There are four types of cardiac valves that control the flow of blood to and fro the heart. Over a period of time, the heart valves may get diseased or damaged because of several reasons. A reduction in the functioning of the valves can cause serious complications.
The aortic and the mitral valve are most commonly affected by the heart valve disease. Aortic valve replacement (AVR) and mitral valve replacement (MVR) are the two types of valve replacement surgeries in which the diseased aortic or the mitral valve are replaced. Sometimes, both the valves are replaced in the same surgery. Such a surgery is known as double valve replacement surgery.
Types of Valves
The following types of valves may be used to replace the diseased or damage valve:
Tissue valves: These valves are created from animal tissue, wither heart valve tissue or pericardial tissue. These types of tissue valves reduce the risk of rejection and calcification. In some of the cases, a homograft may be used to replace the diseased valve. The homograft is either retrieved from a deceased donor or the patient’s own pulmonary valve.
Mechanical valves: These are made up of flexible and durable material and they tend to last for an entire lifetime of the patient. However, there is an increased risk of blood clotting in patients who receive mechanical valves. This is the reason why they may have to take blood-thinners for their entire life.
Immediately after the procedure, the patient is shifted to intensive care for at least 12 to 36 hours. This is followed by a day or two of hospital stay. The patient is discharged after four to six days of the surgery. Total recovery may take around four to six months.
Heart valve diseases occur due to improper functioning of the valves. Sometimes a valve does not open or does not close proper. In this condition, the blood does not flow properly and requires valve replacement. The important valves present in human body are aortic valve, mitral valve, tricuspid valve and pulmonary valve. If a valve cannot be repaired, then a heart valve replacement surgery is performed.
Heart valve replacement surgery is the replacement of heart valves with artificial valves or bioprosthesis. It is an alternative treatment to valve repair.
Valve replacement includes four procedures:
The aortic valve and the mitral valve replacements are the most common. Pulmonary and tricuspid valve replacements are uncommon in adults.
Aortic valve replacement (AVR)
It is a procedure in which a diseased aortic valve is replaced with an artificial heart valve. Many diseases affect the aortic valve; the valve can either become leaky or partially blocked. Recent aortic valve replacement procedures include open-heart surgery via a sternotomy, minimally invasive cardiac surgery (MICS) and transcatheter aortic valve replacement (TAVR).
Surgical procedure- In Aortic valve replacement the incision is made by cutting through the sternum. After the pericardium is opened, the patient is put on a cardiopulmonary bypass machine, which is also known as the heart-lung machine. This machine performs the task of breathing for the patient and pumping their blood around while the surgeon replaces the heart valve.
The surgeon makes a cut in the aorta when the patient is on bypass and applies a crossclamp. The patient's diseased aortic valve is removed and is replaced by a mechanical or tissue valve. After the placement of artificial valve and closing the aorta, the heart-lung machine is taken off from the patient. A transesophageal echocardiogram helps to confirm whether the new valve is functioning properly.
Surgical procedure- General anaesthesia is given to the patient before mitral valve replacement. Incision is made horizontally under the left breast, or vertically through the sternum. After exposing the heart, cannula is placed and blood is directed to the heart-lung machine for cardiopulmonary bypass. The mitral valve is exposed by creating an incision in the left atrium. Then the valve is replaced. Left atrium is closed and cardiopulmonary bypass is removed. The patient is taken to an intensive care unit after the surgery.
The most common complication after mitral valve replacement is atrial fibrillation. The other complications are bleeding and infection.
The patient can engage in his or her normal activities again. The replaced new valve will help the heart to function more efficiently.
Blood clot formation can occur after surgery. These clots move to the lungs and cause shortness of breath and chest pain. Arrhythmias or abnormal heart beats can happen after surgery.
Regular check-ups from a heart specialist is required after the surgery. The patient is instructed good diet and regular exercise in the follow up appointments.
Pro’s of mechanical valves-
Con’s of mechanical valves-
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