Valve Repair and Replacement

What is heart valve repair or replacement surgery?

Heart valve repair or replacement surgery are treatment options for valvular heart disease. When heart valves become damaged or diseased, they may not function properly. Conditions that may cause heart valve dysfunction are valvular stenosis and valvular insufficiency (regurgitation).

When one or more valves becomes stiff, the heart muscle must work harder to pump blood through the valve. Some reasons why heart valves become stiff include infection (such as rheumatic fever or staphylococcus infections) and aging. If one or more valves become insufficient (leaky), blood leaks backward, which means less blood is pumped in the proper direction. The physician may decide the diseased valves must be surgically repaired or replaced.

Traditionally, heart valve repair or replacement involved open-heart surgery, which means the chest is opened and the heart stopped for a time so the surgeon may repair or replace the valves. To open the chest, the breastbone is cut in half and spread apart. Once the heart is exposed, large tubes are inserted into the heart so the blood can be pumped through the body during the surgery by a cardiopulmonary bypass machine (heart-lung machine). The bypass machine is necessary to pump blood because the heart is stopped and kept still while the surgeon performs the valve repair or replacement procedure.

Newer, less invasive techniques have been developed to replace or repair heart valves. Minimally-invasive procedures in which the incision is much smaller often mean less pain post-operatively and shorter hospital stays. Valvuloplasty is another method used to treat valve stenosis.

The diseased valve is repaired using a ring to support a person's own valve, or the entire valve may be removed and replaced by an artificial valve. Artificial valves may be mechanical (made of metal or plastic) or tissue (made from animal valves or human valves taken from cadavers).

Other related procedures used to assess the heart include:

  • Resting and exercise (ECG) electrocardiogram
  • Holter monitor
  • Signal-averaged ECG
  • Cardiac catheterization
  • Chest X-ray
  • Chest CT scan (computed tomography)
  • Echocardiography
  • Electrophysiological studies
  • Heart MRI (magnetic resonance imaging)
  • Myocardial perfusion scans
  • Radionuclide angiography
  • Ultrafast CT scan