Damaged Heart Valve: Repair or Replace? - Medx Health Assistance

Damaged Heart Valve: Repair or Replace?

Repairing or replacing a valve can avoid damages to the heart and sudden death. Heart valve repair is preferred over heart valve replacement, if possible. Valve repair secures the strength and function of the heart muscle. However, not all valves can be repaired. Mitral valves can do with repair, if plausible, whereas pulmonary and aortic valves have to be replaced once defected. 

The decision to repair or replace heart valves is based on a number of factors, including the following:

  • The severity of the valve disease.
  • Whether the patient requires heart surgery for other conditions, such as bypass surgery to treat coronary heart disease.
  • Patient’s age and general health.

Repairing Heart Valves

Valve repair is usually done on congenital valve defects with a good success record.

In short, surgeons can repair heart valves by:

  • Extracting or reshaping tissue, which will let the valve close tightly. 
  • Tissue can be added to patch holes or tears, which might increase the support at the base of the valve.
  • Segregate fused valve flaps. 

Here are few detailed procedures used to repair a valve:

  • Commissurotomy- It is a procedure for narrowed valves with thickened and possibly stuck leaflets. The surgeon opens the valve by cutting the points where the leaflets intersect in this operation.
  • Valvuloplasty– It is a procedure that strengthens the leaflets of the valve to provide more protection and enable the valve to close tightly. A ring-like system that surgeons mount outside of the valve opening provides this support.
  • Reshaping– A section of a leaflet is cut out and might even be sewed to reshape and resume proper functioning of the valve. 
  • Decalcification– The calcium accumulation on the leaflets is extracted in this procedure. Tissue patches are used to cover gaps or tears in the leaflets. 

The cords that protect the valves (the chordae tendineae and the papillary muscles) are replaced or shortened when structural support is repaired.

The valve will close properly when the cords are of the correct length.

Sometimes cardiac catheterization is used to repair heart valves. Balloon valvuloplasty can be used to patch heart valves that can’t completely open (stenosis). It reduces many symptoms of the heart valve dysfunction. This treatment involves insertion of a small balloon into the patient’s heart where it’s inflated slightly. The inflation helps to increase the size of the opening in the valve, and then the balloon is taken out. This treatment has a shorter recovery time than surgery. But, the patient may still require medicines to treat symptoms or to cope with the surgery. 

 

Heart Valve Replacement 

When the heart valves are difficult to repair, they are replaced. In this surgery the faulty valve is removed and replaced with a man-made or biological valve. That might include using one of the following:

  • Own tissues.
  • An animal valve, if the patient has a biological valve replacement.
  • A donated valve.
  • An artificial or mechanical valve. 

Biological valves may be made from pig, cow, or human heart tissues, and they can also contain man-made components. These valves are specially treated, so that the patient won’t require medicines to stop the body from rejecting the valve. Man-made valves, on the other hand, last longer than biological valves and usually do not require to be replaced. Although, man-made valves might require the in take of blood-thinning medicines for the rest of the patient’s life. These medicines avert blood clot formations on the valve. Man-made valves might also increase the risk of infective endocarditis.

 

Several surgeons are now using a minimally invasive, catheter-based treatment to replace damaged valves, called transcatheter aortic valve replacement or implantation, TAVR/TARI. This treatment is adopted for the patients who are at high or moderate risk of having complications with an open heart surgery. TAVR can ease the patients from the signs and symptoms of aortic valve stenosis and might also improve the survival rate. 

 

Conclusion 

In spite of similar risks, including bleeding, heart attacks, strokes, and lung complications, a heart valve repair surgery is considered to be more complicated than valve replacement. Doctors might recommend repairing or replacing the heart valve(s), even if there are no symptoms. With the advancement in science and technology we can analyze the conditions in a better way to make the best decisions. For instance, for certain patients with mitral valve stenosis, balloon valvuloplasty can be as successful as surgery; Adults with aortic valve stenosis, however, do not undergo balloon valvuloplasty. A discussion with the doctor is always helpful in deciding the best suited treatment for one’s condition. 

 

 

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