Heart Valve Repair and Replacement Surgery

718.780.7700

What is a Heart Valve?
The heart is a powerful pump that sends blood and nutrients throughout the 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, opening their corresponding flaps (called leaflets) as blood flows out and then closing tightly to prevent 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 that 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 other vital organs. As the heart senses the lack of blood flow, it pumps harder to compensate. In some cases the leaflets of the valve stiffen or fuse together, preventing full blood flow through the body and again forcing the heart to work harder.

Causes of valve problems range from infection to calcium build-up to coronary artery disease. In some cases, medications and lifestyle changes can alleviate symptoms and pain associated with a diseased valve. Often 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.


What is the difference between Repair and Replacement Valve Surgery?
A valve which has become narrowed and stiffened due to calcium deposits 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.

Traditional Surgery and  Minimally Invasive Surgery
During traditional heart valve surgery, a surgeon will make an incision down the center of the sternum (breastbone) to access the heart directly.

Minimally invasive surgery is performed through smaller incisions. This type of surgery reduces blood loss, trauma, and length of hospital stay. Heart valve surgery is the most common minimally invasive procedure. 

Surgeons affiliated with New York Methodist Hospital take advantage of the most advanced technologies available including minimally invasive surgery as well as minimally invasive robot-assisted surgery. Learn more about robot-assisted surgery here.

Types of Valves

Mitral Valve
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.

Aortic Valve
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.

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.


Tricuspid Valve
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.

For more information on these procedures, call 718.780.7700.