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What is valve surgery?

David H. Adams, MD
Thoracic Surgery (Cardiothoracic Vascular)

Heart valve surgery is used to repair or replace any of the four valves in the heart if they are tight (stenosis) or leaky (regurgitation).

In almost all cases, heart valve surgery involves open-heart surgery through either a 3-4 inch incision through the breast bone, or between the ribs.

Mitral valve repair is the most effective treatment for mitral valve regurgitation. It is the only treatment shown to restore life-expectancy to normal. Your surgeon will restore the structure supporting the valve leaflets to its normal size and shape usually using a manufactured ring, and use a variety of techniques to make sure enough leaflet meets in the middle of the valve to make it watertight again. The quality of the repair is tested by injecting saline into the heart and seeing whether any leaks back through the valve. Mitral stenosis is usually treated by replacing the valve with a manufactured valve.

The most effective treatment for aortic stenosis is aortic valve replacement. Aortic regurgitation can sometimes be treated by valve repair, but usually involves valve replacement. Once the surgery is complete the valve can be rechecked in the operating room using echo. 

Heart valves malfunction because they either do not close well, causing blood to leak backwards, or they do not open well, preventing blood from flowing forwards. In traditional heart valve surgery, heart surgeons open the chest and stop the heart using the heart-lung machine. Then they can repair heart valves with stitches and special rings, or they can replace heart valves. The most common surgeries are mitral valve and aortic valve surgeries. In the last several years, heart doctors have developed less invasive ways to fix these valves by using small incisions in the groin, without opening the chest. These procedures are called percutaneous mitral valve repair and percutaneous aortic valve replacement. In appropriate patients, these newer procedures might be as effective with lower risk.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.