What Is Heart Valve Surgery?
Heart valve surgery repairs or replaces a heart valve that is not working properly. Depending on your condition, your doctor may perform minimally invasive surgery or a traditional, open-chest procedure to treat your
heart valve disorder.
Types of heart valve surgery
Minimally invasive heart valve surgery
Minimally invasive procedures access your valve through much smaller incisions — without opening your chest. The benefits of these minimally invasive approaches include:
- Fewer postoperative restrictions.
- Less pain.
- Shorter hospital stay.
- Shorter recovery time.
- Smaller scars.
Minimally invasive heart valve surgery procedures include:
- Valvuloplasty — Balloon valvuloplasty is a minimally invasive procedure to repair a narrowed heart valve. During the procedure, a special catheter (hollow tube) is threaded into a blood vessel in your groin and guided into your heart. The catheter, which contains a deflated balloon, is inserted into your narrowed heart valve. Once in place, the balloon is inflated to stretch the valve open, and then removed.
- MitraClip® — MitraClip is a device that is used to treat mitral regurgitation by clipping the mitral valve together. Your surgeon will insert the device through a blood vessel in your groin and guide it to your heart.
- Transcatheter aortic valve replacement (TAVR) — TAVR is a procedure used to replace your aortic valve and treat aortic stenosis. UPMC was the first hospital in Central Pennsylvania to offer catheter-based replacement of aortic valves.
- Robotically Assisted Minimally Invasive Valve Repair or Replacement — Minimally invasive mitral valve repair or replacement is done through a small incision between the ribs on the right side of the chest. Additionally, a few small incisions are made to insert long, thin, instruments. This procedure is done with the help of the DaVinci robot, controlled by the surgeon. This provides greater precision for complex valve repairs.
- Minimally Invasive Aortic Valve Replacement via mini sternotomy or mini thoracotomy — Aortic valve replacement can be done through smaller incisions. Mini-sternotomy is like traditional open-heart surgery, but the incision is much smaller, and only about 1/3 of the breastbone is divided in half. Aortic valve replacement can also be performed through a small incision on the right chest, between the 2nd and 3rd ribs.H4: Traditional heart valve surgery
Traditional, open-heart valve surgery procedures include:
- Heart valve repair or replacement — Our surgeons perform traditional open-chest valve repair and replacement. Whenever possible, our skilled surgeons will recommend repairing your valve. However, if your valve is too damaged to be repaired, your doctor will recommend valve replacement.
- Single, double, or triple valve surgery may be done with or without bypass grafts — UPMC cardiac surgeons are experienced in complex surgeries involving multiple valve replacements and/or repairs.
- Aortic root surgery with or without aortic valve preservation (David procedure, Valve Spraing Root Replacement) — During a valve-sparing aortic root replacement procedure (David procedure), your surgeon will remove the ascending aorta and coronary arteries just above the aortic valve, and a synthetic graft will be attached with small stitches. The coronary arteries also will be reattached to the synthetic graft. Your own valve is resuspended within the graft. This eliminates the need to replace the valve with a tissue or mechanical valve. However, in certain situations your surgeon may replace your aortic valve during aortic root surgery.
- Ozaki Procedure — Ozaki procedure is a specialized type of aortic valve replacement in which your own heart tissue is used to create new aortic valve leaflets. The tissue for the new leaflets is taken from the pericardial sac that surrounds your heart. This is done through a standard open-heart surgery approach and requires the breastbone to be divided in half.
Conditions we treat with heart valve surgery
Why Would I Need Heart Valve Surgery?
You may need heart valve surgery if your aortic, mitral, pulmonary, or tricuspid valve isn’t working properly. Heart valve disorders are usually caused by three main problems:
- Regurgitation (or leakage of the valve) — A valve does not close completely, causing the blood to flow backward through the valve. The heart is forced to handle more blood, making it work harder.
- Stenosis (or narrowing of the valve) — A valve’s opening becomes narrowed, limiting the flow of blood out of the ventricles or atria. The heart is forced to pump blood with increased effort to move blood through the narrowed or stiff (stenotic) valve.
- Endocarditis (Infection of the valve) —Bacteria in the blood stream can cause infection of a heart valve called endocarditis. This may lead to bacterial growths on the valve leaflets, called vegitations, and can destroy valve leaflets.
- Congenital Abnormalities — Atresia is present at birth and occurs when the valve doesn’t form correctly in the womb. Common valve abnormalities present at birth that could require eventual heart surgery include mitral valve prolapse and bicuspid aortic valve.
Who’s a candidate for heart valve surgery?
You may be a candidate for heart valve surgery if you have a damaged or diseased heart valve. Your doctor may recommend heart valve surgery to prevent future complications, even if you don’t have noticeable symptoms.
How serious is heart valve surgery?
Heart valve surgery is a complex surgical procedure. Depending on your condition, your surgeon may use an open or minimally invasive approach. Minimally invasive surgery is typically associated with a shorter recovery time when compared to open-chest surgical procedures.
What Are the Risks and Complications of Heart Valve Surgery?
Many people with severe heart valve disease are at increased risk from surgery, complications, or death. Heart valve surgery may be a treatment option, but it isn’t right for everyone.
Although UPMC has excellent outcomes, as with any surgery, there are some risks, including:
- Stroke.
- Damage to the artery used for insertion of the valve.
- Need for a pacemaker.
- Major bleeding.
- Other serious life-threatening events or even death.
What Should I Expect from Heart Valve Surgery?
If your doctor recommends heart valve surgery, our team of heart valve experts will start by doing a thorough exam. During your heart valve surgery exam, you'll meet with:
- A heart surgeon.
- An interventional cardiologist.
- Advanced practice providers.
Our experts use the latest diagnostic tests to learn about your heart valve condition, including:
- Cardiac catheterization — This diagnostic procedure involves inserting a tiny, hollow tube (catheter) through a large artery in your leg or arm leading to your heart to provide images of your heart and blood vessels. This procedure is helpful in determining the type and extent of certain valve disorders and looks for blockages in the coronary arteries.
- Chest x-ray — A chest x-ray is a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. An x-ray can show enlargement in any area of the heart.
- CT angiogram — A CT angiogram is an imaging test that uses a powerful x-ray machine to look at the arteries that supply your heart muscle, as well as the lungs, aorta, and the heart.
- Echocardiogram (Echo) — This noninvasive ultrasound test uses sound waves to evaluate your heart's chambers and valves. The echo sound waves create an image on a monitor as an ultrasound transducer is passed over your heart.
- Electrocardiogram (ECG or EKG) — This test records the electrical activity of your heart, shows abnormal rhythms (arrhythmias or dysrhythmias), and can sometimes detect heart muscle damage.
- Magnetic resonance imaging (MRI) — MRI is a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.
- Transesophageal echocardiogram (TEE) — TEE is a form of echocardiography that is performed by inserting a probe with a transducer into your esophagus rather than placing the transducer on your chest as in a traditional echocardiogram. A TEE provides a clearer image of your heart because the sound waves do not have to pass through skin, muscle, or bone.
Your doctor may also order other tests, such as:
- An exercise stress test.
- Lung function tests.
- Ultrasound of your carotid arteries and the arteries or veins in your legs.
- Bloodwork and urine tests to look for signs of infection prior to valve replacement.
Before: How to prepare for heart valve surgery
Your doctor will explain the heart valve surgery procedure to you and give you a chance to ask questions. To prepare for heart valve surgery, you should:
- Tell your doctor if you are sensitive or allergic to any medications, iodine, latex, tape, or anesthetic agents (local and general).
- Tell your doctor about all medications (prescription and over-the-counter) and herbal or other supplements you are taking.
- Tell your doctor if you have a history of bleeding disorders or if you are taking any blood-thinning medications, aspirin, or other medications that affect blood clotting. It may be necessary to stop some of the medications prior to the procedure.
- Fast for a certain period of time prior to the procedure. Your doctor will tell you how long to fast (usually overnight).
- Have any tests that your doctor recommends. For example, your doctor may request a blood test prior to the procedure to determine how long it takes your blood to clot.
- Visit any specialists for preoperative clearance. For example, if you have a history of bleeding problems or low blood count, the surgeon may ask you to see a hematologist (blood doctor) before surgery.
- Visit your dentist for cleaning and evaluation prior to surgery. Your dentist will need to provide clearance stating that you can have heart surgery.
On the day of your heart valve surgery procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.
After your heart valve procedure, you will stay in the hospital for several nights. Your doctor will let you know how many nights may expect to stay for the type of procedure you are having.
You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should also arrange for someone to drive you home from the hospital after you are discharged.
How long does heart valve surgery take?
Your heart valve surgery could take as little as an hour or up to several hours, depending on the type of procedure you are having. For less invasive valve surgery, you should expect to spend 1-2 hours in the recovery room before being transferred to your hospital room. For traditional open-heart surgery or robotically assisted valve surgery, you will be transferred directly to the ICU from the operating room.
During your heart valve surgery?
Depending on the type of procedure you are having, you may be placed under general anesthesia or connected to a heart-lung bypass machine that will take over the function of your heart and lungs during your operation.
If you need valve repair surgery, your doctor will provide you with more detail about the approach he or she plans to use before surgery. The specific approach your doctor recommends will depend on your condition and the heart valve that is affected.
During valve replacement surgery, your damaged valve will be cut out, and the new valve will be sewn into place. Your doctor may perform a minimally invasive procedure or an open-chest surgery, depending on your condition.
Recovery after heart valve surgery
When your heart valve procedure is completed, depending on the type of procedure you have, you will either be moved to recovery for observation Or to the ICU. Your doctor will provide more information about your recovery and your hospital stay — including when you can resume your normal activities.
If you receive a mechanical valve replacement, you will need to take blood-thinning medication after heart valve surgery. Follow your doctor’s instructions and go to all your follow-up appointments.
How long does it take to recover from heart valve surgery?
If you have an open surgical procedure, your recovery may take up to three months. A complete recovery after a minimally invasive procedure typically takes about 4 to 6 weeks (about 1 and a half months).
When to call your doctor about heart valve surgery complications
You should call your doctor if you are experiencing any unusual symptoms, including:
- Pain, redness, bleeding, drainage, or increased swelling at the insertion site.
- Burning or pain in your chest.
- Rapid or irregular heartbeat.
- Severe pain, coldness, numbness, or discoloration a limb.
- A fever of more than 100.0°F.
- New or increasing shortness of breath.
- Difficulty breathing.
- Weight gain or worsening of swelling in your legs, arms, or abdomen.
- Difficulty swallowing, throat pain, or bloody cough.
- Redness or rash on your chest or back.
What’s the prognosis after heart valve surgery?
Most otherwise healthy patients continue to lead active, fulfilling lives after heart valve surgery.
Can you live a normal life after heart valve surgery?
For most people, life expectancy after heart valve surgery is the same as anyone else who does not have heart problems. Talk to your doctor if you have questions about your life expectancy and ability to return to your normal activities after your heart valve surgery procedure.
What’s the success rate of heart valve surgery?
Heart valve surgery success rates vary depending on the type of procedure you’re having. Your doctor will discuss the expected success rate with you.
What are the odds of surviving a heart valve replacement?
Most people who have heart valve surgery survive and have outstanding outcomes, reduced symptoms, and improved quality of life.
Why Choose UPMC for Heart Valve Surgery?
The cardiovascular specialists at UPMC are among the most experienced in Pennsylvania at performing heart valve surgery, including minimally invasive valve repair and replacement procedures. Our team regularly participates in the latest clinical trials and delivers outstanding treatment outcomes.
Last reviewed by a UPMC medical professional on 2024-10-01.
