Valvular heart surgery, How and When ?

The heart pumps blood in only one direction. The heart valves play an important role in this unidirectional blood flow, opening and closing with each heartbeat.

The heart has 4 valves: Aortic, Mitral, Tricuspid and Pulmonary, and none of them are free from disease or deterioration. Sometimes more than one valve can be damaged simultaneously.

Repair or valve replacement surgery, is a therapeutic option for heart disease of the heart valves.

When heart valves become injured or sick, they may not work properly. Clínica Cardiovascular has adapted the most innovative and effective techniques for the management of this pathology.
Two types of problems can alter the blood flow through the valves: regurgitation and stenosis.



Regurgitation or insufficiency; occurs when a valve does not close properly and allows blood reflux (to flow back). If blood ebb is large, only a small amount of blood can flow into the organs of the body. The heart tries to compensate by doing more work, but over time the heart enlarges (dilates) and its ability to pump blood to the body is less.

Stenosis is when the valves do not open wide enough and only a small amount of blood can pass through the valves. Stenosis occurs when the valves become thicker, harden (calcification) or fuse. Due to the narrowing of the valve, the heart must work harder to pump blood to the body.

The doctor may decide that the diseased valve (s) should be surgically repaired or replaced, and usually, when the deterioration is serious enough for this damage to begin to enlarge the heart.

WHAT ARE THE OPTIONS FOR SURGERY FOR THE HEART VALVES?

Traditionally, repair (Valve repair) or replacement of the heart valves has consisted of open heart surgery.

The diseased valve can be repaired on certain occasions depending on the disease; using several advanced surgical techniques and also the placement of devices called Rings, this has the advantage that the patient's native valve is maintained, and does not require the use of drugs such as anticoagulants.

However, in case of not being a candidate for Valve repair, the diseased valve must be replaced by an artificial prosthesis, there are 2 types; Mechanical valves (made of metal) or Biological (made of biological animal tissue), each have their advantages, disadvantages and precise indications, so we are available to guide you to make the best decision for your benefit.





More innovative and less invasive techniques have been developed to replace or repair heart valves. The emerging technology has developed bio-prostheses that can be implanted percutaneously (by puncture in the femoral artery, in the leg, similar to a catheterization, without surgery) in adult patients with degenerative aortic stenosis with a high risk for surgery or who do not want to operate. Minimally invasive procedures, in which the incision is much smaller, usually involve less postoperative pain and shorter hospitalizations.

Percutaneous aortic valve implantation is a very attractive procedure for patients of very high risk, since it is not necessary to open the chest of the patient. This type of procedure has its very precise indications

WHAT HAPPENS DURING VALVE SURGERY?

General anesthesia is required so the patient will be asleep and will not feel pain during the operation. In addition, cardiovascular anesthesiologists will be constantly monitoring vital signs and medications throughout the procedure.

During the Valve heart surgery, the sternum and the heart are divided to connect it to the Extracorporeal Circulation machine (Cardiopulmonary Bypass). Once connected, the heart stops and the valve is repaired or replaced. Normally, your heart will stop for about 45-90 minutes of surgery.




When the procedure is finished, the machine is disconnected and the heart will re-establish its heartbeat and functioning, and the process of closing the sternum will begin, using special wires (these wires will remain inside your body without causing discomfort), and the skin will be closed with suture materials.

The average time of surgery is 3 to 4 hours, and implies a stay in Intensive Care of approximately 2 to 3 days depending on the case and then continue its evolution in the hospital room for approximately 2 more days until it is in optimal conditions to be able discharging from the hospital WITH THE RECOMMENDATIONS NECESSARY FOR HOME CARE.