Friday, January 13, 2012

Heart Valve Surgery

“Heart valve surgery,” © 2009 A.D.A.M., Inc.
Reprinted with permission.
Heart valve surgery is used to repair or replace diseased heart valves.
Description
There are four valves in your heart:
1. Aortic valve
2. Mitral valve
3. Tricuspid valve
4. Pulmonary valve
The valves control the direction of blood flow through your heart. The opening and closing of the heart valves produce the sound of the heartbeat. Heart valve surgery is open-heart surgery that is done while you are under general anesthesia. A cut is made through the breast bone (sternum). Your blood is routed away from your heart to a heart-lung bypass machine. This machine keeps the blood circulating while your heart is being operated on.
Valves may be repaired or replaced. Replacement heart valves are either natural (biologic) or artificial (mechanical):
• Natural valves are from human donors (cadavers).
• Modified natural valves come from animal donors. (Porcine valves are from pigs, bovine are from cows.)
These are placed in synthetic rings.
• Artificial valves are made of metal.
If you receive an artificial valve, you may need to take lifelong medication to prevent blood clots. Natural valves rarely require life long medication.
Why the Procedure Is Performed
Heart valve surgery may be recommended for the following conditions:
• Narrowing of the heart valve (stenosis)
• Leaking of the heart valve (regurgitation)
Valve problems may be caused by:
• birth defects;
• calcium deposits (calcification);
• infections such as rheumatic fever;
• medications.
Defective valves may cause congestive heart failure and infections ( invective endocarditis).
Risks
The risks for any anesthesia include:
• problems breathing;
• reactions to medications.
The risks for any surgery include:
• bleeding;
• infection.
The risks for cardiac surgery include:
• death;
• heart attack;
• irregular heartbeat (arrhythmia);
• kidney failure;
• stroke;
• temporary confusion after surgery due to the heart-lung machine.
It is very important to take steps to prevent valve infections. You may need to take antibiotics indefinitely, or before dental work and other invasive procedures.
After the Procedure
The success rate of heart valve surgery is high. The operation can relieve your symptoms and prolong your life. The death rate averages 2% to 5%, depending on the heart valve. About two of every three patients who received an artificial mistral valve are still alive 9 years after the surgery.
The clicking of the mechanical heart valve may be heard in the chest. This is normal.
Outlook (Prognosis)
You will stay in an intensive care unit for the first 2 or 3 days following the operation. Your heart functions will be monitored constantly. The average hospital stay is 1 to 2 weeks. Complete recovery will take a few weeks to several months, depending on your health before surgery.


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