Heart Valve Surgery

When heart valves are severely malformed or damaged, there is no medicine to reverse or repair the damage.  In most cases, surgery is the only effective option for repairing the valve and and alleviating symptoms.  

Heart valve repair: Heart valve repair surgery attempts to preserve the patients native valve.  It may  include cutting scarred flaps so they open more easily; remodeling valve tissue that has enlarged; or inserting prosthetic rings to help narrow a dilated valve.  Because a person's own tissues are used, heart valve repair is possible for aortic regurgitation.  

Valve Sparing Root, also known as the David Procedure is a commonly used aortic valve repair technique.  When the aorta is dilated, but the aortic valve is structurally otherwise normal, the aorta can be replaced ("root replacement") while preserving the aortic valve ("valve sparing"). This avoids the need for a valve replacement with an artificial valve.  Thus offering the possibility for a more durable repair, as well as avoiding the potential need for blood thinning medication. 

Heart valve replacement:  In some cases, particularly for aortic stenosis, heart valve replacement is necessary. When heart valves are severely malformed or destroyed, they may need to be replaced with a new mechanism. Replacement valve mechanisms fall into two categories: tissue (biologic) valves, which include animal valves and donated human aortic valves, and mechanical valves:
 
Mechanical valves are made of  metal, plastic, or another artificial material and thus have greater durability.   The downside is that it requires the patient to remain on anticoagulation for the rest of their life.  They are traditionally recommended for patients:        
  • < 60 years old patients who want to avoid reoperation
  • patients are already on long-term anticoagulation for another reason 

Tissue valves do not require long-term anticoagulation, but they are less durable.  They are traditionally recommended for patients: 
  • > 60 years old
  • patients who prefer to avoid anticoagulation for lifestyles reasons (eg extremely active lifestyle, recent GI bleed, childbearing age)  

Durability of a tissue valve is very good, approximately 85% of tissue valves implanted in patients 70 and over are still functioning at 15 years. However, durability is age dependent due to greater hemodynamic demands in younger patients

         Programs

Getting a second opinion can provide peace of mind and confidence that you have been diagnosed appropriately and understand of all your treatment options. 
Send an email here or please call us at 732-235-7231.
Our team is available 24 hours a day, 7 days a week to discuss issues regarding heart and aortic disease as well as to coordinate urgent, emergent and elective transfers at the local, regional, national and international levels. Please call us at 732-235-7231.