Heart Valve Replacement | Guide to Heart Disease
Surgery on the heart valve involves its replacement (valve prosthesis) or repair (valve plastic).
The heart has four valves that have different structures and locations. Heart valves have a common feature and task: they must pass enough blood but only in a certain direction. That is, the blood must pass through them and not return.
The diseased heart valve either does not allow blood to flow forward or through it. The blood returns in the opposite direction, or both of these pathological processes are present at the same time.
When the heart valve is replaced, the diseased elements of the valve that cannot perform their task are cut out, and an artificial prosthesis of the heart valve is sewn in this place, which ensures the correct one-way movement of blood.
Thus, the pumping function of the heart is restored.
What are the features of heart valve surgery?
There are several basic approaches to heart valve surgery.
First of all, there is prosthetics (replacement) and plastic (repair) of the valve. The choice of surgery is influenced by many factors:
- the cause of the disease (rheumatism, myocardial infarction, trauma, infectious endocarditis, congenital malformation, etc.);
- the condition of the valve;
- and the timeliness of medical treatment.
According to the world standards of evidence-based medicine, it is often possible to preserve the mitral valve of the heart.
The aortic valve of the heart is often subject to complete replacement – prosthetics, and the tricuspid valve of the heart – plastic.
You can also use a mechanical prosthesis or a biological prosthesis. Each of the options of valve prostheses has its advantages and disadvantages.
Mechanical prostheses are implanted once but require constant medication that thins the blood.
Biological prostheses do not require the use of drugs that thin the blood, but they need to be replaced with another prosthesis after a certain period.
The average lifespan of a modern biological prosthesis is about 15 years.
What are the risks during heart valve surgery?
According to the world canons of evidence-based medicine, we calculate the risks of heart surgery in each case using euroSCORE II. This is a specialized international calculator of possible risks of cardiac surgery, where anonymous medical data of the patient are entered.
However, there are some specific possible complications that are directly proportional to the duration of the disease. For example, in severe stenosis of the valve due to calcium, there is an objective risk of separation of small particles. Such valves can literally burst. And this is a risk of stroke.
Also, valve damage can spread to surrounding structures and can be involved in the pathological process. This, in turn, creates additional risks of damage to these structures (aorta, heart walls).
Rehabilitation after heart valve surgery
After minimally invasive heart surgery performed without a sternum incision, there is virtually no special rehabilitation. After discharge from the hospital, which usually occurs a week after surgery, the person can return to the previous way of life. After minimally invasive heart surgery, the operated person does not need outside care and help from family members. The patient can immediately return to favorite occupations, work, business.
If the operation was performed by the classical method, it is necessary to limit physical activity for at least two months. Then you can gradually increase the amount and intensity of physical activity according to age and lifestyle.
The main rehabilitation after classic surgery is an incision of the sternum. The sternum incision heals in about two months. Therefore, after discharge from the hospital operated by the classical method, we recommend limiting for two months the weight that can be taken in hand up to 2.5 kg in each hand. You should avoid driving a car, motorcycle, or bicycle. It is also necessary to sleep on your back during this period.
Terms and features of rehabilitation are individual and are adjusted on repeated visits.