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| Surgical
Procedures |
Cardiac
Valve Procedures
The heart is a pump and needs healthy valves
to function optimally.
Valves within the heart open and close between
the four heart chambers at precise intervals
to keep the blood flowing in one direction.
When heart valves malfunction, it may be due
to obstruction to flow (valvular stenosis),
leakage (valvular insufficiency), or a combination
of both (mixed valve disease).
Defective valves place strain on the heart
by increasing the amount of work your heart
must perform. Corrective surgery can include
valve repair or replacement. In situations
that require replacement, the damaged valve
is removed and replaced with either a "tissue"
valve or a "mechanical" valve.
Although tissue and mechanical valves function
similarly, there are distinct advantages and
disadvantages of each. The advantage of mechanical
valves is that they last longer. The disadvantage
of mechanical valves is that they require
anticoagulation with blood thinners for the
remainder of a patient's life.
The advantage of tissue valves, which are
typically made from cow or pig hearts, is
that they do not require formal anticoagulation.
The disadvantage of tissue valves, however,
is that they generally wear out after 12-15
years, at which time another operation would
be required to replace the worn out valve.
Most valve surgeries are still done conventionally-
meaning that a chest incision is made and
the sternum (breastbone) is divided so that
the rib cage can be opened to expose the heart.
Because valve surgery is a true open-heart
surgery, it requires the use of a heart-lung
machine (cardiopulmonary bypass) during surgery.
This permits the surgeon to safely open and
operate on the heart without blood pumping
through it. The heart-lung machine continues
to pump freshly oxygenated blood to the rest
of the body, in effect, taking over the roles
of the heart and lungs.
The choice of the appropriate procedure can
be a complex decision. Your surgeon will discuss
your options with you.
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