Any individual with a leaky heart valve can get better with surgery. One or more of the four heart valves may not work right, called a leaky heart valve or heart valve failure.

Within the heart, valves keep blood from flowing in the wrong way. They are the mitral valve, the pulmonary valve, the tricuspid valve, and the aortic valve. Every valve has flaps, in which cusps are lip-like structures found on the aortic and pulmonary valves, while leaflets are for mitral and tricuspid valves. There should be one opening and closing of the flaps for every breath. It is more complicated when valves don’t work precisely to open and close, which changes how blood flows from the heart to the body.

During heart valve surgery, a dead or broken heart valve or valves are fixed or replaced. To achieve this purpose, open heart surgery or less invasive heart surgeries may be needed. The seriousness of heart valve disease varies depending on your age and overall health.

Definition of Leaky Heart Valve

One common form of heart valve disease is leaky heart valves. When one of the heart’s four valves doesn’t close properly, this is called valvular failure. This means that when the valve shuts, blood moves backwards.

Your outcome will be determined by the extent of retrograde blood flow. You probably won’t notice anything wrong with your heart if it’s very low. It doesn’t matter how much or how little your heart valves are leaking; you may still have symptoms and need medical help. You should do it to protect your heart.

How blood moves through the heart is controlled by heart valves, which is why these valves continue to keep blood going forward. Your valves could not be operating in the best way possible if you had a genetic disease with your heart or if you caught an illness later in life. If this part of the heart valve is damaged, you develop another type of valve disease, or the valve becomes loose.  

Types of Heart Valve Replacement Surgery

Aortic Valve Replacement

The aortic valve is on the left side of the heart. Its function is to push out blood from the heart muscle. It aids the process of blood flowing out of the human body, which is best performed by the left ventricle, which is the part of the heart that pumps blood. The main purpose of this section is to inhibit the backflow of blood into the left ventricle. They include individuals who were born with a problem or disease that affects the normal functioning of the aortic valve; that is, it stenotic or regurgitates and, therefore, requires surgery.

People who are born with an abnormality usually have a bicuspid valve. Most of the time, three tissue layers make up the aortic valve. This part is known as a tricuspid valve. Bicuspid valves are the least; they are broken valves that only possess two leaves. A new report that has investigated aortic valve replacement surgery states that among the people who underwent the operation, 94% of the subjects survived up to five years.

Mitral Valve Replacement

Mitral, also known as the bicuspid valve, is located on the left side of the heart and functions as the inflow valve. This part of the heart assists blood flow from the left atrium to the left ventricle of the heart. The condition may require surgical intervention if the troubled valve does not open or close as it should. A part of the valve may develop to be too small so that the blood required to reach the organ is not supplied. One of the consequential outcomes is the formation of arterial blockade, which, in turn, increases the pressure within the lungs. Backflow of blood into the lungs may occur if the valve fails to close adequately in any of these scenarios. This could be a result of a disease, a deformity from birth, or a disease that has a progressive nature.

A biological valve or a metal valve will be used to fix the broken valve. The metal valve lasts a long time, but you need to take medicine to stop blood clots after installing it. There is no requirement for anticoagulant medication, and the lifespan of the biological valve is typically between 15 and 20 years. It is estimated that 91% of people who are identified will live for five years.

Double Valve Replacement

Both the mitral valve and the aortic valve undergo modification during the surgical procedure. This is called a “double valve replacement,” and the whole left side of the heart is changed out. It’s not done very often and has a slightly higher death rate than other types of surgery.

Pulmonary Valve Replacement

Pulmonary artery: This part of the heart is concerned with blood circulation from the heart to the lungs. Commonly, pulmonic valves require replacement in patients suffering from Stenosis, a disease that affects blood circulation. Stenosis can be caused by a birth defect, an infection, or a cancer called carcinoid.

When the pulmonary artery attempts to go to the heart’s right atrium, it is shut by the pulmonary valve. Another blood vessel that transports blood is the pulmonary artery, which holds oxygenated blood that goes to the lungs.

Survival rates depend on:

• your heart function
• your age
• other medical conditions you have
• your overall health

Complications

A leaking heart valve lowers cardiac capacity. Due to the fact that some blood flows in the opposite way, your heart has to do extra effort in order to maintain an appropriate flow of blood ahead. Complications resulting from this pressure could be:

• Atrial fibrillation
• Pulmonary hypertension
• Sudden cardiac arrest
• Heart failure
• Enlarged heart (cardiomegaly)

Symptoms

• Coughing
• Swelling (oedema) in your legs and feet
• Heart palpitations
• Chest pain or pressure
• Shortness of breath during physical activity
• Fatigue or weakness

Causes

• Thoracic aortic aneurysm
• myxomatous degeneration due to aging
• Rheumatic heart disease
• Congenital heart disease
• Heart damage from a prior heart attack
• Cardiomyopathy
• Endocarditis
• Heart tumours

Heart Valve Replacement Surgery

If the surgery cannot repair the heart valve, and other forms of treatment cannot be used, then heart valve replacement may be needed. A doctor takes out the damaged valve and replaces it with a new one, either artificial or from the human, cow, or pig’s heart. Technologically and from the point of view of biotechnology, biological tissue valves are made of real living tissue.

Replacing a biological valve is sometimes inevitable because, at some point, the valve will degrade. With the mechanical valve, you have to be on treatments that thin the blood so it will not clot. Mechanical valves tend not to deteriorate with time, and the comparison to biological valves in this regard is rather unfair. Medical practitioners you will interact with will explain the positives and negatives of each type of valve.

One non-operative catheter-based procedure is relatively simple to perform and can be employed to replace some valves. For instance, one can use a catheter to implant a living valve in place of the faulty valve in the heart.

Diagnosis and treatment of leaky heart valves

A stethoscope is utilised to listen to the heart murmurs and determine whether or not there is a broken heart valve. This is normally the first thing doctors do if they discover a leak when you are getting a routine physical check or experiencing symptoms. The next step is to do echocardiography, which is an ultrasound of the heart to see if there is one or if the doctor is aware of any noise or hears it. This will confirm the problem.

Now, it is possible to treat a leaky heart valve, which is a good sign. Different methods are used based on what caused the leak and how badly it hurt the body. On a regular basis, people check small valve leaks to see if they get better over time. Regular medical checkups and close monitoring are very important parts of the watching process. In addition, various medicines are available to fix the issue based on the valve leaking. Examples include vasodilators (lower blood pressure) and diuretics (help reduce swelling).

If you want to fix a health problem like diabetes, high blood pressure, or high cholesterol, you should get to the root of it. Based on your symptoms and the ultrasound data, your doctor can figure out how bad the leak is. Usually, the only way to fix this is to have surgery to fix or replace the valve.

Some leaky heart valves may be small and not be noticed for a long time. Other leaks may be much worse and cause a wide range of issues. Avoid getting weak heart valves by keeping your health in good shape and lowering your risk factors. For immediate help, please call GoMedii to schedule a meeting with one of the best heart surgeons in India if you are experiencing signs that could be related to valves that aren’t working properly.

Process of Leaky Heart Valve Surgery

It is necessary to stay in the hospital after surgery to replace or fix a heart valve. Here are some steps that might be different for you if your doctor does things differently in other cases. You usually do things in a certain order when you need to fix or replace an open-heart valve. Your jewels and other things that could get in the way of the surgery will need to be taken off before it starts. Make sure you are completely dry before the treatment, and wear a hospital gown. People from the medical team will lay you on your back on the operation table. Doctors and nurses may inject medicine and IV fluids into your body using a thin tube into your arm or hand.

Following the procedure, more tubes will be inserted in the blood vessels of your neck and wrist to monitor your heart rate, BP, and to take blood samples. That is the reason why patients have their heart rate, blood pressure, respiratory rate, and even blood oxygen levels checked by the anaesthesiologist during the procedure. Before the operation itself, your surgeon will insert a breathing tube into the lungs through your mouth. Another device that would be connected to you is a ventilator, which breathes for you, or a breathing apparatus during the surgery. To monitor your valves’ performance, the doctor will insert a transoesophageal echocardiography (TOE) probe into your oesophagus.

A Foley catheter and some bendable tube will be inserted to make your bladder empty well. This is how the stomach juices are taken out. An endoscope tube is then inserted into your stomach through your mouth or your nose. The skin on your chest will be preoperatively cleaned by one of the teams of operating surgeons using an antibiotic sponge. Instead, re-shaving the affected area might assist in clearing hair as much as possible in the place where the surgery was carried out.

When open heart surgery in India is carried out, the doctor will incise in between the sternal notch down to the sub-umbilical region. A slightly invasive treatment might mean that the cuts need to be smaller. It will be cut in half lengthwise. The sternum is also known as the breastbone. Your doctor or nurse will operate to divide your breastbone in half or create a space between the two ends so they can see your heart more clearly.

Your heart will have to stop beating so the doctor can fix or replace the valve. A heart-lung bypass machine allows the doctor to momentarily halt the heart’s contractions and insert tubes into the heart to improve blood flow. Your doctor will stop your heart from beating by filling it with a cold solution once all the blood has been moved to the bypass machine.

The broken valve will be taken out, and the new one will be put in once the heart stops beating. Your doctor might move joined valve leaflets apart, fix torn leaflets, or change the shape of valve parts to make them work better. Your doctor will use small paddles to give your heart an electric shock so that it can start beating again after the surgery. Following that, the doctor will assist the blood currently moving through the bypass machine to return to your heart. The tubes connected to the machine will then be taken away.

Once your heart begins to beat normally again after surgery, the doctor will closely monitor it and its valves to ensure that there are no leaks. You might get lines put in your heart to make it beat faster. In case you need to keep your heart beating while you heal, the lines can be connected to an outside pacemaker. Weak wires, those used to fix broken bones, will be used by the doctor to put the sternum back together. For blood and other fluids from around your heart, a medical professional or assistant will insert tubes into your thoracic cavity. Along with surgery staples or stitches to keep the cut closed, the doctor will sew the skin over the sternum. A Medical team associate will put on a clean patch or dressing.