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Heart Valve Replacement Surgery - Topic Overview

Valve replacement surgery is generally performed as an open-heart procedure in the operating room of a hospital. It may also be done as a minimally invasive surgery.

Although valve surgery is an intricate procedure, it is also common. In the majority of cases, valve replacement surgery is a straightforward procedure with a high rate of success and a low risk of complications. A cardiac surgeon, who specializes in heart surgery and has had years of training, will do the surgery. A team of nurses, an anesthesiologist, and possibly a surgical resident will assist the surgeon.

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In rare cases, a more complex operation is done. The aortic valve may be replaced with one of the person's other heart valves (usually the pulmonary valve between the lower right heart chamber and the opening to the artery that goes to the lungs). Since the pulmonary valve is used in the heart to replace the aortic valve, an artificial valve is implanted to replace the pulmonary valve. This type of valve surgery may be used in people younger than 25 years of age who are more likely to benefit the most from this difficult surgery. The pulmonary valve is more durable, grows with the person, and has a lower risk of infection.

Prepare for surgery

Preparing for valve replacement surgery is similar to preparing for other major surgeries. You will be asked to not eat before surgery to prevent the risk of vomiting while you are under anesthesia. Your doctor may also have you stop taking certain medicines temporarily.

When you are in the operating room, a nurse will attach a number of monitoring devices, such as an EKG, to monitor the function of your heart and other vital signs during surgery. The nurse also will insert an intravenous (IV) line into your arm to deliver fluids and any necessary medicine. Finally, the nurse will place sterile drapes over your body, shave your chest if needed, and sterilize the area.

To help you breathe during surgery, you will be placed on a respirator, which involves placing a tube down your throat and into your lungs. This tube may be uncomfortable, but you will not be awake for most of the time that the tube is in your throat.

An anesthesiologist will place you under general anesthesia so that you do not see or feel anything during surgery. After you are unconscious, a transesophageal echocardiogram, which is a type of ultrasound device, will be inserted into your esophagus to display images of your heart during surgery.

Open the chest

The surgeon will use a marker to outline the incision on your chest before making it. To gain access to the heart, the surgeon will typically cut straight down the middle of your chest, from the top of your rib cage to just above your belly button. The incision goes through your sternum, or breastbone. Some surgeons are currently doing a new type of procedure called minimally invasive surgery, which uses an incision that is about one-third the size of a normal incision.

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