Heart valve repair or replacement surgery be done when valves are damaged or diseased and do not work the way they should. Conditions that may cause heart valve dysfunction are valve stenosis (stiffness) and valve regurgitation (leaky valve).
Heart valve replacement surgery requires a stay in a hospital. Procedures may vary depending on your condition.
Generally, open heart valve replacement follows this process:
- An intravenous (IV) line will be started in your arm or hand for injection of medication and to administer IV fluids. Additional catheters will be put in blood vessels your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples.
- A soft, flexible tube (called a Foley catheter) will be put into your bladder to drain urine.
- A tube will be put through your mouth or nose into your stomach to drain stomach fluids.
- If you are having an open-heart surgery, your doctor will make an incision (cut) down the centre of the chest from just below the Adam's apple to just above the navel. If you are having a less invasive procedure, it may require smaller incisions.
- The sternum (breastbone) will be cut in half. The doctor will separates the two halves of the breastbone and spread them apart to expose your heart.
- To do the valve repair or replacement, the heart must be stopped. Tubes will be put into the heart so that the blood can be pumped through your body by a bypass machine while your heart is stopped.
- Once the blood has been completely diverted into the bypass machine for pumping, your heart will be stopped by injecting it with a cold solution.
- When the heart has stopped, the doctor will remove the diseased valve and put in the artificial valve, in the case of a valve replacement. For a valve repair, the procedure performed will depend on the type of valve problem that exists, for example, separation of fused valve leaflets, repair of torn leaflets, and/or the reshaping of valve parts to ensure better function.
- Once the surgery has been completed, the blood circulating through the bypass machine will be allowed to re-enter your heart and the tubes to the machine will be removed. Your heart will be shocked with small paddles to restart your heartbeat.
- Once your heart is beating again, the doctor will watch it to see how well the heart and valves are working and be sure that there are no leaks from the surgery.
- Wires for pacing may be put into the heart. These wires can be attached to a pacemaker outside your body for a short time and your heart can be paced, if needed, during the initial recovery period.
- The sternum will be re-joined and sewn together with small wires (like those sometimes used to repair a broken bone).
- The skin over the sternum will be sewn back together. The incision will be closed with sutures or surgical staples.
- Tubes will be put into your chest to drain blood and other fluids from around the heart. These tubes will be connected to a suction device to drain fluids away from the heart as it heals.
- A sterile bandage or dressing will be applied.
After the surgery, you may be taken to a recovery room before being taken to the intensive care unit (ICU) to be closely monitored for several days. Or, you may be taken directly to the ICU from the operating room. You will be connected to machines that will constantly display your electrocardiogram (ECG) tracing, blood pressure, other pressure readings, breathing rate, and your oxygen level. Open heart valve repair or replacement surgery generally requires an in-hospital stay of several days or longer.
When your doctor decides that you are ready, you will be moved from the ICU to a surgical unit or acute care unit. Your recovery will continue there. Your activity will be gradually increased as you get out of bed and walk around for longer periods. You can begin to eat solid foods as you tolerate them.
Arrangements will be made for you to go home and a follow-up visit with your doctor will be scheduled.
Once you are home, it will be important to keep the surgical area clean and dry. You will be given specific bathing instructions. The sutures or surgical staples will be removed during a follow-up office visit, if they were not removed before leaving the hospital.
Welcome to KIMS, a one-stop destination for the screening and evaluation of heart disease. As pioneers in Heart Valve replacement, we are experts in the latest minimally invasive options as well as traditional options for treating heart valve disease.