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Heart Valve Surgery and Valvuloplasty

Heart valve surgery: If the cardiologist determines that your symptoms of breathlessness, chest pain and dizziness are due to a malfunctioning heart valve then you may be asked to do a heart valve surgery to repair or replace the affected valves. After the operation you may notice a significant improvement in your symptoms and it may also reduce or prevent changes associated with long-term heart muscle strain. If the valves are narrow or if you have a leaking valve then they are usually be replaced by an artificial valve. Most valves are made from a combination of metal and plastic materials. Sometimes a leaking mitral valve is not replaced but is repaired by stitching, using sutures. Traditional valve surgery is performed under general anesthetic and the surgery begins with the surgeon makes an incision down the length of your breastbone to expose your heart. The surgeon then repairs or replaces your abnormal heart valve or valves. It may be necessary to use a bypass machine to pump the blood around your body during your operation. Minimally invasive heart valve surgery is performed by making smaller incisions and this type of surgery reduces blood loss, trauma, and length of hospital stay. The mitral valve is the most commonly repaired heart valve, but the aortic, pulmonic, and tricuspid valves may also undergo some of these repair. If your valve can be repaired, the following types of heart valve repair surgeries:

  • Commissurotomy: Valve opening is widened by separating the fused valve leaflets.
  • Decalcification: Calcium deposits are removed, which allows the leaflets to become more flexible and is also enables it to close properly.
  • Reshape leaflets: If one of the leaflets is floppy, a segment may be cut out and the leaflet sewn back together, allowing the valve to close more tightly.
  • Annulus support. If the valve is too wide, it may be reshaped or tightened by sewing a ring structure around it.
  • Patched leaflets. The surgeon uses a tissue patch to repair any leaflets with tears or holes.

Valvuloplasty

When the valves in your heart become restricted, it can be corrected without major heart surgery. Valvuloplasty involves inflating a balloon inside the valve to widen it. During this procedure the cardiologist inserts and guides a catheter through a small incision into the femoral artery in your groin and moves it up to the heart. A guide wire is then inserted through the guide catheter and across the narrowed valve and when it is in place, the balloon catheter is threaded along it until the balloon is in the correct position. A small portion of the balloon is then inflated and passed across your valve, which is then locked in position by inflating it a little bit more. The main balloon will then be inflated and deflated until the opening of the leaflets of your valve has been significantly improved. After this the catheters and guide wire are removed. Usually the pulmonary valves in children; and the mitral valve in adults are considered for valvuloplasty. This procedure cannot be used if the patient's valve has become thickened with deposits of calcium as the balloon is not strong enough to break these deposits.

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