Heart Valve Surgery
When heart valves are severely malformed or damaged, there is no medicine to reverse or repair the damage. In most cases, surgery is the only effective option for repairing the valve and and alleviating symptoms.
Heart valve repair: Heart valve repair surgery attempts to preserve the patients native valve. It may include cutting scarred flaps so they open more easily; remodeling valve tissue that has enlarged; or inserting prosthetic rings to help narrow a dilated valve. Because a person's own tissues are used, heart valve repair is possible for aortic regurgitation.
Valve Sparing Root, also known as the David Procedure is a commonly used aortic valve repair technique. When the aorta is dilated, but the aortic valve is structurally otherwise normal, the aorta can be replaced ("root replacement") while preserving the aortic valve ("valve sparing"). This avoids the need for a valve replacement with an artificial valve. Thus offering the possibility for a more durable repair, as well as avoiding the potential need for blood thinning medication.
Heart valve replacement: In some cases, particularly for aortic stenosis, heart valve replacement is necessary. When heart valves are severely malformed or destroyed, they may need to be replaced with a new mechanism. Replacement valve mechanisms fall into two categories: tissue (biologic) valves, which include animal valves and donated human aortic valves, and mechanical valves:
Mechanical valves are made of metal, plastic, or another artificial material and thus have greater durability. The downside is that it requires the patient to remain on anticoagulation for the rest of their life. They are traditionally recommended for patients:
Tissue valves do not require long-term anticoagulation, but they are less durable. They are traditionally recommended for patients:
Durability of a tissue valve is very good, approximately 85% of tissue valves implanted in patients 70 and over are still functioning at 15 years. However, durability is age dependent due to greater hemodynamic demands in younger patients