Valve Replacement/Repair Surgeries

Blood is pumped through your heart in only one direction. Heart valves play a key role in this one-way blood flow, opening and closing with each heartbeat. Pressure changes on either side of the valves cause them to open their flap-like “doors” (called cusps or leaflets) at just the right time, then close tightly to prevent a backflow of blood.

There are 4 valves in the heart

  • Tricuspid
  • Pulmonary
  • Mitral
  • Aortic

These valves are on the left side of the heart, which works harder than the right. They control the flow of oxygen-rich blood from the lungs to the rest of the body. If valve damage is mild, doctors may be able to treat it with medicines. If damage to the valve is severe, surgery to repair or replace the valve may be needed.

What is valve repair?

Valve repair can usually be done on congenital valve defects (defects you are born with) and has a good success record with treating mitral valve defects.

Here are some procedures surgeons may use to repair a valve:

  • Commissurotomy is used for narrowed valves, where the leaflets are thickened and perhaps stuck together. The surgeon opens the valve by cutting the points where the leaflets meet.
  • Valvuloplasty strengthens the leaflets to provide more support and to let the valve close tightly. This support comes from a ring-like device that surgeons attach around the outside of the valve opening.
  • Reshaping is done when the surgeon cuts out a section of a leaflet. Once the leaflet is sewn back together, the valve can close properly.
  • Decalcification removes calcium buildup from the leaflets. Once the calcium is removed, the leaflets can close properly.
  • Repair of structural support replaces or shortens the cords that give the valves support (these cords are called the chordae tendineae and the papillary muscles). When the cords are the right length, the valve can close properly.
  • Patching covers holes or tears in the leaflets with a tissue patch.

What is valve replacement?

Severe valve damage means the valve must be replaced and most often involves the aortic or mitral valve. It is also used to treat any valve disease that is life-threatening. Some patients may need more than one valve repaired or replaced.

Two kinds of valves can be used for replacement:

  • Mechanical valves are usually made from materials such as plastic, carbon, or metal. Mechanical valves are strong, and they last a long time. Because blood tends to stick to mechanical valves and create blood clots, patients with these valves will need to take blood-thinning medicines (called anticoagulants) for the rest of their lives.
  • Biological valves are made from animal tissue (called a xenograft) or taken from the human tissue of a donated heart (called an allograft or homograft). Sometimes, a patient’s own tissue can be used for valve replacement (called an autograft). Patients with biological valves usually do not need to take blood-thinning medicines. These valves are not as strong as mechanical valves, though, and they may need to be replaced every 10 years or so. Biological valves break down even faster in children and young adults, so these valves are used most often in elderly patients.