There are four valves in your heart. The job of each valve is to make sure that the blood flows through the heart in the correct direction.
If one or more of your valves is diseased or damaged, it can affect how your blood flows through your heart in two ways:
- If your valve does not open fully, it will obstruct the flow of blood. This is called valve stenosis or narrowing
- If the valve does not close properly, it will allow blood to leak backwards. This is called valve incompetence, or regurgitation, or a leaky valve.
Many people with heart valve disease need little or no treatment. However, you may be advised to have surgery on your valve, which can greatly improve your symptoms and quality of life.
What are the treatment options?
There are two options for valve surgery: valve repair and valve replacement.
- Valve repair is often used for mitral valves that become floppy and leak but are not seriously damaged.
- Valve replacement is when the diseased valve is replaced with a new valve. The most common types of replacement valves are mechanical (artificial) valves or tissue (animal) valves.
In some cases, a Transcatheter aortic valve implantation (TAVI) procedure may be used if you are an adult and not well enough to have traditional heart surgery.
Whether or not you have heart valve surgery, and whether the operation is a repair or a replacement will depend on many factors, including the cause of the problem, which valve is affected, how badly the valve is affected, how many valves are affected, your symptoms, and your general health.
What will happen during a heart valve repair or replacement?
In most valve operations, your surgeon will:
- reach your heart by making an incision down the middle of your breastbone
- use a heart-lung machine to circulate blood around your body during the operation
- open up your heart to reach the affected valve, and
- perform the repair or replacement.
In a small number of cases, one or more small incisions can be made in your chest and your breastbone may not even need to be cut. Speak with your surgeon about the advantages and disadvantages of this type of surgery as it is not suitable for everyone.
How long will it take me to recover?
If all goes well, you will be helped to sit out of bed the day after the procedure. You can expect some discomfort after your operation and you will be given pain relief medication. Your pain level will be monitored to make sure you are as comfortable as possible. Many people return home within about a week. On average, it takes between 2-3 months to fully recover, but this can vary greatly as it depends on your individual condition.
What are the benefits and risks?
For most people, the operation will greatly improve symptoms and quality of life.
Like all operations, valve surgery isn’t risk free. Your own risk will depend on your age, your current state of health and the degree of valve disease. Before your procedure, your surgeon will discuss with you both the benefits and risks of the operation.
Endocarditis is a rare but serious condition where the inner lining of the heart becomes infected. This most commonly takes place in one of the heart valves.
If you have a heart valve problem or have had surgery on your valve, you are at risk of developing endocarditis. You are also at risk if you have had endocarditis before.
Until recently, people at risk of endocarditis were advised to take antibiotics before having dental treatment and some other procedures. However, that is no longer recommended.
Will I have to take any medication afterwards?
If you have a mechanical valve replacement, you’ll need to take anticoagulant medicine, like Warfarin, for the rest of your life. This is because a mechanical valve is made of artificial material, which increases the risk of a blood clot developing on the valve’s surface.
If you have a tissue valve replacement, you may need to take anticoagulants for a shorter period. This may be from a few weeks to 2-3 months after surgery.
The most commonly prescribed anticoagulant is called Warfarin. For more information, please see our booklets on Heart Valve Disease or Medicines for your heart.
It is important that you speak to your doctor or pharmacist before you take any medicines in addition to those you have been prescribed.
Future treatments
A BHF-funded chemical engineer is perfecting a material to tackle heart valve disease. A heart valve needs to be strong yet flexible, capable of opening and closing 200 million times or more. It needs to be compatible with the human body and able to let blood flow easily through it.
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