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Valve Repair or Replacement? 

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Why are healthy valves critical to a healthy heart?
Valves are like flood gates in your body. They must open to let blood pass through, taking vital oxygen and nutrients to your body. They also must close tightly, so the blood will flow in an outward direction. If blood flow is inefficient -- either because the valve opening is too small or the blood is leaking backward, your heart has to work harder to supply your body. Backed-up fluid overfills the heart, enlarging it and making it weaker. The excess fluid can put additional pressure on the arteries going to the lungs, affecting the lungs also. Decreased blood flow deprives your body of what it needs to thrive. 

Example of a Mechanical Heart Replacement Valve
Valve repair or replacement?

Approximately 65,000 heart valve repairs are performed each year in the United States. This surgery, often performed using minimally invasive techniques, is generally the first choice of surgeons for several reasons:
The procedure is easier on the patient.
Repairing a valve preserves the heart muscles strength.
There is a lower risk of infection.
Recuperation is quicker for patients.
Repairs, using your own body tissue, dont require anti-rejection (no valves require immunosuppression) medications or life-long blood thinner medications.
May last longer
While repair is preferred, surgeons may not know until surgery begins whether the valve can be repaired or will need to be replaced.

Valve replacement choices
Your surgeon has two choices for valve replacement surgery:
Mechanical valve or
Biological valve

The surgeon will work with you to decide which is best for you. Each type of valve has strengths and weaknesses.

A mechanical valve is durable and is designed to last a lifetime. It is often made of carbon, a metal that is well-tolerated by the body. The metal is covered in a polyester knit fabric that can be stitched to your own tissue. A drawback of the mechanical valve is that patients will take anticoagulants for the rest of their life to prevent blood clots from forming on or near the valve. If blood clots become dislodged, they could travel to the brain and cause a stroke (blood interrupted to the brain) or damage other organs, or disrupt blood flow to the heart, causing a heart attack. (Emboli to the heart are rare.) Younger patients may want a mechanical valve to avoid another operation 10-15 years in the future. Women can't take coumadin during the first and last trimesters of their pregnancy.

A biological valve can be porcine (from pig tissue), bovine (from cow tissue) or from a human cadaver (allograft or homograft).

Pig valves have a proven track record, for they have been available for more than 30 years. The tissue is preserved, sterilized, and covered in fabric that will encourage your own tissue to grow around it.

Cow valves have been used in the United States since 1991. They have a reliable track record for long-term durability.

A human cadaver valve is ideal for aortic valve replacements because its the closest match in size and shape to your anatomy.

The advantage of biological valve replacement is there is no need to take blood thinner medicine for the rest of your life. The disadvantage is their durability; when they first were used in humans, they tended to wear out in about 10 years. Over time, they have become more durable and some studies now show that biological valves may last 17 years.

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