Cardiac valve surgery: what happens from surgery to aftercare?

Heart valve surgery is needed either in cases where a patient has been born with a diseased or malfunctioning valve, or in patients with disease of the heart valves that have been acquired during the patient’s life. In most cases, the latter involves a narrowing of the valve.

What are the different types of heart valve surgery?

Heart valve surgery can generally be divided into different methods: either repair or replacement of the valve.

When replacing the valve of the patient, there are two possible ways of doing this: either choosing a mechanical prosthesis to replace the valve or using a biological prosthesis.

Heart valve surgery requires open heart surgery. The surgeon has to open the large vessel, known as the aorta, and either repairs the valve or resects the valve and replaces it with a prosthesis in order to produce of a newly functioning valve. In both cases, the replaced valve will work and function well for a long time and the patient can resume life after a short while.

What is the difference between a mechanical and biological replacement heart valve?

The difference between mechanical and biological heart valves is that mechanical heart valves are engineered valves made from carbon, while biological heart valves are taken from porcine donors meaning pigs, calves or other cattle and are engineered around a frame.

Heart valve surgery aftercare

Usually after heart valve surgery, the patient stays in hospital for around five days before they are discharged. After being discharged, the patient then has to recover slowly before being able to do daily exercises such as walking, doing light work. After a period of around 4 to 6 weeks, patients should usually be fully recovered and be back to full fitness.

Medication following surgery depends on the type of valve implanted. If the patient receives a mechanical valve, they will need to be on lifelong anticoagulation medication. That means that clotting will be reduced and the patient will need to make some lifestyle changes. Whereas if a biological valve is received, the patient will not need any medication for the valve, therefore will not have to make any lifestyle changes. The same applies for heart valve repair.

The future of heart surgery

The future of heart surgery lies in what we call hybrid procedures. That means procedures where conventional surgery is combined with interventional catheter-based technology.

The best example these days is the transcatheter aortic valve implantation (TAVI), where the surgeon implants the valve using a catheter via the arteries, rather than the more traditional methods of open heart surgery.

At this stage, this procedure is only available for patients who are deemed not suitable for surgery, but in the next 10 years, this will develop to a technology that will be applicable for every patient.

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