Heart
Valve Disease
Heart valve disease
occurs when a valve
doesn't work right. A
valve may not open all
the way. Or, a valve may
have problems closing.
If this happens, blood
doesn't move through the
heart's chambers the way
it should.
Problems with Your
Heart Valves
If a valve doesn't open
all the way, less blood
moves through to the
next chamber. If a valve
doesn't close tightly,
blood may leak backward.
These problems may mean
that the heart must work
harder to pump the same
amount of blood. Or,
blood may back up in the
lungs or body because
it's not moving through
the heart as it should.
Problems Opening
Stenosis occurs when a
valve doesn't open
fully. The valve may
have become hardened or
stiff with calcium
deposits or scarring.
So, it's hard to push
open. Blood has to flow
through a smaller
opening, so less blood
gets through the valve
into the next chamber.
Problems Closing
Insufficiency (also
called regurgitation)
results when the valve
doesn't close tightly.
The valve's supportive
structures may be loose
or torn. Or, the valve
itself may have
stretched or thinned.
Blood may then leak back
the wrong way through
the valve.
Heart Valve Surgery
During heart valve
surgery, one or more
valves are repaired or
replaced. Repair means
that the valve is mended
to help it work better.
Replacement means your
diseased valve is
removed and a new valve
is inserted in its
place. Whether a valve
will be repaired or
replaced can only be
decided once surgery has
begun. Your surgeon will
talk with you about his
or her plans for surgery
and any other procedures
you may need.
Repairing a Valve
During valve repair, a
ring may be sewn around
the opening of the valve
to tighten it. Other
parts of the valve may
be cut, shortened,
separated, or made
stronger to help the
valve open and close
right.
Replacing a Valve
If a valve can't be
repaired, it may be
replaced with a
prosthetic valve. Two
kinds of prosthetic
heart valves are
available:
Mechanical and
biological heart valves.
Mechanical valves are
created from man-made
materials. Lifetime
therapy with an
anticoagulant (sometimes
called a "blood
thinner") is needed when
these types of valves
are used. This
medication prevents
blood clots from forming
on or around the valve.
Biological (tissue)
valves are taken from
pig, cow, or human
donors. These valves
don't last as long as
mechanical valves. But
when tissue valves are
used, long-term use of
an anticoagulant often
isn't needed.
Your doctor will talk
with you about choosing
the best valve for you.
Factors weighed include
your age, your
occupation, the size of
your valve, how well
your heart is working,
your heart's rhythm,
your ability to take an
anticoagulant, and how
many new valves you
need.
Reaching Your Heart
To get to your heart,
one or more incisions
must be made in your
chest. For minimally
invasive valve surgery,
these incisions are most
often much smaller than
those made for
traditional valve
surgery. One of two
types of incisions may
be used. Which type your
surgeon chooses depends
on the location of the
valve and the method of
surgery used. Your
surgeon will talk with
you about which incision
you will receive.
Stopping Your Heart
During valve surgery,
your heart must not
beat. To keep your blood
flowing, it is passed
through a heart-lung
machine. This machine
gives oxygen to your
blood and pumps the
blood back through your
body. Your surgeon may
choose to connect your
body to the machine
through the vessels in
your heart or through
vessels in your groin.
Once the valve surgery
is done, your heart and
lungs take over again.
Repairing or
Replacing the Valve
To reach the valve, an
incision is made in your
heart or aorta. If the
valve can be mended, the
needed repairs are done.
If the valve must be
replaced, part or all of
the damaged valve and
its supportive
structures may be
removed. The right-sized
replacement valve is
selected, positioned in
the valve opening, and
sewn firmly into place.
The incision in your
heart or aorta is
closed. Your heart is
then started so it beats
on its own again.
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