What are the different kinds of replacement valves?

For replacing faulty valves of the heart, both biological tissue and mechanical valves are used. It is evident from the name that mechanical valves are artificial elements which have the same purpose as a natural heart valve. Usually polyester and carbon materials are used in these as the body accepts such materials well. The longevity of these valves is 10-20 years. The only risk associated with these valves is that of blood clots. When such a heart valve is implanted in the heart, one has to take blood thinning medicines for whole life for reducing the risk of stroke.

On the other hand, are biologic valves, which are also known as bio-prosthetic valves/tissue. These valves are created from animal or human tissues. These valves are of three kinds:

Homograft or allograft is made from the tissue, which is taken from the human donor heart.

Cow tissue is used for making bovine valve. Silicone rubber is used for connecting this valve with the heart.

Pig tissue is used for making porcine valve and this can be implanted without or with a frame (stent).

Risks of developing blood clots with biologic valves are minimal. Hence no need to take anti-clotting due to wear & tear phenomenon. However, these valves don’t have great longevity and might need quicker replacement.

Various factors are taken into consideration when it is decided which kind of heart valve will be most suitable for a patient. These are:

• Age of the patient
• Extent of the valve damage
• Overall health condition of the patient
• The ability of the patient of taking anticoagulant medications

What are the different kinds of valve repair/replacement surgeries commonly done?

Mitral Valve Replacement

Situated on the left side of the heart, the mitral valve functions as inflow valve. The main role of this valve is allowing blood from the left atrium to flow into the left ventricle. Surgery is recommended in case there is problem in total opening and closing of the valve. With narrowing of the valve, the entry of blood becomes hampered. The blood flows in backward direction and puts pressure on the lungs. Infact on improper closing of the valves, there are high chances of the blood leaking into the lungs. Biologic valve or an artificial valve is used for replacing such a damaged and defective valve. If mechanical artificial valve is implanted you will need blood thinners all throughout your life, but you will not need to replace the valve again. The survival rate for 5 years is 91%.

Aortic Valve Replacement

Located on the left side of the heart, the aortic valve works as an outflow valve. Its main function is allowing blood to leave the left ventricle, which is the main pumping chamber of the heart. It also maintains and controls that blood does not leak into left ventricle. For problems like stenosis or regurgitation or congenital issues, surgery of the aortic valve is needed.

A bicuspid valve is the most common congenital abnormality seen. There are three sections of tissues called leaflets in the aortic valve. This is known as tricuspid valve. However, when there is a defect, there are only two leaflets and hence known as bicuspid valve. Surgery of this valve has shown 94% 5-year survival rate.

Double Valve Replacement

When both the mitral and aortic valve need replacement, it is known as double valve replacement. The whole left side of the heart is operated. This is a rare kind of valve replacement.

What happens during valve replacement procedure?

General anesthesia is administered for heart valve replacement surgery. Depending on the kind of replacement needed, the implemented technique can be conventional or minimally invasive one. In case conventional surgery is done, there will be a larger incision made right from the neck to the navel area. However, in minimally invasive surgery, the length and extent of incision are shorter and hence the chances of infections are also lesser.

For removing the damaged valve and replacing the same with a new one, the heart should be still. The surgeon will place the patient on a bypass machine, which helps in maintaining the blood circulation all throughout the body. Not only this, the machine also helps in keeping the lungs functioning all throughout the surgery period. The incisions are made into the required cardiac chambers/vessels, via which the valves are removed and replaced. The risk of mortality is negligible in this kind of valve replacement surgery.

Recovering from heart valve replacement surgery

The hospital stay period of majority of heart valve replacement patients is for 5-7 days approximately. If the surgery is minimally invasive, the stay might be little shorter. Post the replacement process, vitals have to be monitored, which include heart function, breathing and blood pressure. Medicine for alleviating pain and discomfort is also administered.

Depending upon the kind of heart valve replacement surgery and the rate of healing, complete recovery might take few weeks to few months. The main risk with these surgeries is that of infection; as a result the incision areas have to be kept clean and sterile as much as possible. If you experience chills, fever, swelling or tenderness at the incision area or more drainage from the incision site consult your doctor immediately. Never take the follow up treatment easy and visit the doctor as asked. This will help the doctor in determining your condition for giving permission so that daily activities can be resumed. Proper rest and medications are the two most important things that must be followed after a heart valve replacement surgery.