Steps Of Heart Valve Surgery

Steps of heart valve surgery:

Before admission to the hospital, you should:

1. Stop Smoking: smoking produces excess secretions in the lungs, raises blood pressure and increases the heart rate. If you continue smoke the incidence of complications especially those affecting your lung will increase. Of these complications is prolonged dependence on the mechanical respirator and lung infections.
2. Have Dental Clearance: you should have a complete checkup on your teeth. This information is critical because if you have any oral bacterial infections, they can cause infections of your heart valves. Infective endocarditis of a mechanical valve is a serious disease that requires long term treatment and surgery.
3. Stop Anticoagulants: If you are taking Warfarin (brand name Coumadin) or medications containing aspirin, you will be instructed to discontinue them prior to your surgery.
4. Have blood preparation. The amount of blood needed will be determined with your surgeon.

On admission to the hospital:

You will be admitted to the hospital one day before your surgery. All necessary LABS and investigations will be repeated. Blood preparation will be confirmed. You will be asked to stop eating and drinking at midnight. Medications can be taken with a small sip of water after midnight.

On the day of surgery

You will be transported to the pre-operative area outside the operating room a few hours prior to surgery. Here, the anesthesia team will insert an intravenous line (IV) to sedate you. Once the operating room team is prepared for your surgery, the anesthesiologist will take you to the operating room. You will be anesthetized; an endotracheal tube (breathing tube) will be inserted; and other tubes and lines will be placed to monitor your heart, blood pressure, respirations and other bodily functions.

Through an incision along the length of your breastbone (sternum), your heart is exposed, although some surgeons prefer to use other incisions depending on the circumstances. The pericardium is opened, and the patient is connected to the heart-lung machine that will support your breathing and blood circulation during the procedure.

The damaged heart valve will be removed and replaced. The new valve will be one of two basic types: mechanical, made of metal or plastic; or a tissue valve, usually from a pig. After that, the heart or blood vessel is sutured closed, and the patient is disconnected from the heart lung machine. The chest incisions are closed in layers with stitches, and the skin is closed with stitches or staples.

After the operation (which lasts several hours), you will spend one or more days in a coronary or intensive care unit where your heart function and general recovery will be closely monitored.

You wil then be transfereed to the ward and then home after few days. You can read more about your ward and home stay after surgery here.

Minimally Invasive Heart Valve Surgery

For patients without coronary disease, heart valve replacement or repair can now be performed through very small incisions (3 inches) compared with those used in conventional surgery.

Minimally invasive valve replacement surgery is performed in two different ways:

1. Aortic valve replacement incisions are performed through an upper mini sternotomy, in which an incision is made from the sternal notch to the third intercostal space.
2. Mitral valve replacement or repair incisions are performed through a lower mini-sternotomy, in which a 6-8 cm incision is made at the lower end of the sternum upward to the second intercostal space and extending into the interspace on the right.