Heart valve replacement is a surgical procedure in which a damaged or improperly functioning heart valve is replaced with an artificial prosthesis. This operation is performed to restore normal blood flow through the heart and to prevent complications associated with heart failure and other valvular heart diseases.
When is heart valve replacement performed?
- Valve stenosis. Narrowing of the valve opening that obstructs normal blood flow.
- Valve regurgitation (insufficiency). Inability of the valve to close tightly, leading to backward blood flow.
- Infective endocarditis. Infection of the valve resulting in structural damage.
- Congenital heart defects. Structural abnormalities of the heart valves present from birth.
- Degenerative changes. Age-related deterioration of valve tissues, such as calcification.
Which valves can be replaced?
- Aortic valve. Most commonly replaced due to aortic stenosis or regurgitation.
- Mitral valve. Replaced in cases of mitral stenosis or insufficiency.
- Tricuspid valve. Replaced less frequently, usually due to infection or congenital abnormalities.
- Pulmonary valve. Typically replaced in patients with congenital heart disease.
Types of valve prostheses
Mechanical valves
- Manufactured from durable materials such as titanium or carbon composites.
- Advantages. Long-lasting durability, often functioning for several decades.
- Disadvantages. Require lifelong anticoagulant therapy to prevent thromboembolism.
Biological (bioprosthetic) valves
- Made from animal tissues (porcine or bovine) or human donor tissue.
- Advantages. Usually do not require lifelong anticoagulation.
- Disadvantages. Limited lifespan (approximately 10–20 years), with possible need for reoperation.
Homografts (human donor valves).
Used in selected complex or infectious cases, particularly in specialized cardiac centers.
Preoperative preparation
Diagnostic evaluation
- Electrocardiography (ECG) to assess heart rhythm and function.
- Echocardiography as the primary method for evaluating valve structure and severity of disease.
- Coronary angiography to assess the condition of coronary arteries.
- Blood tests to evaluate coagulation status and overall health.
Discussion of prosthesis selection
- The physician and patient jointly decide on the type of valve (mechanical or biological), taking into account age, comorbidities, lifestyle, and patient preferences.
Medication adjustment
- Temporary discontinuation or modification of anticoagulants and other medications may be required before surgery.
How is the operation performed?
- Anesthesia. The procedure is performed under general anesthesia.
- Surgical access. A median sternotomy is usually performed to access the heart. In selected cases, minimally invasive approaches through small incisions may be used.
- Cardiopulmonary bypass. The heart is temporarily stopped, and circulation is maintained by a heart-lung machine.
- Removal of the diseased valve. The surgeon excises the damaged valve and prepares the annulus for implantation.
- Valve implantation. The prosthetic valve is secured in place using sutures or fixation mechanisms.
- Restoration of cardiac activity. The heart is restarted and the function of the new valve is carefully assessed.
- Completion. The surgical incision is closed, and the patient is transferred to the intensive care unit.
Postoperative period
- Intensive care. Patients are monitored in the ICU for 1–2 days.
- Rehabilitation. Full recovery typically takes 6–12 weeks and includes gradual physical activity and dietary recommendations.
- Medication therapy. Anticoagulants (such as warfarin or, in selected cases, direct oral anticoagulants) to prevent thrombosis, as well as antibiotics for infection prevention.
- Follow-up. Regular cardiology visits, echocardiography, and blood tests are required to monitor valve function.
Outcomes of valve replacement surgery
- Durability. Mechanical valves may function for 20–30 years or longer, while biological valves usually require replacement after 10–20 years.
- Quality of life. Most patients experience significant symptom relief and improved functional capacity.
- Long-term monitoring. Lifelong follow-up with a cardiologist is essential to ensure optimal outcomes.
Heart valve replacement in Belarus is an effective treatment for severe valvular heart disease, significantly improving quality of life and reducing the risk of serious complications. The use of modern surgical techniques and advanced prosthetic materials ensures high safety and durability. Regular cardiology follow-up and strict adherence to medical recommendations are key to maintaining long-term heart health.
