Center Valve Repair or Replacement Surgery

The centre is a pump made of muscle tissue. Information technology has 4 pumping chambers: ii upper chambers, chosen atria, and 2 lower chambers, called ventricles. Valves between each of the centre's pumping chambers keep blood flowing forward through the heart.

ACardio_20140402_v0_004

  • Tricuspid valve.Located between the right atrium and the correct ventricle
  • Pulmonary valve.Located between the right ventricle and the pulmonary artery
  • Mitral valve.Located between the left atrium and the left ventricle
  • Aortic valve.Located between the left ventricle and the aorta

When valves are damaged or diseased and exercise non work the way they should they may need to exist repaired or replaced. Weather condition that may cause heart valve dysfunction are valve stenosis (stiffness) and valve regurgitation (leaky valve).

ACardio_20140402_v0_003

When one (or more) valve(s) becomes stenotic (strong), the center has to piece of work harder to pump the blood through the valve. Valves can go narrow and stiff from infection (such equally rheumatic fever or staph) and aging. If one or more valves get leaky, blood leaks backwards, which means less blood is pumped in the right management. Based on your symptoms and the overall condition of your heart, your healthcare provider may decide that the diseased valve(due south) needs to be surgically repaired or replaced.

Traditionally, open-heart surgery is used to repair or replace heart valves. This means that a big incision is made in the breast and the heart stopped for a time so that the surgeon tin can repair or supersede the valve(s). Newer, less invasive techniques accept been adult to replace or repair middle valves. Minimally invasive procedures make smaller incisions, and mean less hurting afterward and shorter hospital stays.

The diseased valve may be repaired using a ring to support the damaged valve, or the entire valve may be removed and replaced past an artificial valve. Artificial valves may be made of carbon coated plastic or tissue (made from creature valves or human valves taken from donors). You and your healthcare provider volition talk about the pros and cons of each blazon and what might be all-time for y'all.

Why might I need heart valve repair or replacement surgery?

Valve repair or replacement surgery is washed to correct the problems caused by one or more diseased heart valves.

If your centre valve(due south) becomes damaged or diseased, you lot may have the post-obit symptoms:

  • Dizziness

  • Chest pain

  • Breathing difficulties

  • Palpitations

  • Edema (swelling) of the feet, ankles, or abdomen (belly)

  • Rapid weight gain due to fluid retention

There may exist other reasons for your healthcare provider to recommend heart valve repair or replacement surgery.

What are the risks of eye valve repair or replacement surgery?

Possible risks of heart valve repair or replacement surgery include:

  • Bleeding during or after the surgery

  • Blood clots that tin crusade heart assail, stroke, or lung problems

  • Infection

  • Pneumonia

  • Pancreatitis

  • Breathing bug

  • Arrhythmias (abnormal heart rhythms)

  • The repaired or replaced valve doesn't work correctly

  • Death

In that location may exist other risks depending on your specific medical status. Be sure to hash out any concerns with your healthcare provider before the procedure.

How exercise I get ready for eye valve repair or replacement surgery?

  • Your healthcare provider will explain the procedure and y'all can enquire questions.

  • You will be asked to sign a consent form that gives your permission to do the surgery. Read the grade advisedly and ask questions if anything is unclear.

  • Along with a complete medical history, your healthcare provider may do a complete physical exam to make sure that yous are in otherwise adept health before surgery. You may demand claret tests or other diagnostic tests.

  • Yous will exist asked to fast (non eat or drink) for viii hours earlier the process, generally after midnight.

  • If you are pregnant or think you could exist, tell your healthcare provider.

  • Tell your healthcare provider if you are sensitive to or are allergic to whatever medicines, iodine, latex, tape, or anesthetic agents (local and general).

  • Exist sure your healthcare provider knows about all medicines (prescription and over-the-counter), vitamins, herbs, and supplements that you are taking.

  • Tell your healthcare provider if y'all have a history of bleeding disorders or if y'all are taking any anticoagulant (blood-thinning) medicine, aspirin, or other medicines that affect blood clotting. You may be told to stop some of these medicines before surgery.

  • Your healthcare provider may do a blood exam before surgery to run into how long information technology takes your blood to jell.

  • Tell your healthcare provider if you have a pacemaker or any other implanted cardiac devices.

  • If you smoke, stop smoking as soon equally possible. This improves your chances for a successful recovery from surgery and benefits your overall health status.

  • Based on your medical condition, your healthcare provider may request other specific preparation.

What happens during center valve repair or replacement surgery?

Heart valve repair or replacement surgery requires a stay in a infirmary. Procedures may vary depending on your condition and your healthcare providers practice.

Generally, open up-heart valve repair or replacement follows this procedure:

  1. You volition be asked to remove any jewelry or other objects that may interfere with the procedure.

  2. You will change into a hospital gown and empty your bladder.

  3. The surgical team will position you on the operating table, lying on your back.

  4. A healthcare professional will start an intravenous (Four) line in your arm or paw for injection of medicine and to give Four fluids. More catheters will be put in blood vessels your neck and wrist to monitor the condition of your heart and claret pressure, and to take claret samples.

  5. The anesthesiologist will continuously monitor your centre rate, blood pressure, breathing, and blood oxygen level during the surgery.

  6. Your doc will put a breathing tube through your mouth into your lungs and connect you to a ventilator, a automobile that volition breathe for you during the surgery.

  7. Your doc will place a transesophageal echocardiogram (TEE) probe into your esophagus (swallowing tube) and so he or she can monitor the function of the valves.

  8. A soft, flexible tube (called a Foley catheter) will be put into your bladder to drain urine.

  9. A tube will be put through your mouth or nose into your stomach to drain breadbasket fluids.

  10. Someone on the surgical team will clean the skin over your chest with an antiseptic solution. If there is a lot of hair at the surgical site, it may be shaved off.

  11. If yous are having an open-eye surgery, your healthcare provider volition make an incision (cut) down the center of the chest from just below the Adam'southward apple to just higher up the navel. If you are having a less invasive process information technology may require smaller incisions.

  12. The sternum (breastbone) will exist cut in half lengthwise. The healthcare provider volition separates the halves of the breastbone and spread them apart to expose your heart.

  13. To do the valve repair or replacement, your doctor must stop your center. He or she will put tubes into the heart so that the claret can exist pumped through your trunk by a heart-lung bypass automobile while your heart is stopped.

  14. In one case the claret has been completely diverted into the bypass auto for pumping, your doc will terminate your heart by injecting information technology with a cold solution.

  15. When the heart has stopped, your doc volition remove the diseased valve and put in the bogus valve, in the example of a valve replacement. For a valve repair, the process done will depend on the blazon of valve problem you take, for example, your physician may separate fused valve leaflets, repair torn leaflets, or reshape valve parts to ensure better function.

  16. Once the surgery is done, your doctor will stupor your center with small paddles to restart your heartbeat. Next, he or she will let claret circulating through the bypass machine to re-enter your eye and remove the tubes to the machine.

  17. Once your heart is beating again, your md will sentinel information technology to see how well the middle and valves are working and exist sure that there are no leaks from the surgery.

  18. Your doctor may put wires for pacing into your heart. He or she can attach these wires to a pacemaker outside your body for a short time and your heart tin can exist paced, if needed, during the initial recovery flow.

  19. Your md will rejoin the sternum sewing it together with small-scale wires (like those sometimes used to repair a broken bone).

  20. Your doctor will put tubes into your chest to bleed blood and other fluids from around the heart.

  21. Your doctor will sew the skin over the sternum back together and close the incision with sutures or surgical staples.

  22. A member of the surgical team will apply a sterile bandage or dressing.

What happens after center valve repair or replacement surgery?

In the hospital

After the surgery, a member of the surgical squad will take you to a recovery room and later the intensive care unit (ICU) to be closely monitored for several days. A nurse volition connect yous to machines that will constantly brandish your electrocardiogram (ECG) tracing, blood pressure, other force per unit area readings, breathing rate, and your oxygen level. Open-heart valve repair or replacement surgery generally requires an in-infirmary stay of several days or longer.

Yous will nigh likely have a tube in your pharynx that's connected to a ventilator to help yous breath until you lot are stable enough to breathe on your own. Every bit you wake upwards from the anesthesia more and start to breathe by yourself, your doctor can arrange the breathing machine to allow you to take over more of the breathing. When you are awake enough to breathe completely by yourself and are able to cough, your medico volition remove the breathing tube. He or she may also remove the stomach tube at this time.

After the breathing tube is out, a nurse will assistance you lot coughing and take deep breaths every couple of hours. This will be uncomfortable due to soreness, but it is very important that you do this to continue fungus from collecting in your lungs and perchance causing pneumonia. Your nurse will testify you how to hug a pillow tightly against your chest while cough to assistance ease the discomfort.

You will get pain medicine if you are hurting. Ask for the medicine earlier you become extremely uncomfortable.

You may exist on IV (intravenous) medicines to help your blood pressure and your heart and to control any problems with haemorrhage. Equally your condition stabilizes, your doctor will gradually decrease then finish these medicines. He or she will likewise remove any pacing wires in your center you may have.

One time your doc has removed the animate and tum tubes and you are stable, you may offset to drink liquids. You tin can start eating more solid foods every bit soon as you lot can tolerate them.

When your healthcare provider decides that you lot are set up, you volition be moved from the ICU to a surgical unit or acute care unit of measurement. Your recovery will continue there. Your activity will be gradually increased as y'all exit of bed and walk around for longer periods.

A member of your healthcare squad volition conform for you to go home and schedule a follow-upwardly visit with your healthcare provider.

At home

Once you are domicile, it volition be important to keep the surgical area clean and dry out. Y'all volition be given specific bathing instructions. Your dr. volition remove the sutures or surgical staples during a follow-up part visit, if they were non removed before leaving the infirmary.

Do not drive until your healthcare provider tells you it'due south OK. Other activity restrictions may employ.

Tell your healthcare provider right away if you have whatsoever of these:

  • Fever of 100.4°F (38°C) or higher, or chills (these may be a sign of infection)

  • Redness, swelling, bleeding, or drainage from the incision site or any of the catheter sites

  • Increase in pain around the incision site

  • Trouble animate

  • Increased swelling in the legs or abdomen

  • Easy bruising

  • Persistent nausea or vomiting

  • Rapid or irregular pulse

  • Weakness in the arms and legs

Your healthcare provider may give y'all other instructions afterward the procedure, depending on your state of affairs.

Health care workers discussing

Your thoughts affair to us. Join our customs today.

Johns Hopkins Medicine Virtual Advisors (Virtual Advisors) is a grouping of individuals who share their insights near the Johns Hopkins intendance experience. One to two times per month, Virtual Advisors receive a link to short, interactive surveys. All responses are confidential.