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Heart Valve Surgery

Alternate Names

  • surgery of the heart valves

Definition

There are 4 valves in the heart. Two of them control blood flow between the heart chambers and the other two control blood flow out of the heart. Valves that are not working properly can sometimes be repaired with surgery.

Who is a candidate for the procedure?

The following conditions may require heart valve surgery:
  • heart valve defects that are present from birth, causing congenital heart disease
  • heart valves that become narrow and stiff, blocking the flow of blood through the heart
  • heart valves that leak, allowing blood to flow the wrong way through the heart
  • heart valve infections, such as those caused by rheumatic fever

How is the procedure performed?

Some heart valve problems can be fixed without open heart surgery. In these cases, a narrow tube, called a catheter, is inserted into an artery in the groin. The catheter is threaded through the body into the heart. The physician can then repair the heart valve using special tools inserted through the catheter.
Most people, however, require open heart surgery for repair of heart valve defects. This is an extensive operation that is performed under general anesthesia. After the patient is put to sleep, the chest area is cleaned with antibacterial chemicals. Next, an incision is made into the breastbone or sternum to expose the heart.
The person is then put on a heart-lung bypass machine. This device keeps the blood supplied with fresh oxygen and moving throughout the blood vessels of the body at an appropriate pressure, until the heart can be reconnected.
A heart valve operation can involve repair of the valve or a complete replacement. There are two types of replacement valves: artificial and biologic. Artificial valves are generally made of metal or plastic. Biologic valves may come from human organ donors or from animals such as pigs.
After the valve is repaired or replaced, the person is taken off the heart-lung machine. Once the person's heart is working again to pump the blood, the chest incision is closed. The person is awakened from the anesthesia and taken to the surgery recovery room.

Sources

Heart Disease, 1997, Braunwald et al.

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