Heart Valve Surgery

Types

Mayo Clinic heart (cardiac) surgeons perform heart valve surgery to treat many types of heart valve disease. Your surgeon can perform many procedures using minimally invasive heart surgery, using smaller incisions than in open heart surgery.

Your treatment depends on several factors including your age, your general health, the condition of your heart valves and your preference. A team of heart specialists (cardiologists), heart surgeons and other specialists work with you to determine the appropriate surgery to treat your condition.

Heart valve repair

Heart valve specialists and surgeons agree that whenever possible a heart valve should be repaired rather than replaced. Heart valve repair leaves you with your normally functioning tissue, which resists infection more effectively, and you don't need to take blood-thinning medications after the surgery.

If you have mild to moderate heart valve disease, your surgeon often performs heart valve repair. If your heart valve isn't closing properly (regurgitation), your surgeon may treat your condition using one of three surgeries.

In annuloplasty, the surgeon tightens or replaces the ring around the valve.

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The surgeon removes part of a prolapsing mitral valve to allow the valve to fully close and stop leaking.

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• Annuloplasty. In this procedure, your surgeon tightens the ring of tissue around the valve to help the valve flaps (leaflets) come together. Sometimes your surgeon will implant a ring where the leaflets meet to make the valve opening smaller so the leaflets can come together.
• Repair of structural support. In this procedure, your surgeon replaces or shortens the cords that support the valves (chordae tendineae and papillary muscles) to repair the structural support. When the cords and muscles are the right length, the valve leaflet edges meet and eliminate the leak.
• Valve leaflet repair. In valve leaflet repair, your surgeon surgically separates, cuts or pleats a valve flap (leaflet) to repair a floppy or prolapsed valve leaflet.

Heart valve replacement

If your heart valve can't be repaired, your surgeon will remove your damaged valve and replace it with an artificial (prosthetic) valve. You may need heart valve replacement if you have valve narrowing (stenosis) or severely damaged valves affected by calcium buildup in the valves (calcification) or rheumatic disease. Surgeons perform procedures often to replace mitral or aortic valves, but your surgeon can replace any heart valve.

Heart valve replacements include:

Mechanical valve replacement

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Biological valve replacement

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• Mechanical valves. Mechanical valves are made of synthetic materials, which are designed to last many years. However, blood tends to stick to mechanical valves and create blood clots. If you have a mechanical valve, you'll need to take blood-thinning medicines (anticoagulants) for life.

• Biological valves. Biological valves, or tissue valves, are made from animal tissue (xenograft) or taken from the human tissue of a donated heart (called an allograft or homograft). Sometimes, your own tissue can be used for valve replacement (autograft/Ross procedure).

  If you have a biological valve, you usually don't need to take blood-thinning medication. However, biological valves aren't as durable as mechanical valves, and they eventually may need to be replaced. Surgeons most often use biological valves in older patients.

See a video on mitral valve repair at MayoClinic.com.