Heart Valve Surgery vs. Valve Replacement

Healthy valves are critical to a healthy heart. Valves are like floodgates in your body. They must open to let blood pass through, bringing vital oxygen and nutrients to your body. They also must close tightly, so the blood will flow in an outward direction. If there is a problem with a heart valve, an experienced surgeon can perform a valve repair or replacement to treat the problem.

Heart Valve Disorders: Advanced Care in Virginia

If the heart valve opening is too big or too small, or the blood is leaking backward, it causes an inefficient blood flow. This means:

  • Your heart has to work harder to supply blood to your body
  • Backed up fluid can overfill the heart, enlarging and weakening it
  • Excess fluid can put additional pressure on the arteries leading to the lungs, affecting the lungs as well
  • Your body is deprived of its necessary oxygen and nutrients

Heart valve disorders can cause a number of different symptoms. Learn more about the signs and symptoms of heart valve disorders.

Valve Repair 

Every year in the United States, heart surgeons perform approximately 65,000 heart valve repairs. At Sentara, we use minimally invasive heart surgery whenever possible, providing you with a less risky surgery and quicker recovery. Surgeons generally prefer valve repair rather than valve replacement 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, don’t require anti-rejection medications or life-long blood thinner medications.
  • The valve repair may last longer.

While heart surgeons often prefer a repair, we often do not know until surgery begins whether we can repair the valve or whether we will need to replace it. Our surgeons have the necessary expertise to perform both types of operations, and we will choose the approach that offers you the best outcome.

Valve Replacement: Types of Valves

If your surgeon decides valve replacement is the best approach, we will discuss with you the two options for replacement valves. Each type of valve has strengths and weaknesses. The valve types are:

  • Mechanical heart valve
  • Biological heart valve

Advantages of a mechanical heart valve include:

  • It is durable and designed to last a lifetime.
  • It is often made of carbon, a metal that the body can tolerate well.
  • The metal is covered in a polyester knit fabric that can be stitched to your own tissue.
  • It is a good choice for younger patients, who may want to avoid another operation 10-15 years in the future.

Drawbacks of the mechanical heart valve include:

  • You need to take anticoagulants for the rest of your life to prevent blood clots from forming on or near the valve.
  • There is a risk that if blood clots become dislodged, they could travel to the brain and cause a stroke (an interruption of the blood flow to the brain) or damage other organs. There is even a risk, though rare, of a blood clot traveling to the heart, causing a heart attack.
  • There is a risk for pregnant women, who can’t take blood thinners during the first and last trimesters of their pregnancy.

Biological Heart Valve

There are three types of biological valves. Each has its own advantages:

  • Porcine (from pig tissue). Pig valves have a proven track record. They have been available for more than 30 years. The tissue is preserved, sterilized and covered in fabric that encourages your own tissue to grow around it.
  • Bovine (from cow tissue). Cow valves have been used in the United States since 1991. They have a reliable track record for long-term durability.
  • Allograft or homograft (from a human donor). A human valve is ideal for aortic valve replacements because it’s the closest match in size and shape to your anatomy.

The main 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 physicians first started using biological valves, they tended to wear out in about 10 years. They have since become more durable; some studies now show that biological valves may last as long as 17 years.