Your heart has four valves that open to let blood move forward and close to stop it flowing backwards. A narrowed valve doesn't open fully, so the heart has to work harder to push blood through the smaller opening. This is called stenosis.
A leaking valve lets some blood flow backwards because it doesn't close properly. Doctors call this regurgitation. Both narrowing and leakage can put extra strain on the heart. Surgery aims to improve blood flow by repairing the damaged valve or replacing it.
Call triple zero (000) for severe, worsening or persistent chest pain, or chest discomfort with breathlessness, sweating, nausea or pain spreading to your arm, jaw or back.
Do not wait for a routine appointment or drive yourself to hospital.
Before surgery, the hospital checks your heart and general health and gives you instructions about medicines, fasting and any dental checks needed. Don't change medicines without those instructions. Let the hospital know about a new illness or infection.
You're asleep under a general anaesthetic. The surgeon commonly reaches the heart by cutting through the breastbone, although some operations use smaller cuts in the chest. A heart-lung machine pumps blood and adds oxygen so the heart can be kept still. The surgeon can then open the heart or aorta, the main artery leaving it, to reach the affected valve.
For replacement, the surgeon removes the damaged valve tissue but keeps a rim of the original tissue, then stitches the new valve to that rim in the old valve's position. Before the operation ends, the team checks the valve's function and makes sure the heart has taken over from the heart-lung machine. If the breastbone was divided, wires hold it together while it heals.
Afterwards, you're cared for in intensive care or a closely monitored unit. You may still have a breathing tube when you first wake, along with drips and chest drains, which staff remove as your condition allows. Pain relief helps you breathe deeply and start moving, with support from nurses and physiotherapists. You move to a ward when you no longer need intensive monitoring.
Doctors consider surgery when a valve problem is severe, causing symptoms or affecting how well the heart works. Breathlessness, reduced energy, chest discomfort or fainting can be signs that a valve needs treatment. An echocardiogram, or heart ultrasound, shows the valve's movement, the flow of blood through it and how the heart is pumping.
A scan may show severe valve disease and strain on the heart before obvious symptoms appear, so surgery may be considered even if you feel well. Milder problems can often be monitored with check-ups and scans. Medicines may ease symptoms or treat related heart problems while the valve is monitored or treatment is planned.
A repair corrects the part of your valve that isn't working properly. For example, a leaking mitral valve may have excess tissue in one of its flaps, called leaflets. The surgeon can remove that excess and stitch the remaining edges together. A supporting ring or band around the valve's base can reduce a stretched opening and help the leaflets meet when they close. The type of damage determines whether a repair like this is possible.
When a valve can't be repaired, it can be replaced with one of two main types:
Choosing between them means weighing the possibility of another valve procedure against the effects and bleeding risk of lifelong warfarin, and your health and preferences are part of that decision.
Recovery after open heart surgery takes weeks to months. Tiredness and discomfort are common early on. Hospital staff explain wound care and how to increase activity while the chest heals. Get individual advice about lifting, work and driving.
Cardiac rehabilitation helps you build up exercise safely and manage your recovery. Before leaving hospital, ask about a referral. Let staff know if you live alone or will need help at home.
An echocardiogram after surgery records how the repaired or replacement valve is working. It checks how freely blood passes through, whether there is significant leakage and how well the heart pumps, and it gives a starting point for comparing later scans. Further ultrasound checks can detect deterioration or a return of leakage. When you have them depends on the repair or valve type and any changes in your condition. Don't wait for a scheduled check to report new breathlessness or reduced exercise ability.
Bleeding and changes in heart rhythm can happen after valve surgery. Serious complications include stroke, kidney or lung problems, and infection of the wound or valve. Some can be life-threatening. Your surgeon will explain your own risk, including how other health conditions affect it, before you decide whether to proceed.
Keep up with dental care and tell your dentist you've had valve surgery. Some people need antibiotics before certain dental procedures; your doctor and dentist will advise. Seek medical advice promptly for an unexplained fever or a wound that becomes red, hot or starts leaking fluid.
Your GP or specialist can refer you for a cardiologist appointment about valve disease. The cardiologist reviews your symptoms and scans and can refer you to a hospital specialist if surgery may be needed. Heartscope doesn't perform valve surgery at its clinics.
Consultations are privately billed. If you're eligible, Medicare pays part of the consultation fee when you have a valid referral from your GP or specialist. The clinic will confirm the amount left to pay before the visit.
Hospital and surgery fees are separate from the Heartscope consultation. The hospital or treating provider confirms those costs.
Heartscope cardiologists see patients at clinics in Melbourne and Queensland. If you have a referral, our team can confirm the location and appointment details.
View clinic locationsNo. It's performed in hospital. Heartscope cardiologists may be able to see patients with a valid referral from their GP or specialist, and can refer you for hospital treatment when appropriate.
TAVI places a new valve inside a narrowed aortic valve through a thin tube called a catheter, leaving the old valve in place. A mitral valve clip joins parts of a leaking mitral valve to reduce backward flow. A hospital specialist assesses the valve's structure and your health to decide whether surgery or a catheter procedure is suitable.
You may need medicines to prevent blood clots on a replacement valve or to treat another heart condition. Keep taking them as prescribed, even if symptoms improve.
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