Leaky Heart Valve Surgery

A leaky heart valve lets blood flow in two directions when it should flow in only one. This happens when something is wrong with the valve's flaps, or leaflets, which control the flow and direction of blood.

Blood either leaks through when the flap should be completely shut or goes back into the valve as the flap closes. This can make your heart work harder and keep it from pumping the right amount of blood.

A leaky heart valve, also called regurgitation, can happen suddenly or it may develop slowly over many years.

If it's a minor issue, it can be treated with medication, or you may not need treatment at all. But in some cases, your doctor may recommend surgery to repair or replace it to prevent damage to your heart.

Most doctors would rather repair the damaged valve than replace it because fixing it is easier on your heart. You're likely to recover more quickly after valve repair surgery, and you won't need to take a blood-thinner for the rest of your life as you would if your damaged heart valve was replaced.

But it can be harder for a surgeon to repair a valve than replace one. And some valves can't be repaired. Your doctor will work with you to decide which kind of surgery you should have.

Repair

Some of the ways your doctor can fix a damaged valve include:

  • Annuloplasty: A special ring is put around the valve to make it close right.
  • MitraClip: A small cut is made in your groin, and the clip is pushed up to your heart through a thin tube. It clips a small area of the flaps together to limit the leak.
  • Patching:If there are holes or tears in the valve's flap-like doors, a tissue patch is put in place to cover them.
  • Repair of structural support: The cords and muscles that support the valve are replaced or shortened to make the edges of the flap meet. Once they're the right length, the valve will seal as it should.
  • Reshaping: Part of the flap is cut out, and then it's sewn back together in the right shape.

 

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Replacement

If your doctor recommends that the valve be replaced, your surgeon will remove the valve that's not working well and put in a new one.

Some valves are made from specially treated tissue from the heart of a pig, a cow, or a person. These may only last 10 to 15 years.

Other valves are manmade. These "mechanical" valves last longer, but you'll need to take a drug that keeps blood clots from forming on it.

Other ways a valve can be replaced include:

  • Ross Procedure: A problem aortic valve is swapped out with your pulmonary valve, which is the same shape. You'll get a new pulmonary valve from a human donor. This can be a good choice for children because their "new" valve will grow as they do. But it's a complicated surgery, and in some cases, the valves stop working within a few years.
  • Transcatheter Aortic Valve Replacement (TAVR): This new procedure, also known as transcatheter aortic valve implantation (TAVI), is easier on your body than open heart surgery. It's done through small cuts, so your chest bones don't have to be separated. A new flexible valve is carried to your heart through a thin tube.

 

How Do I Prepare?

Your surgery could be scheduled weeks in advance, and it's a good idea to go into your surgery as healthy as you can. Focus on eating well and getting enough sleep and exercise. Try to keep your stress under control.

Your doctor will need information about your health. He'll want to know what medications or supplements you take. You should also let him know if you smoke, have any allergies, could be pregnant, or have a pacemaker.

He also may want to do a blood test or other tests to make sure you're healthy enough for surgery.

What to Expect Afterward

Once your heart valve has been repaired or replaced, your doctor will want you to walk, eat, and drink again as soon as possible. But it'll be a few weeks before you get your energy back.

You may need to follow a special diet. If not, just make sure to eat plenty of "heart healthy" foods like fruits, vegetables, and whole grains.

Exercise is important to get your heart strong again, but you'll need to slowly build up your activity level and pace.

Most people recover from heart valve surgery in 4 to 8 weeks. If you don't need open heart surgery, the time frame could be shorter.

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on November 10, 2018

Sources

SOURCES:

Mount Sinai Hospital: "Treatment for Heart Valve Disease."

National Heart, Lung and Blood Institute: "How Is Heart Valve Disease Treated?"

Johns Hopkins Medicine: "Heart Valve Repair or Replacement Surgery."

Cleveland Clinic: "When Leaky Heart Valves Are at the Heart of the Problem."

Mayo Clinic: "Mitral Valve Regurgitation," "Heart Valve Surgery."

American Heart Association: "Problem: Heart Valve Regurgitation," "Options for Heart Valve Repair," "Ross Procedure," "What Is TAVR?" "Heart Valve Surgery Recovery and Follow Up."

Texas Heart Institute: "Valve Repair or Replacement."

University of Washington Health: "A new fix for 'leaky' heart valves drastically cuts patient recover time."

Brigham and Women's Hospital: "Open-Valve Surgery."

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