Valves are made of thin but strong flaps of tissue that open and close as your heart beats.  A human heart beats an average 100,000 times a day.  The valves must flex, stretch and hold back pressure hundreds of millions of times in an average lifetime.  When valves weaken and harden they cannot open properly and blood flow is blocked.

The mitral and aortic valves on the left side of the heart are more common sites of heart valve disease because pressures are higher on the left side.

What causes a heart valve problem?

There are various causes of heart valve problems.  A heart valve may have a defect at birth that can slightly weaken the valve or calcium build-up, more common in the elderly, that can affect blood flow.  Over time, this can lead to failure of the valve.  Diseases such as rheumatic fever or bacterial infections may scar or destroy a valve.  

Aging and normal wear and tear of tissues also can weaken or harden heart valves.  Your heart valves open and close with each heartbeat for your entire life.  Some wear and tear is to be expected.

Diagnosing your problem.

Breathlessness is a common symptom of heart valve disease along with swelling of the ankles.  Other symptoms may include fatigue, fainting, palpitations, and chest pain.

Valve disorders can usually be diagnosed by listening to the heart with a stethoscope.  However, a definitive diagnosis of valve disease usually requires tests such as electrocardiogram (EKG), chest x-ray, or echocardiogram (a noninvasive and painless procedure in which soundwaves are used to visualize the shape and motion of the heart).  If surgery is being considered, a cardiac catheterization also may be done.  Your doctor can recommend appropriate testing for your case.

What is heart valve surgery?

Heart valves may be either repaired or replaced, depending on the damage.  Sometimes the surgeon can restore the valve to function normally by remodeling the tissue--removing stretched tissue or sewing the edges.  Prosthetic or artificial rings may be used to narrow a dilated valve and to reinforce valve repairs. 

Replacement is a possible option for heart valves too seriously deformed or degenerated to be repaired.  The old valve is removed and replaced with a new valve mechanism.  The new valve is attached by sewing it to a rim of tissue kept from the original valve.  There are different types of valve mechanisms in two categories--tissue valves and mechanical valves.

Your doctor can advise you on appropriate surgery for your case.

How do I prepare for heart surgery?

Feeling anxious is natural when considering any type of operation.  You may reduce your anxiety by resting, eating a healthful diet, limiting exercise, and talking to the health care professionals who are handling your case.

Being informed--having the procedure explained to you, voicing your concerns, getting your questions answered--may help you feel more relaxed as the procedure draws near.  Your doctor can give you information about your own case.

What are the risks?

Over 75,000 heart valve replacement surgeries are performed each year.  As in all major surgery, there are risks.  Risks generally depend on age, general health, specific medical conditions, and heart function.  After review of your medical history and a physical exam, your cardiologist and surgeon can identify your risks.

What happens after surgery?

After you are discharged from the hospital, regular visits are scheduled with your cardiologist and surgeon.

Eating nutritious meals is important to your recovery.  Limiting your salt intake is often advised after heart valve surgery.  You are urged to give up tobacco products if you are a consumer. 

Follow a gradual exercise program as outlined by your healthcare providers to help you have a quicker recovery.  Your doctor can discuss your medications including approval of any over-the-counter medications.  Discuss also with your doctor when you can resume driving, return to work, and with what limitations.

Your successful recovery depends on how well you follow medical advice, exercise, and follow healthy living suggestions.

 What will my condition be like after heart valve surgery?

After successful valve surgery, you may expect to return to your preoperative condition or better in time.  Depending on the type of valve replacement, you may need anticoagulation therapy.  If so, ask your doctor how long to continue the therapy.  Once wounds have healed there should be few, if any, restrictions on activity.

Whenever you have dental work done, you are advised to take prophylactic antibiotics as a preventive measure against infection.  Before any surgical procedure, always tell your doctor or dentist that you have had valve surgery.

This information is provided as a general overview of heart valve surgery.  It is not intended as a substitute for discussion with your doctor.

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