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Heart Valve Repair and Heart Valve Replacement Surgery

written by: Finn Orfano • edited by: Emma Lloyd • updated: 4/5/2011

Heart valve repair and heart valve replacement surgery is required when a person has a valve defect or when damage is present. Learn the different types of replacement and repair procedures and what they consist of.

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    The heart valves play a important role in pumping blood through your heart. This one-way blood flow is controlled by the opening and closing of flap-like doors that change the pressure on either side of the valves. This is a timely rhythm that helps prevent the backflow of blood.

    The heart has four valves: tricuspid, pulmonary, mitral, and aortic. All four valves are required in getting blood to where it needs to go. If there is a problem, heart valve replacement surgery may need to be performed.

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    Heart Valve Repair Surgery

    Heart valve repair is performed to repair congenital valve defects as well as mitral valve defects.

    Valvuloplasty: This surgery is used to strengthen the leaflets so they can provide more support and help to close tightly. The surgeon will insert a ring-like device that attaches around the outside of the valve opening.

    Commissurotomy: This surgery is performed when a patient has narrowed valves. The leaflets are thickened and may be stuck together. The surgeon opens the valves by cutting the points where the leaflets meat.

    Structural Support Repair: 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 correct length, the valve can close properly.

    Reshaping: This is where a surgeon may have to cut out a section of a leaflet. Once the leaflet is sewn back together, the valve will be able to close properly.

    Decalcification: This is the removal of calcium buildup from the leaflets. The calcium buildup can prevent the leaflets from closing properly. Once removed, the leaflets can close tightly.

    Patching: The surgeon will cover the holes or tears in the leaflets with a tissue patch.

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    Heart Valve Replacement Surgery

    If severe damage is present, heart valve replacement surgery is required. Valve replacement is used to treat aortic valves and severely damaged mitral valves.

    When severe damage is present, the valve will need to be replaced. Valve replacement can be used to treat valve disease that may be life threatening. More than one valve may be damaged in the heart, so it may be necessary for patients to have more than one repair or replacement.

    The two kinds of valves used for replacement include:

    Biological Valves: Biological valves are made from animal tissue; this is called a xenograft. They may also be taken from human tissue of a donated heart, in which case the graft is called an allograft or homograft. In some cases, a patient’s own tissue can be used for valve replacement (autograft). These valves are not as strong as mechanical valves and may need to be replaced after 10 years. Because they tend to break down faster in children and young adults, these types of valves are used in elderly patients. Patients with biological valves usually do not need to take blood-thinning medications.

    Mechanical Valves: These valves are made from materials such as plastic, carbon, or metal. Mechanical valves are strong and can last a long time. Because blood can stick to the mechanical valves and create clots, patients with these valves will need to be administered blood-thinning medicines, anticoagulants, for the remainder of their lives.

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    References

    Montefiore Medical Center: Heart Valve Replacement/Repair Surgery - http://montefiore.org/healthlibrary/centers/heart/prvsur01/

    Mayo Clinic: Heart Valve Surgery - http://www.mayoclinic.org/heart-valve-surgery/


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