Heart Valve Disease

When functioning properly, these valves have flaps, known as leaflets for the mitral and tricuspid valves and cusps for the pulmonary and aortic valves. These flaps open and close with each heartbeat. However, when they fail to open or close correctly, they disrupt the normal flow of blood through the heart.

In heart valve surgery, a skilled surgeon either repairs or replaces the damaged or diseased heart valve(s). This surgery can be approached through various methods, such as open-heart surgery or minimally invasive heart surgery. The choice of surgical approach taken depends on multiple factors including your age, overall health, and the type and severity of heart valve disease.

Disclaimer: The information in this article is for informational purposes only and is not intended to be a substitute for professional medical advice. Please contact your doctor or a qualified healthcare professional for further queries.

Types of Heart Valve Surgery

Listed below are the major types of heart valve surgery

• Annuloplasty: This procedure involves repairing the ring-like structure around the valve to ensure its proper functioning.
• Valvuloplasty: Valvuloplasty is used for the repair of a heart valve that has been narrowed.

When is Heart Valve Surgery Necessary?

Heart valve surgery is recommended to treat heart valve disease, which can manifest in two primary forms: valve narrowing (stenosis) or valve leakage (regurgitation). This surgical intervention becomes necessary when heart valve disease negatively impacts the heart's ability to pump blood.

In some cases, even if you are asymptomatic or have mild symptoms, your doctor may suggest regular monitoring and lifestyle adjustments along with medications to manage your condition. Sometimes, heart valve surgery might be recommended even in the absence of symptoms, particularly if you require heart surgery for another condition.

Preparing for Heart Valve Surgery

Before undergoing heart valve surgery, your healthcare team will thoroughly discuss the procedure with you and address your questions or concerns.

You should communicate with your family regarding your upcoming hospital stay and the support you will require once you return home. Here are some more points to keep in mind -

• Food and Medications: Consult your doctor regarding the timing of your regular medications and whether you should take them before surgery. Inform them about any allergies or previous adverse reactions to medications. You will also receive instructions about when to stop eating and drinking before the surgery.
• Skin Preparation: In some cases, body hair near the incision sites may need to be shaved and a special soap might be used to reduce the risk of infection.
• Clothing and Personal Items: Prepare a list of your medications and consider bringing personal care items like glasses, hearing aids, dentures, and comfortable clothing. Don't forget to pack a copy of your advance directive and items for relaxation. Leave jewellery, contact lenses, and nail polish at home.

What to Expect During Heart Valve Surgery?

During the procedure, you will be administered anesthesia to induce a sleep-like state. A heart-lung bypass machine will maintain blood circulation throughout your body during the surgery.

There are two main approaches to heart valve surgery:

• Open-Heart Surgery: This method involves a chest incision through the breastbone.
• Minimally Invasive Heart Surgery: This approach uses smaller incisions, resulting in reduced pain and a quicker recovery. Minimally invasive surgery can be performed through small chest incisions or with robotic assistance.

Potential Risks of Heart Valve Surgery

Heart valve surgery, like any medical procedure, carries certain risks that you should be aware of -

• Bleeding: There is a possibility of bleeding during or after the surgery, which is closely monitored by medical professionals.
• Infection: Infections can occur after surgery, necessitating prompt medical attention and treatment to prevent complications.
• Irregular Heart Rhythm (Arrhythmia): Some patients may experience irregular heart rhythms following surgery. These arrhythmias are typically managed and may resolve over time.
• Valve Dysfunction Affecting Replaced Valves: The newly replaced heart valve(s) may not function optimally, leading to complications that might require further medical intervention.
• Stroke: Although uncommon, there is a slight risk of stroke during or after heart valve surgery. 
• Heart Attack: While rare, a heart attack is a potential risk associated with heart valve surgery, especially in patients with underlying heart conditions.
• Death: While the risk is relatively low, any surgical procedure carries a potential risk of mortality.

It's important to remember that these risks are assessed and carefully managed by medical teams and that the benefits of heart valve surgery typically outweigh the potential complications. Your healthcare provider will discuss these risks with you in detail and provide personalised guidance to ensure the best possible outcome.

Types of Heart Valve Repair

• Heart Valve Repair: Aiming to preserve the natural valve, this method may include repair techniques such as patching holes, removing excess tissue, reconnecting valve flaps, and reinforcing the valve's structural support.
• Catheter-Based Procedures: In some cases, heart valve repair can be done using long, thin tubes (catheters) and various devices. For instance, balloon valvuloplasty is used to treat narrowed valves by inflating a balloon within the valve to expand it.

Heart Valve Replacement

When a heart valve can't be repaired, it may require replacement. Replacement valves can be mechanical or made from biological tissue — the latter may include pig, cow, or human heart tissue. Mechanical valves require lifelong blood-thinning medication, while biological valves may need replacement over time.

Recovery After Heart Valve Surgery

After surgery, you will spend time in the intensive care unit (ICU) before moving to a regular hospital room. Your recovery duration depends on your condition and the specific surgery performed.

Throughout your recovery, the concerned healthcare team will monitor your progress, manage pain, and encourage you to gradually increase physical activity. You'll receive instructions on caring for incisions, taking medications, and recognising signs of infection.

Regular follow-up appointments will be scheduled to monitor your condition, and your doctor may recommend lifestyle changes to promote heart health, including a balanced diet, exercise, stress management, and tobacco avoidance.

What are the Benefits of Heart Valve Surgery?

Heart valve surgery can enhance your lifespan and lower the chances of a life-threatening situation.

When it comes to fixing heart valves, there are a couple of ways to do it. One is fixing the valve you have (repair), and the other is putting in a new valve (replacement).

The advantages of fixing a valve instead of replacing it are as follows -

1. It's less likely to cause an infection.
2. You may not have to take blood-thinning medicine for the rest of your life.

These surgeries, whether related to repairing or replacing, are the most common type of minimally invasive surgery. Here's why minimally invasive surgery makes for a good choice -

• There's a lower risk of getting an infection
• You won't have to stay in the hospital for too long.
• Your recovery time will be shorter.
• Usually less trauma and bleeding

Understanding the Role of Health Insurance With Respect to Heart Valve Surgery

Undergoing a heart valve surgery is a significant medical event, both physically and financially. In the UAE, as in many parts of the world, the costs associated with such critical procedures can be substantial. This is where the importance of having the right health insurance, specifically a critical illness insurance plan for open heart replacement, comes into play.

With a critical illness insurance plan, you can get financial coverage in the form of a lump sum payment on the diagnosis of a condition listed in the plan. Most insurance providers offer coverage for heart valve surgery under plans related to critical illness cover. Depending on your preferences, you can get a standalone critical illness cover or obtain a health insurance plan that has this cover in-built.

References

• Heart valve surgery - Mayo Clinic
• Heart Valve Surgery: Repair and Replacement Procedures

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