What are heart valves?

Blood that flows between different chambers of your heart and between the heart and large arteries must flow through a heart valve. These valves open up enough so that blood can flow through. They then close, keeping blood from flowing backward.

There are four valves in your heart:

• Aortic valve
• Mitral valve
• Tricuspid valve
• Pulmonic valve

The most common problem affecting heart valves are stenosis or narrowing of the valve. In some, the valves fail to close properly, resulting in the valves' backflow or regurgitation. The aortic valve is the most common valve to be replaced. The mitral valve is the most common valve to be repaired. Only rarely is the tricuspid valve or the pulmonic valve repaired or replaced.

What are the Types of artificial heart valves?

• Mechanical valves: Metals, carbon, etc. are the materials used to make a mechanical valve. These valves are strong and durable. A disadvantage is the tendency of the blood to clot around the metal surface. To prevent this, one will have to take blood thinners regularly. These valves usually last the life of the person having the replacement. 
• Biological valves: These are from human or animal heart tissues. The body more easily accepts biological valves. The main advantage is that the recipient need not be on anticoagulants. The disadvantage is that the life of the valve is around twelve to fifteen years. After that, one will need another valve replacement surgery.

What are the common types of valve replacement?

Among the four heart valves, the aortic and mitral valve replacement is more common than others.

Aortic Valve Replacement: The aortic valve separates the left ventricle and the aorta. The left ventricle is the heart's main pumping chamber. The aorta is the main artery that supplies oxygen-enriched blood to the body. If the aortic valve does not work correctly, then it can cause various symptoms. They include breathing problems, fatigue, chest pain, arrhythmias, and sudden cardiac arrest.

Mitral Valve Replacement: The mitral valve divides the left atrium and the left ventricle in the heart. The left atrium receives oxygenated blood from the lungs. Once the left atrium contracts, the blood flows from the atrium to the left ventricle through the open mitral valve. When the left ventricle fills up, the mitral valve shuts down. It stops the blood from flowing back into the atrium while the ventricle contracts.

Mitral valve disease will have symptoms like fatigue, swelling of legs and ankles, heart murmur, shortness of breath, palpitations, arrhythmia.

Pulmonary valve replacement surgery

The most common disorder affecting the pulmonary valve is stenosis or narrowing. It causes a decrease in the blood flow to the lungs as well as from the lungs. In pulmonary regurgitation, there is a flow of blood back into the right ventricle. It is due to the inability of the valve to close properly.

Tricuspid valve replacement surgery

In tricuspid stenosis, there is a narrowing of the valve. It leads to a decrease in the flow of the blood to the right ventricle. In tricuspid regurgitation, the blood flows back as the valve fails to close correctly.

What is the procedure for a heart valve replacement surgery?

During a valve replacement surgery, you will have general anesthesia to put you to sleep. Once you are asleep, your surgeon will make an incision across your chest. The next step is to divide the midline breastbone surgically to expose the heart. The surgeon will then shift your blood circulation to the heart-lung machine during the surgery. It enables the surgeon to operate on a still heart. The surgeon will then remove the diseased heart valve. The next step is to attach the artificial valve in its place with the help of sutures.

Your surgeon will then shift the circulation from the heart-lung machine back to your heart. He or she will then check how the artificial valve performs while the heart is functioning. Once everything is ok, the surgeon will go on to close the chest cavity. The incisions in your chest will have sutures or staples. After the surgery, the staff will move you into the observation room near the operation theatre. Here you will slowly wake up from the effects of anesthesia.

Minimally invasive valve replacement surgery

In this surgery, you will have only two or three small incisions in your chest. The surgeon will insert a camera through one of the holes without dividing any bone on the chest. It will then beam images of the heart to a monitor. You will recover faster as the incisions are small. The chances of complications like bleeding and wound infections are also less.

Recovery after valve replacement surgery

You will be in the ICU for a day or two. In the ICU, you will find that there is a bandage over the middle of the chest. There will be wires that connect your body to various machines. These help the nurses to assess the functioning of your body carefully and regularly. You will be given liquid food on the first day. Your appetite will also be less, as you will be feeling exhausted. You will go back to your hospital room the next day.

In the room, you will be able to sit up by the second day. The appetite will show signs of improvement. But it is better to stick to a soft and easily digestible diet.  It will be advisable to walk around a few steps in the room. It will improve your blood circulation. The benefits are faster wound healing and recovery. It also helps prevent blood clots from forming in your legs. You will have medicines to prevent the rejection of the artificial valve as well as blood thinners. You will go back home after three or four days.

At home 

It is natural for you will feel exhausted in the first few days of surgery. You will also find it difficult to sleep, which is normal. You will have to take care of the incision wound very well to prevent any infections. Keeping the wound dry is essential. You will have to do mild physical activities a week after surgery. But over-exertion is not good. Avoid climbing stairs too many times.

Driving: It will take about five to six weeks for you to start driving

Household chores: You can start doing light household chores after a couple of weeks. It is better to have help for heavy tasks.

Going back to work: If your job is not strenuous, you can go back after four to five weeks.

Risks of Heart Valve Surgery

Although rare, some of the risks are bleeding, infection, arrhythmias, pneumonia, breathing difficulties.