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Heart Valve Replacement Surgery

Heart valve surgery is a medical procedure used to treat heart valve disease, which occurs when one of the four heart valves responsible for pumping blood in the right direction is not functioning properly. The heart is a pump composed of muscle tissue, and it has four chambers responsible for pumping. The upper chambers are called atria, and the lower ones are known as ventricles. Between each of these chambers are valves that ensure the blood flows through the heart and into the right direction. There are four valves in the heart, including the pulmonary valve between the right ventricle and pulmonary artery, tricuspid valve between the right atrium and right ventricle, mitral valve between the left ventricle and left atrium, and aortic valve between the aorta and left ventricle. Each valve has flaps or cusps that open and close with every heartbeat. However, at times, the valves are unable to open and close properly, which affects the blood flow from the heart to the body.

When any of the heart valves are diseased or damaged, medical intervention is required. Heart valve surgery involves a surgeon repairing or replacing the affected heart valves. The mitral and aortic valves are the two most commonly replaced valves, while tricuspid and pulmonary valve replacements are less common. There are many surgical procedures available to repair the heart, including minimally invasive heart surgery and open-heart surgery.

Reasons for Heart Valve Replacement Surgery

Heart valve disease may occur before birth or be acquired throughout one's life, with some cases having unknown causes. The common causes of heart valve disease include congenital valve disease affecting the pulmonic or aortic valve, bicuspid aortic valve disease affecting the aortic valve, and acquired valve disease caused by infection or disease like rheumatic fever or endocarditis.

Rheumatic fever is a bacterial infection that leads to inflammation of the valves and was more prevalent before the use of antibiotics. Endocarditis, caused by bacteria attacking the valves, can result in holes, growths, scarring, and leaky valves. Other conditions that may affect the valves include the tearing or stretching of papillary muscles or chordae tendinea, the dilation of the annulus of the valve, stiffness, and calcification. Mitral valve prolapse is another condition that causes abnormal tissues and leakage due to the flopping back of the mitral valve leaflets during the heart's contraction.

Heart attack, coronary artery disease, syphilis, connective tissue diseases, and high blood pressure are other causes of heart valve disease, with radiation, tumor, and drug abuse being some lesser-known causes.

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Symptoms that Require Heart Valve Replacement Surgery

Heart valve disease can be congenital or acquired throughout one's life, and there are several causes. Symptoms of this condition include shortness of breath, dizziness, chest discomfort, constant palpitations, swollen ankles, abdomen or feet, and sudden weight gain. These symptoms can negatively impact daily activities, and may require treatment to manage.

Diagnosis Before Heart Valve Replacement Surgery

Before suggesting a replacement surgery, your doctor will thoroughly discuss your condition, conduct a physical examination, and perform tests. The physical exam involves listening to the heart sounds to detect murmurs or irregular rhythm, and assessing the circulation and organ functioning. Tests such as transoesophageal echocardiography, echocardiography, and cardiac catherization are conducted to diagnose the progress of valve disease and recommend a suitable treatment method.

Heart Valve Repair Surgery

Heart valve repair is often recommended by the doctor if feasible, as it allows for the preservation of the valve and proper heart function. The repair process typically involves patching any holes in the diseased valve, reconnecting the valve cusps, removal of any excess tissue between the valves to allow for proper closure, replacing the cords for structural support, separating any fused valves, and tightening the ring around the valve, also known as the annulus.

Heart Valve Surgery Procedure

During the heart valve replacement surgery, you will be given anesthesia and connected to a heart-lung bypass machine that maintains blood flow throughout the procedure. The surgery can be done through an open-heart procedure with a large incision in the chest or a minimally invasive approach with smaller incisions using long instruments or robotic arms. The latter option often results in a shorter hospital stay and faster recovery.

Heart Valve Replacement Surgery

AWhen a heart valve cannot be repaired, heart valve replacement surgery may be recommended by doctors. This involves removing the damaged valve and replacing it with either a mechanical valve or a valve made from biological tissue, such as human, pig, or cow tissue. While biological tissue valves tend to degenerate over time and require eventual replacement, mechanical valves require lifelong blood-thinning medication to prevent blood clots.

Before making a decision on which type of valve replacement to choose, the patient will be informed of the pros and cons of each option. The surgery is typically carried out using a minimally invasive catheter process.