feeding tubes, all of which need to be maintained. Possibly you may need to change the dressing on your wound.
• Many patients are unable to consume regular food or are not eating enough to maintain enough protein levels for healthy wound healing. Therefore, plans are made for you to get your meals via a feeding tube or a specialized IV known as a PICC tube (peripherally inserted central catheter).
• Adherence to Medication: As instructed by your healthcare practitioner, take all prescribed medications as advised, including anticoagulant or antiplatelet drugs for blood clot prevention, pain management, blood pressure control, and infection prevention.
• Limitations on Activities: As you become able, increase your activity level gradually and adhere to the recommendations of your healthcare practitioner regarding activity limits. Wait to lift heavy objects or do difficult tasks until your healthcare team gives the all-clear.
• Aftercare: Keep all of your scheduled follow-up appointments with your doctor to have your heart function monitored, have your medication adjusted, and have your recovery progress evaluated.
• Heart Rehabilitation: If your physician advises it, consider signing up for a cardiac rehabilitation program. You can learn heart-healthy lifestyle practices, progressively raise your tolerance to exercise, and get emotional support during your recovery with cardiac rehab.
• Monitoring symptoms: Any new or worsening symptoms, such as palpitations, dizziness, fainting, chest discomfort, or shortness of breath, should be noted and reported immediately to your healthcare professional.

9. What is the outcome of the AVR MVR surgery?

Variables such as the patient’s general health, the underlying cardiac problem, the type of valve replacement procedure used, and the expertise and experience of the surgical team, can affect how well an AVR (aortic valve replacement) or MVR (mitral valve replacement) surgery turns out.

Relieving symptoms related to heart valve disease, such as fatigue, exercise intolerance, shortness of breath, and chest pain, is one of the main objectives of AVR and MVR surgery.

• Survival statistics: Patients who receive AVR or MVR surgery before the onset of severe heart failure or considerable cardiac dysfunction typically have positive long-term survival statistics.
• Valve type: Despite their value for lifespan and robustness, mechanical valves necessitate lifelong anticoagulant medication. Particularly in younger patients, bioprosthetic valves may have a limited lifespan and may eventually need to be repaired or replaced.
• Quality of Life: By reducing symptoms, re-establishing normal cardiac function, and allowing patients to resume everyday activities, employment, and leisure activities, AVR and MVR surgery can considerably enhance the quality of life.
• Long-Term Follow-Up: Following AVR and MVR surgery, patients usually need lifelong follow-up treatment to monitor valve performance, evaluate heart function, control medication, and handle any problems or new difficulties.

10. How complicated is heart valve replacement surgery?

A defective or damaged aortic valve is removed during a replacement procedure, and a new valve consisting of synthetic materials or animal tissue is installed in its place. It’s a major procedure, and the recovery period may be lengthy.

11. What is the survival rate of heart replacement surgery?

Heart valve replacement surgery survival statistics are frequently used to estimate the amount of time patients may live after the procedure (5 years, 10 years, etc.). But these can be different for you based on age, general health, and heart function. Generally, the survival rates for the following are:

• Aortic valve replacement: 94% (5-year) and 84% (10-year)
• Mitral valve replacement: 64% (5-year) and 37% (10-year)

12. Are there any medications that I need to take after the surgery?

Depending on the type of surgery you have, you may require anticoagulant medication (blood thinners) following the procedure. The medication stops blood clots from forming and from damaging your heart valve.

13. How long does sternum pain last after open heart surgery?

Your chest muscles and breastbone will typically heal in six to eight weeks after you are discharged from the hospital and gradually get back to your regular activities.