“All you need to know about Valve Replacement”
— Get Well in India
Heart valve replacement is a procedure to repair or replace the diseased or damaged heart valve. In some cases, it is an open heart operation. This means that the surgeon opens your chest and heart to remove the damaged valve. The new artificial (prosthetic) valve is then put into the heart. In some cases, the valve can be replaced without opening the chest.
The heart is a pump that circulates blood throughout the body. It is made up of muscles tissue. It has four pumping chambers: two upper chambers, called Atria, and two lower chambers, called Ventricles. To keep the blood flowing forward during its journey through the heart, there are valves in between each of the heart’s pumping chambers.
There are four valves in the heart:
- Aortic valve: Located between the left ventricle and the aorta. It separates left ventricle and the aorta.
- Mitral valve: Located between the left atrium and the left ventricle. It controls the blood flow between left atrium and left ventricle.
- Tricuspid valve: Located between the right atrium and the right ventricle. It controls the blood flow between right atrium and the right ventricle.
- Pulmonic valve: Located between the right ventricle and the pulmonary artery, the blood vessel that carries blood from heart to the lungs.
The aim of each valve in the heart is flowing of blood through the heart in the correct direction. If one or more of your valves is damaged, it can affect the blood flows through your heart in two ways:
- If the valve is not opening fully, it will restrict the blood flow. This is called valve stenosis or narrowing.
- If the valve is not closing fully, it will allow blood to leak backwards. This is called valve incompetence, or regurgitation, or a leaky valve.
Blood that flows between different chambers of your heart must flow through a heart valve. Blood that flows out of your heart into large arteries must also flow through a heart valve.
It’s been seen that replacing aortic valve and repairing mitral valve is the most common. However, repairing or replacing the tricuspid valve or the pulmonic valve is rare.
Many people with heart valve issues does not always need a treatment. However, if your doctor suggests you to have a surgery on your valve, it can greatly improve your symptoms and quality of your life.
Dr. Anvay Mulay
Dr. Devi Shetty
Valve replacement surgery is needed if you have the following symptoms:
- Chest pain
- Breathing difficulties
- Edema (or swelling) of the feet, ankles, or abdomen
- Rapid weight gain due to fluid retention
For diagnosis, your doctor will review your signs and symptoms, go through your medical history, and conduct a physical examination. Your doctor will check your heart with a stethoscope to see if there is a heart murmur which means an aortic valve condition. Your doctor will ask you to do several tests to diagnose your condition and determine the cause and severity of your condition. Tests such as:
- Echocardiogram: This test uses sound waves to produce video images of your heart in motion. During this test, the specialist will hold a wandlike device (transducer) on your chest. This test will evaluate your heart chambers, the aortic valve and the blood flow through your heart.
- Electrocardiogram (ECG): In this test, the electrical activity of your heart is measured through wires (electrodes) attached to pads on your skin. An ECG can detect enlarged chambers of your heart, heart disease and abnormal heart rhythms.
- Chest X-ray: A chest X-ray can also help doctors determine the condition of your lungs. It can also determine if your heart is enlarged, which can happen in aortic valve stenosis.
- Exercise tests or stress tests: It determines if you have symptoms of aortic valve disease during physical activity.
- Cardiac computerized tomography (CT) scan: A cardiac CT scan uses a series of X-rays to create detailed images of your heart and heart valves.
- Cardiac MRI: A cardiac MRI uses magnetic fields and radio waves to create detailed images of your heart. This test may be used to determine the severity of your condition and evaluate the size of your aorta.
Stages & Treatment Details
Aortic Valve Replacement: The aortic valve is on the left side of the heart and serves as an efflux valve. Its aim is to allow blood to leave the left ventricle, which is the heart’s main pumping chamber and then close so that blood doesn’t leak back into the left ventricle. If you have a defect or disease that causes stenosis or regurgitation on your aortic valve, you may need a surgery in that case.
The most common type of abnormality is a bicuspid valve. The aortic valve, in general, has three sections of tissue, known as leaflets, also called a tricuspid valve. A defective valve has only two leaflets, so it’s called a bicuspid valve.
Mitral Valve Replacement: The mitral valve is located on the left side of the heart. It serves as an influx valve. Its aim is to allow blood from the left atrium to flow into the left ventricle. If the valve doesn’t fully open or completely close, then surgery may be required.
When the valve is too narrow, the blood cannot enter properly causing it to move backwards and so putting pressure in the lungs. When the valve doesn’t close properly, the blood can leak back into the lungs. This can happen due to a congenital defect, infection, or a degenerative disease.
The defective valve will be replaced with either a metal artificial valve or a biological valve. The metal valve will last a lifetime but requires you to take blood thinners. The biological valve lasts between 15 to 20 years, and you won’t be required to take medication that thins your blood.
After your surgery, you will need regular blood tests. Avoid lifting weight more than 10 pounds, or pushing or pulling activities with your arms. You will take 6-8 weeks to heal generally.
While bathing, showers are permitted but tub baths are discouraged for 4-6 weeks or until your incisions are healed. Avoid extremely hot water which may cause you to feel dizzy or weak.
Avoid driving a car for 4-6 weeks after surgery. Your reaction time will be delayed due to weakness, fatigue, and/or medication.
Do not cross your legs while lying in bed or sitting. This puts pressure on the veins under the knees and slows blood flow.
Take proper rest throughout the day for complete healing. Don’t get tired or breathless. Take your time to do things. Pace your activities to minimize fatigue. If you feel tired, rest for a while. Don’t push yourself to finish a task.
It is important to distinguish incisional discomfort from chest pain (angina). Contact your physician if you are experiencing chest pain.
Drink plenty of water and take a good diet, medications, and exercise.
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