Heart Valve Replacement Surgery - Topic Overview
Establish heart-lung bypass
When your heart is visible, the surgeon will place you on a heart-lung machine, which will take over the function of your heart and lungs for the remainder of the operation by circulating oxygen-rich blood throughout your body. To attach you to the heart-lung machine, the surgeon will insert a tube into your right atrium, which receives oxygen-depleted blood from your body. Instead of going to your lungs to receive oxygen, the blood travels to the heart-lung machine to exchange carbon dioxide for oxygen. The blood then travels through a tube back to your aorta, which supplies blood to your entire body.
During bypass, your aorta is clamped near your valve to prevent blood from interfering with the surgery. To stop your heart temporarily, the surgeon will flush it with cold salt water or with a medicine. The surgeon will then bathe the heart in a solution that allows it to survive being deprived of blood for a short time.
This bypass is needed because it is difficult to work on your heart while it is beating. The bypass allows the surgeon to stop your heart temporarily without interfering with the circulation of oxygen-rich blood to your body. Bypass also reduces the risk of serious bleeding (hemorrhage).
Remove the old valve
After blood flow is diverted to the heart-lung machine, the surgeon will make a cut to expose the valve that is going to be replaced. For example, for an aortic valve replacement, the surgeon will make an incision in the aorta to expose the aortic valve. The surgeon will cut out the parts of the valve that will be replaced.
Attach the new valve
After parts of the old valve are removed, the surgeon will use a device to measure the size of the valve opening to select the proper size for the replacement valve. In general, the surgeon will choose the largest possible valve to ensure the best possible blood flow through the valve. The surgeon may then place the valve in the opening to make sure it fits correctly. After properly aligning the valve, the surgeon will sew it in place.
The surgeon will then check the placement to make sure there is no room for leaks. The stitches are then tied off and trimmed.