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Heart valve replacement

Heart valve replacement surgery is done to replace diseased (leaky or narrow) aortic or mitral heart valve. The replaced valve is either mechanical (made of plastic, metal or carbon) or made from animal tissue. Homo graphs- donated by human donor can be used too. Metal valves last longer and are stronger, compared to animal tissue valve.
Heart valve replacement

Why is it needed?

It is advised for leaky or narrow heart valve caused by

  • Medication
  • Calcium deposits
  • Infection
  • Birth defects

Facts and figures

  • Aortic valve was replaced with caged-ball artificial valve done by Hufnagel in year 1952
  • Aortic stenosis is the 3rd most common heart disease, usually congenital, occurring in 4 out of 1000 births
  • AHA data claims 99,000 heart valve surgery is done per year in the US

Risk and Complications

  • Infection
  • Bleeding
  • Heart attack/stroke
  • Breathing problems
  • Confusion/ lack of clarity
  • Kidney problems
  • Arrhythmia
  • Reaction to anesthesia or medicine

Advantages

  • High success rate
  • Successful surgery relieves the patient from weakening symptoms, prevents heart risk failure
  • 80% of patients who survive first-year post-surgery can return to normal activity

Disadvantages

  • Blood thinners have to be taken by patients using metal valves
  • Risk of a malfunctioning or developing leakage, requiring another surgery
  • 5% mortality risk
  • The long recovery period, especially for older people

Symptoms

  • Breathlessness on making slight movements
  • Palpitation
  • PND – Paroxysmal Nocturnal Dysponea i.e. sudden difficulty in breathing in early morning or at night, awaking the patient
  • Black outs – symptom caused by the narrowing of the aortic valves
  • Angina
  • High temperature

Preoperative Preparation

  • Avoid antibiotics and dental procedures pre-surgery
  • Full body examination
  • Blood and urinalysis
  • X-Rays, ECG, stress tests, and cardiac catheterization
  • Consult with doctor/surgeon to know which medicines to take or leave out
  • Quitting smoking and informing surgeon about alcohol and smoking habits
  • The surgeon should be told about a sore throat, cold, fever development before surgery
  • Arrange for caregivers post-surgery
  • Home should be prepared as advised by the doctor
  • No eating or drinking after midnight pre-surgery
  • Medical tourists should plan for a long trip and flexible ticket should be booked

Post operative care

  • Patient usually stays for 7-10 days in hospital post-surgery, including ICU stay. The patient is constantly monitored.
  • Drainage tube is usually removed 1-3 days post surgery
  • Blood clot prevention medicines are given
  • Patient will feel uncomfortable in the chest while moving about for approx 2 months
  • After stabilization, cardiac rehabilitation is started
Heart valve replacement Dos, Don’ts and Precautions

Dos, Don’ts and Precautions

  • Keep the incision hole dry and clean
  • Walk daily
  • Random blood tests required for patients taking blood thinners
  • Change to a healthy lifestyle
  • Quit smoking
  • Maintain a healthy weight
  • Take medicines meticulously
  • Take part in a cardiac rehabilitation program
  • Regularly visit physician or surgeon

Recovery time is long, especially for the elderly. Health before surgery also has a hand in recovery time. Usually, patients recover fully in 6-8 weeks after surgery.

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