Valve heart surgery

Your heart is a muscle which pumps blood around your lungs and the rest of your body. There are four valves in your heart and the job of each valve is to make sure that blood flows in the correct direction. 

If one of your valves is diseased or damaged, it can affect your blood flow in two ways:

• If the 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 if you've been diagnosed with heart valve disease, you may be advised to have surgery on the valve. This can greatly improve your symptoms and quality of life.

What are the different types of valve surgery?

There are two types of valve surgery:

• Valve Repair: Often used for mitral valves which leak but are not seriously damaged
• Valve Replacement: This is when the diseased valve is removed and replaced with a new valve. The most common types of replacement valves are mechanical (manufactured) valves or tissue (animal) valves.

Whether or not you have 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 
• Your general health  

So what happens during the surgery?

In most valve operations, the surgeon reaches your heart by making an incision down the middle of your breastbone. A heart-lung bypass machine is used to circulate blood around your body while the surgeon operates on your heart. The surgeon then opens up your heart to reach the affected valve and performs the repair or replacement.

In a very small number of cases, a smaller incision can be made in your chest, so that your breastbone doesn't need to be cut. This type of operation is called minimally invasive surgery.

What are the benefits?

For most people this operation will greatly improve symptoms and quality of life. Overall, around 95 in every 100 people having valve surgery have a successful operation.

What are the risks?

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 any operation, your surgeon will discuss with you both the benefits and the risks of the operation.

How long will it take to recover from the surgery?

Most people are sitting out of bed a day or two after their operation, and return home within about a week. On average, it takes most people between 2-3 months to fully recover, but this can vary greatly as it depends on your individual condition and how old you are.

Will I have to take any medication afterwards?

If you have a mechanical valve replacement you'll need to take anticoagulant drugs 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 valves surface. If you have a tissue valve replacement, you may need to take anticoagulants for a shorter period from a few weeks to 2-3 months after surgery.

The most commonly prescribed anticoagulant is called Warfarin. For more information, please see our information sheet on Warfarin, and our booklets Heart Valve Disease or Medicines for the heart.

What is Endocarditis?

Endocarditis is a rare but serious condition where the inner lining of the heart - most commonly one of the heart valves - becomes infected.

It affects about 1,500 people a year in the UK. Most already have some form of abnormality in the structure of the heart. People who have a heart valve problem, or those who have had surgery on their valve, are at higher risk of endocarditis.

Up until recently, people at risk of endocarditis were advised to take antibiotics before having dental treatment and some other procedures. However all the latest research has been reviewed and it has been concluded that it is very unlikely that there are any benefits from taking antibiotics before having dental treatment or certain other procedures. In other words, taking antibiotics before having dental treatment will not reduce your risk of developing endocarditis.

If you'd like more information please read our endocarditis information sheet.

Who can I talk to?

Whatever the reason for your surgery, you may be feeling a whole range of emotions. You may feel anxious, afraid, angry, worried about the future or glad that you are about to have treatment for your condition. It’s natural to have these sort of feelings and important to talk about them with your partner, a friend, relative or health care professional.

If you need heart surgery, it’s important that you and your family understand why you’re having an operation and what it’ll involve. It’s natural to feel worried, but it often helps to talk about your feelings with someone close to you or with a healthcare professional.

It’s also important that you understand what to expect in hospital afterwards during your recovery.

If you have any questions, talk to your doctor or call our Heart Helpline on 0300 330 3311.