heart and blood vessel disorders
Overview of Heart Valve Disorders
Repairing or replacing a heart valve
A faulty valve may be repaired or replaced. Repair may require surgery but may sometimes be accomplished during Cardiac Catheterization and Coronary Angiography , particularly when the problem is a valve with stenosis. A stenotic valve can sometimes be stretched open using a procedure called balloon valvuloplasty. In this procedure, a catheter with a balloon at the tip is threaded through a vein or artery into the heart. Once across the faulty valve, the balloon is inflated, separating the valve cusps. This procedure does not require a general anesthetic and allows a quick recovery. Two types of valves are available for replacement Mechanical type Bioprosthetic type (made from the heart valve of a pig or cow) for the rest of their lives to prevent blood clots from forming in the valve. Taking an anticoagulant increases a person's risk of spontaneous bleeding, such as in their brain (see Overview of Hemorrhagic Stroke ). Bioprosthetic valves generally deteriorate and require replacement after 10 to 12 years but do not require use of anticoagulants for more than 3 to 6 months after surgery, but people with bioprosthetic valves will need to take A damaged heart valve may be replaced with a mechanical valve made of plastic and metal or with a bioprosthetic valve made of heart valve tissue, usually from pigs, placed in a synthetic ring. There are many types of mechanical valves. A St. Jude valve is commonly used. Choice of a valve depends on many factors, including characteristics of the valve. A mechanical valve lasts longer than a bioprosthetic valve but requires that anticoagulants be taken indefinitely to prevent the formation of blood clots on the valve. A bioprosthetic valve requires only short-term use of anticoagulants. So whether a person can take anticoagulants is an important factor. For example, anticoagulants may not be appropriate for women of childbearing age because anticoagulants cross the placenta and may affect the fetus. Also considered are How old the person is What the person's activity level is How well the heart is working Which heart valve is damaged When anaortic valveis being replaced, a mechanical valve is usually chosen for people who are under age 50 and a bioprosthetic valve is chosen for those age 50 or older. When amitral valveis being replaced, a mechanical valve is usually chosen for people who are under age 65 and a bioprosthetic valve is chosen for those age 65 or older. The tricuspid and pulmonic valves do not need to be replaced or repaired as often as the aortic or mitral valves. For heart valve replacement, a general anesthetic is given. The heart must be still to be operated on, so a heart-lung machine is used to pump blood through the bloodstream. The damaged valve is removed, and the replacement valve is sewn in place. The incisions are closed, the heart-lung machine is disconnected, and the heart is restarted. The operation takes from 2 to 5 hours. For some people, a heart valve can be replaced using a less invasive procedure (without cutting through the sternum), available at some medical centers. The length of the hospital stay varies from person to person. Full recovery may take 6 to 8 weeks. Abnormal valves and all replacement valves can become infected. People with replacement valves need to take prophylactic antibiotics, which are antibiotics taken at certain times (for example, before some dental or medical procedures)r to prevent bacterial infection of the valves ( Infective Endocarditis ). Also, blood clots may form on replacement valves. The blood clots may partially block the valve or break loose and travel through the bloodstream to block arteries elsewhere in the body (for example, causing a Overview of Stroke ). Doctors use echocardiography to monitor replaced valves by looking at the blood flow through the valves and the rest of the heart. 