Heart valve surgery is a procedure to treat heart valve disease that involves at least one of the four heart valves not working properly.

The four valves are the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Theses valves The four valves need to be working properly to allow normal flow of blood through the heart. Valves that don’t open or close properly disrupt blood flow through the heart to the body.

The treatment depends on several factors, including age, general health, condition of the affected heart valve and the severity of the condition.

The surgery usually last between 4 – 5 hours. After surgery, the patient will stay in the hospital according to his condition and his doctors decision for few days, which usually about 5-7 days (few days in the post-operative ICU and the rest is the ward)

The patient is expected to return to his daily activities and resume driving after 6 – 8 weeks after surgery.

• Valve Repair surgery:

The surgeon may recommend heart valve repair when possible, as it preserves the native heart valve. Valve repair surgery may include: removing excess valve tissue, replacing cords that support the valve or reinforcement by a prosthetic ring around the valve.

• Valve Replacement surgery

If the heart valve can’t be repaired and a catheter-based procedure is not feasible, the valve will be replaced. To replace a heart valve, the surgeon removes the heart valve and replaces it with a mechanical valve or a valve made from cow, pig or human heart tissue (biological tissue valve).

Biological valves often eventually need to be replaced, as they degenerate over time. Mechanical valves don’t degenerate but the patient will need to take blood-thinning medications (e.g. Warfarin) to prevent blood clots. Doctors will discuss with patients the risks and benefits of each type of valve.

Heart valve surgery can be performed by different approaches:

• The Traditional midline incision: it is done by an incision in the center of the chest. This allows access to the most of the heart allowing management of different valves. It is still considered the preferred and safest approach for valve surgery especially when more than one valve need to addressed.
• Minimally invasive approaches: they are done by different smaller incisions in the chest or with the use of video-assisted instruments (thoracoscope). The technique differs according to the diseased valve. The choice of minimally invasive approaches depend on many factors and needs to be discussed with the surgeon.

 

• Trans-catheter valve replacement: It is a new technique that allows valve replacement by a tissue valve inserted by a trans-catheter approach. The technique is expensive and requires certain criteria. This technique can be done for the aortic valve replacement and called TAVI (Trans-catheter Aortic Valve Implantation) and still under trial for the replacement of other valves.