What Happens During this Procedure?
A heart valve replacement and repair surgery steps vary depending on the age, condition, and severity of the valve issue.
Generally, heart valve replacement procedure includes:
- The surgeon will ask the person to remove particular jewelry or objects that may interfere during the procedure.
- A patient will be laid down on the operating bed and the healthcare professionals will start an intravenous (IV) line in the hand or arm to inject medicines or IV fluids.
- The surgery is performed under general anesthesia.
- The professionals will put catheters in blood vessels around the neck and wrist to monitor the heart rate, blood pressure, and draw blood samples.
- The physician will put you on ventilatory support to help you breathe normally during the surgery.
- The doctor will place a transesophageal echocardiogram (TEE) into the esophagus so that the surgeon can monitor the patient’s valve functions.
- The medical professionals will put a soft and flexible tube called a Foley Catheter into the bladder to get urine out from the body.
- Also, a tube will be put into the stomach through the nose or mouth to drain stomach fluids.
- A medical professional will clean the skin over the chest with an antiseptic. Also, the professional may shave off hair around the surgical site.
When the surgery starts
- For the surgery, the surgeon will make an incision at the center of the chest. If the patient is having a less invasive procedure, it may require smaller incisions.
- The breastbone of the sternum is cut in half lengthwise. The surgeon will then separate the breastbone halves to expose the heart.
- For valve replacement or repair, the doctor must stop the heart and connect a tube to the heart so that the blood can be pumped through a heart-lung bypass machine.
- Once the blood is completely diverted into the bypass machine for pumping, the doctor will inject a cold solution to stop the heart.
- Once the heart is stopped, the doctor will remove the diseased valve and place the artificial or metal valve.
- After placing the valve, the doctor will shock the heart with small paddles to restart the heartbeat. Next, the surgeon will make blood circulation through the bypass machine to re-enter the heart.
- Once the heart starts working again, the surgeon will monitor if the heart and valves are working properly. Also, the surgeon ensures there are no leaks from the surgery.
- After confirming the healthy functioning of valves and heart, the surgeon will rejoin the sternum, sewing it back together.
- The surgeon will put small tubes into the chest to drain blood and other fluids around the heart.
- Next, the surgeon will stitch the skin over the sternum and close the incision with surgical staples or sutures.
- The surgical site will be covered by a sterile bandage or dressing.
The majority of patients after heart valve replacement stay in the hospital for a week or two. For the initial few days, the patient remains in the intensive care unit (ICU). The medical staff will monitor the blood pressure, heart pulse, and breathing for a few days post-surgery. Depending on the type of valve that is used, a patient may need to take blood-thinning medicines for life.
Full recovery may take a few weeks or months, depending on the type of heart valve replacement and the healing process.
Infection is one of the major risks that might occur. Therefore, keep the incisions clean. Ensure that the patient immediately rushes to the surgeon if he or she experiences the symptoms of infection like:
- Increased drainage from the incision site
- Tenderness or swelling at the incision site
Once a patient is at his or her home, it is important that the surgical area and incisions are kept clean and dry. This helps to prevent any possible infection in the surgical area.
The surgeon will give specific bathing instructions that should be followed strictly. The sutures or surgical staples will be removed within a few days or before getting discharged from the hospital.
A patient should not perform any stressful activities until the doctor suggests to do so. Doctors will also recommend that the patient avoid driving in the meantime.
A patient should immediately rush to the surgeon if he or she experiences the following:
- Weakness in the legs and arms
- Easy bruising
- Severe pain around the incision
- Irregular or rapid heart pulse
- Redness, swelling, bleeding, or drainage from the incision or any of the catheter sites
- Frequent nausea or vomiting
- Fever of 100.4 degrees F (38 degrees C) or higher, or chills
- Breathing issues
- Increased swelling in the abdomen and legs
The surgeon will give necessary instructions looking at the patient’s condition. Also, it is advisable to consult the doctor before using any drug, medicine, herb, supplement, or taking up any physical activity that promises recovery from heart valve replacement or boosting heart health.