Heart Valve Repair and Replacement Surgery -- 718.780.7700

What is a Heart Valve?

Your heart is a powerful pump that sends blood and nutrients throughout your body. It has four chambers arranged two over two and each chamber has a valve responsible for permitting blood to flow through the heart in only one direction. When functioning properly, the valves respond to pressure changes and open their corresponding flaps (called leaflets) as blood flows out, then close tightly to keep blood from flowing back.

There are four major valves in the heart. On the right side, the Tricuspid and Pulmonary valve bring oxygen depleted blood through the heart to the lungs. On the left side, the Mitral and Aortic valve accept oxygen rich blood from the lungs and send it out to the rest of the body. When any of these valves become diseased or malfunction, it is imperative a patient receive treatment to restore a normal consistent blood flow through the heart.

What is Heart Valve Disease?

A diseased heart valve may be one that does not close or open properly allowing blood to leak backwards and not sending enough oxygenated blood to your other vital organs. As the heart sense the lack of blood flow, it pumps harder to compensate. In some cases the leaflets of the valve stiffen or fuse together not allowing full blood flow through the body and again forcing the heart to work harder.

Several things can happen to cause a valve to malfunction or weaken from infections to calcium build-up to coronary artery disease. Some medications and lifestyle changes can alleviate symptoms and pain associated with a diseased valve, but often times surgery is needed to repair or replace the valve itself. In some cases valves are not formed correctly before birth. Those are called congenital valve defects which most often affect the pulmonary and aortic valves and usually require surgery to alleviate the condition.

What is the difference between Repair and Replacement Valve Surgery?

A valve which has become narrowed and stiff due to calcium deposits forming within can be repaired with surgery that widens the valve and permits better blood flow. Repairs can also be made to leaflets of the valve by patching areas that have become torn or need reshaping or support to close properly.

A valve that is too damaged must be removed and replaced with a prosthetic (artificial) valve made either from mechanical (plastic or metal) or biological materials (animal or human tissue). Mechanical valves generally last longer than biological, but require the patient to take blood-thinning medications for the rest of his or her life.

In either case, valve surgery is traditionally performed invasively requiring the surgical team to open the chest cavity and attach the patient to a heart-lung machine. In recent years, some minimally invasive techniques have been developed to repair and replace valves. The advantages are many: quicker recovery time, lower risk of infection, reduced pain and less need for transfusion, however not everyone is a candidate for minimally invasive valve surgery. The decision will depend on the type of valve being repaired or replaced and your general medical condition. Your NYM heart doctor will discuss all your options with you thoroughly.

What is Mitral Valve Surgery?

Mitral Valve disease, along with Aortic Valve disease, is the most common and most serious form of valve malfunction. It can take two main forms: First, the Mitral valve might allow a backflow (called regurgitation) of blood into the left atrium which, if left untreated, could cause enlargement of the heart. Second, the Mitral valve may become narrowed or blocked not allowing proper blood flow. This is called Mitral Stenosis.

NYM surgeons can either repair or replace the Mitral valve depending on the extent of the damage.

What is Aortic Valve Surgery?

The aortic valve may be malformed from birth (called congenital aortic disease) or become worn out over time (called acquired aortic valve disease). Unlike Mitral valves, the aortic valve is not often repaired, but is more normally replaced with a prosthetic.

A normal aortic valve has three flaps or leaflets, but if the valve is malformed before birth (congenitally) it may have only two flaps. This is called a Bicuspid Aortic Valve which can function for years before requiring surgery. With acquired aortic valve disease the valve becomes worn over time and calcium builds up restricting the opening (called stenosis) and closing (called leakage or regurgitation) motion of the leaflets.

In recent years surgeons have developed a bridge technique for patients unable to tolerate invasive valve replacement or repair surgery. The procedure is called Balloon valvuloplasty for aortic valve stenosis (restricted aortic valves). A thin flexible tube is threaded through the heart and as it reaches the blocked aorta the balloon at the end of the tube is inflated thereby enlarging the valve opening. It is only a temporary relief in older patients, but has been shown to have longer lasting affects in teens.

What is Tricuspid Valve Surgery?

When one or more of the leaflets of the tricuspid valve do not close effectively allowing blood to seep backwards from the right ventricle to the right atrium the condition is called tricuspid regurgitation or more commonly, a leaky heart valve. In most cases, the leaky valve does not deteriorate any further and people lead full lives never knowing about the malfunction. However, if symptoms become severe such as extreme weakness, fainting or heart failure a valve repair or even replacement may be necessary. Often times, other medical conditions will dictate which is right for you, but you can be certain that at New York Methodist Hospitals Cornell Heart Center your doctors will explore every type of treatment available.

For more information on these procedures, call 718.780.7700.