Valve surgery is a type of cardiac surgery that involves the repair or replacement of one or more heart valves. Heart valves are essential structures that regulate the flow of blood through the heart, ensuring that blood flows in one direction. There are four heart valves in the human heart: the aortic valve, mitral valve, tricuspid valve, and pulmonary valve.
Valve surgery may be necessary when heart valves become damaged or diseased, leading to conditions such as stenosis (insufficient opening) or regurgitation (insufficient closing). Here are the key points about valve surgery:
Indications for Valve Surgery
Valve surgery is recommended when a heart valve condition becomes severe and is causing significant symptoms or complications. Symptoms are predominanatly chest pain, shortness of breath and palpitations. Complications include atrial fibrillation, stroke and recurrent episodes of heart failure.
Types of Valve Surgery:
– Valve Repair: In some cases, the damaged valve can be repaired rather than replaced. Valve repair is typically preferred when the valve can be effectively restored without the need for replacement. It often involves techniques to reshape, tighten, or reconstructing the valve’s components.
– Valve Replacement: When a valve is too damaged to be repaired or when repair is not feasible, the valve is replaced with either a mechanical valve (made of durable materials like metal or plastic) or a biological valve (usually made from animal tissue or a human donor’s valve). The choice of valve replacement depends on various factors, including the patient’s age, lifestyle, and medical history. Dr.Nikhil says, “Mechanical valves are usually for younger people since they can theoretically last forever. But strong blood thinners have to be consumed for them to work. Tissue valves do not need strong blood thinners, but is for older people because they usually last for only around a decade.”
MICS – Minimally Invasive Cardiac Surgery (keyhole surgery)
Valve surgery can be performed using smaller incisions and specialized instruments, often resulting in shorter hospital stays and faster recovery.
Transcatheter Valve Treatments (TAVR/TAVI/MitraClip):
This is also called Incision-less valve surgery. Instead of making incisions on the chest the surgeon inserts a catheter into a blood vessel and threads it through to the heart, guided by X-ray and echocardiography. The new artificial aortic valve is compressed and mounted on a catheter. It is positioned within the existing aortic valve.The new valve is deployed using a balloon or a self-expanding mechanism. It pushes aside the diseased valve leaflets and takes over the function of the aortic valve, allowing for better blood flow.
Recovery and Rehabilitation:
Recovery after valve surgery can vary depending on the type of surgery and the individual’s overall health. After surgery, patients typically spend a few days in the hospital for recovery. Full recovery usually takes 6-8 weeks, depending on the individual and the complexity of the procedure. MICS and Robotic patients usually recover in 3-4 weeks time. Incision-less valve surgery recovery is 3-4 days. Cardiac rehabilitation is often recommended to help patients regain their strength and improve cardiovascular health.
Valve surgery can effectively correct heart valve conditions, relieve symptoms, and improve the overall function of the heart. Successful valve surgery can lead to a better quality of life and, in some cases, increased life expectancy.
Valve surgery is a major surgical procedure and carries certain risks, including infection, bleeding, blood clots, complications related to anesthesia, and, in some cases, the need for future valve surgery or intervention. These risks are the same regardless of how the procedure is done.
Dr.Nikhil says, “A Heart specialist who is well versed with medical, surgical and trans-catheter options is the best person who can guide you on treatment”.