There are many different types of valve repair. Depending on the extent of your valve disease, you may need to have the valve repaired or replaced. A commissurotomy is performed for a tight valve (stenosis). The valve leaflets are cut to loosen the valve slightly, allowing blood to pass easily. Another type of valve repair is a valve ring annuloplasty. A ring is sewn in place to tighten up a leaking (regurgitant or insufficient) valve. The valve leaflets are tucked in place with the ring. Some repairs require removal of damaged or poorly functioning valve tisue and others may require the implantation of materials to fix the valve.
Often the valve cannot be repaired and the surgeon must replace the damaged valve with a tissue (bioprosthetic) or mechanical valve. Tissue valves are made from animal heart valves (e.g., cow, pig) or the material surrounding the heart (pericardium). They generally do not require long-term anticoagulation and are not as durable as mechanical valves. Mechanical valves are made from materials such as plastic or metal. They require long-term anticoagulation and are considered extremely durable, lasting longer than tissue valves.
Your surgeon will discuss the need for repair or replacement of the valve with you prior to surgery as well as the type of valve (tissue or mechanical) should replacement be necessary.