What is Heart Valve Replacement?

The heart is a muscular pump that has four chambers. The upper two chambers are the left and right atria (singular: atrium), and the lower chambers are the left and right ventricles. The atria receive blood into your heart, while the ventricles pump blood out of the heart.

The left ventricle pumps blood to all parts of the body through the aorta, while the right ventricle conducts blood to the lungs through the pulmonary artery. This movement of blood in and out of the heart occurs in an orchestrated pattern regulated by valves which open and close to allow blood flow in one direction at the right time.

There are four valves in the heart and they include the following:

• Mitral valve: This is located between the left atrium and ventricle
• Tricuspid valve: Located between the right atrium and ventricle
• Aortic valve: Located between the left ventricle and the aorta
• Pulmonary valve: This occurs between the right ventricle and the pulmonary artery.

If any of these valves is damaged, it would affect the flow and direction of blood and ultimately, the amount of blood the heart receives and pumps out. This would put the organs of the body at risk of receiving insufficient blood supply.

Heart valve replacement or repair is done when heart valves do not perform their functions as they should. The damage to the valves may be such that they become stiff and narrow, or they become leaky.

How is Heart Valve Replacement Surgery Done?

The traditional way doctors perform heart valve replacement is via open heart surgery. This involves making a large incision in the middle of your chest to get access to your heart for repair or replacement of your damaged valve.

There are newer and less invasive methods of performing a heart valve replacement developed recently. These techniques use small incisions in the chest or groin to reach the heart. A catheter is inserted through these incisions to replace the damaged valves.

Before the procedure, you would be given a consent form to sign. This form grants permission to the surgeons to go ahead with the procedure. You would be asked to avoid eating and drinking for 8 hours before the procedure.

For an open heart surgery, you would be asked to remove your clothes and jewellery, and you would be positioned on an operating table. A general anaesthetic, which would keep you asleep during the procedure would be administered to you while the anaesthesiologist continuously monitors your breathing, heart rate, and blood pressure throughout the procedure.

A breathing tube would be passed through your mouth into your lungs and connected to a ventilator which breathes for you while the procedure is performed.

Your surgeon would make a skin incision from just below your neck to a level above your navel, then cut open your breastbone to get access into your heart. For your doctor to operate on your heart, it needs to stop pumping. So some tubes are used to connect your heart to a bypass machine which does the pumping of blood to all parts of your body while your heart is stopped.

When your heart is stopped, the surgeon goes in to either repair or replace the damaged valve. Once the procedure is completed, the heart is started again by shocking it with electric paddles and it is observed to see if the replaced valves are functioning well. Your sternum is sewn back and your skin incision is sutured and dressed before you are taken to a recovery room.

What risks are Associated with Heart Valve Replacement?

Bleeding, chest infection, and irregular heartbeats are common complications of a heart valve replacement surgery.