Repair

Your heart has four valves that open to let blood pass through and close to prevent blood from flowing back in the wrong direction. Valvular surgery is performed to repair heart valves that are blocked, narrowed (stenosis) or leaking (regurgitation). In most cases, our surgeons will seek to repair damaged heart valves instead of replacing them. This practice allows patients to avoid the use of blood thinners and reduces their risk of infection. In the surgery to repair a damaged valve, surgeons either loosen stiff valve leaflets or tighten loose valve leaflets. Many valvular repair procedures may be performed using minimally invasive cardiac surgery.

How it works

There are several types of valve repair surgery. Three of the most common are:

• Balloon valvuloplasty is used to treat narrowing of a heart valve. A catheter is inserted through a large vein in the leg and threaded up to the valve. A balloon on the end of the catheter is then inflated to widen the opening of the valve. This allows more blood to flow through the valve.
• Traditional valve repair is a form of open heart surgery. Your surgeon will have direct access to the valves of your heart in order to make the needed repairs. Surgery may involve widening the valve opening, removing calcium deposits, reshaping the valve, patching holes or removing sections of the valve that interfere with its operation
• Minimally invasive valve repair uses smaller incisions to repair your heart's valves. Many of the same repairs that are done in traditional valve repair surgery can also be done in a minimally invasive fashion. The benefits of minimally invasive surgery include a smaller scar, less blood loss and a quicker recovery. Not everyone is a candidate for minimally invasive valve surgery. Your surgeon will determine if this type of surgery is right for you.

Risks

• Bleeding
• Infection
• Reaction to anesthesia
• Heart attack
• Irregular heartbeat
• Stroke
• Kidney failure
• Death

A seasoned team of experts who’ve led their field

Through our proven, multidisciplinary approach, UR Medicine Cardiac Care provides the most advanced valve repair surgeries and treatments available today. We regularly handle the most complex cases in the Rochester region with excellent outcomes.

Our team of surgeons has extensive experience with minimally invasive procedures, which can be effective for many valve repair surgery patients—even the most challenging repairs. For instance, our surgeons routinely use minimally invasive procedures for mitral valve repair and replacement as well as MVR/Tricuspid repair.

UR Medicine is also a leader in the use of robotic surgery for valve repair—the first facility in our region to do so. Robotic surgery lets us perform valve repair through smaller incisions with greater control and accuracy.

Replacement

Your heart has four valves that open to let blood pass through and close to prevent blood from flowing back in the wrong direction. Valvular surgery is performed to repair heart valves that are blocked, narrowed (stenosis) or leaking (regurgitation). If a diseased heart valve can't be treated with medication or repaired, it must be replaced. Today, valve replacement operations are fairly commonplace. If you have heart valve disease, we'll consider performing heart valve replacement surgery to improve your health and energy.

How it works

Heart valve replacement surgery requires general anesthesia and the use of a heart-lung machine to maintain blood flow while your heart valve is being replaced. The surgeon makes an incision to expose your heart, your old valve is removed and a new one is sewn into its location.

There are three types of replacement heart valves:

• Human heart valves provide a low risk of infection and do not require the use of blood thinners. Valve replacement with a human heart valve requires a more complex surgical procedure than other valve replacements. Additionally, patients must be included on a waiting list because donor heart valves are in short supply.
• Tissue valves or biologic valves are made from animal or human tissue and may be combined with artificial materials, too. These are more readily available than human heart valves, and like human heart valves, they don't require blood thinners. Tissue valves generally last about 15 years, not as long as mechanical heart valves.
• Mechanical heart valves are developed completely from man-made materials. They are reliable and last much longer than tissue valves. Mechanical heart valves require that patients take blood thinners permanently to prevent a clot from forming on the valve.

Specialized procedures

• The Ross Procedure is highly effective for children and adults under the age of 35. The patient's own pulmonary valve is used to replace the aortic valve. The pulmonary valve is then replaced with the same valve from a human donor. Compared to traditional valve replacement using manufactured prosthetic valves, the Ross Procedure is most beneficial for young people and active older patients–it lasts longer than prosthetic valves and does not require blood thinners.
• Homograft replacement is valve replacement with donated human aortic valves. The use of human valves decreases the risk of infection.
• Mitral valve replacement surgery is performed with mechanical heart valves, tissue valves and donated human heart valves.
• Transcatheter Aortic Valve Replacement (TAVR) is a rapid non-invasive approach to treat severe valve disease.

Risks

As with all surgeries, the risks of valve replacement surgery are related to the age and relative health of the patient. Those risks include:

• Bleeding
• Infection
• Reaction to anesthesia
• Heart attack
• Irregular heartbeat
• Stroke
• Kidney failure
• Death

A seasoned team of experts who’ve led their field

UR Medicine Cardiac Care provides the most advanced valve replacement surgeries in the Rochester region. We also provide the widest range of valve replacement options for our patients. Our team regularly handles the most complex cases in the region with excellent outcomes.

Find out more

For details on heart valve replacement at UR Medicine, call us at (585) 275-2475.