Heart Valve Replacement: Types, Procedure & Recovery (2024)

What is a heart valve replacement?

Heart valve replacement is a procedure to replace one of your heart’s valves with a biological or mechanical valve.

Sometimes, a valve doesn’t form right when you’re born. Some people may have a valve that gets too narrow, stiff or leaky. In these cases, your blood can’t move through your heart efficiently.

You have four valves that control where your blood goes in your heart. Normally, your heart’s valves are all opening and closing completely when your heart beats. This allows blood to move in an organized way.

Your blood moves:

• From one part of your heart to the next.
• To your lungs to get oxygen.
• To your aorta, which sends your oxygen-rich blood out to the rest of your body.

Like a sink drain that doesn’t hold all the water or completely drain it, a diseased valve keeps some of your blood from going where it’s supposed to go.

If one of your valves isn’t working right, you may need to take medicine or have your valve repaired. If these treatments don’t work, you may need a heart valve replacement.

Types of Heart Valves

Biological Valves

Biological valves (also called tissue or bioprosthetic valves) are made of:

• Cow tissue (bovine).
• Pig tissue (porcine).
• Human tissue (allografts or hom*ografts).

In general, there’s no difference in durability between the types of biological valves. Biological valves may have some artificial parts to give the valve support and make it easier to put in place.

hom*ograft Valves

A hom*ograft (or allograft) is:

• A human heart valve that comes from a donor after they die.
• Most often used to replace a diseased aortic valve in children or young adults or when an infection destroys an aortic valve in adults.
• Also used to replace the pulmonary valve during the Ross procedure.

Mechanical Valves

Mechanical valves are made of metal or carbon and are designed to work just like your own valves. The bileaflet valve is the most common type of mechanical valve. It’s made up of two carbon leaflets mounted in a ring covered with polyester knit fabric.

Mechanical valves are:

• Well-tolerated.
• Very durable.
• Designed to last a lifetime.

Heart valve replacement: mechanical vs. tissue

When choosing between a biological valve and a mechanical valve, you may want to consider:

• The inconvenience and risk of bleeding while taking a blood thinner when you have a mechanical valve.
• The possibility of needing another biological valve replacement during your lifetime.
• Your age. (A mechanical valve is best for people younger than 50 for an aortic valve and younger than 65 for a mitral valve.)
• How active you are.
• Which heart valve is affected?

Biological valves

• Advantages: Most people don’t need to take lifelong blood-thinner medication unless they have other conditions, such as atrial fibrillation. If you’re older than 60 years of age, the bovine pericardial valve will probably last for the rest of your life.
• Drawbacks: In the past, biological valves usually needed to be replaced after about 10 years. However, recent studies show these valves often last 15 to 20 years or more without a decline in function.

Mechanical valves

• Advantages: Mechanical valves are very durable. They’re designed to last a lifetime.
• Disadvantages: Because of the artificial material in mechanical valves, people who receive these valves need to take warfarin, a blood-thinning (anticoagulant) medication, for the rest of their lives. Blood thinners are medications that delay your blood’s clotting action. They help prevent clots from forming on your new valve. Clots can cause a heart attack or stroke. If you take warfarin, you’ll need to have regular blood tests to see how well you’re responding to the medication and if you need a different dose. Also, some people who have a mechanical valve replacement hear the valve make a clicking noise at times. This is the sound of the valve leaflets opening and closing.

Types of Heart Valve Replacement Surgery

In addition to the biological or mechanical valve choices, there are options in the method your surgeon uses. They can do open-heart surgery, minimally invasive surgery or go through a blood vessel.

Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter aortic valve replacement is a treatment option for some people with severe aortic stenosis (narrowing). You may have TAVR if you’re high-risk, although a provider can use it for someone of any risk level.

Younger people, those with a bicuspid valve or those who need other procedures like a maze procedure or coronary bypass are more likely to have open-heart surgery.

In TAVR, your healthcare provider uses a catheter to replace your diseased valve with a biological valve. They insert the catheter into an artery in your groin or a cut (incision) in your chest. They put the new valve inside of the old one. Your provider can also use this method to replace your pulmonary valve.

Ross Procedure

The Ross procedure involves switching your pulmonary valve to the aortic valve position and then placing a pulmonary hom*ograft. This is a very complex procedure. However, it has many benefits, especially for young people with aortic valve disease.

When is a heart valve replacement necessary?

A heart valve replacement is necessary when valve repair surgery isn’t a treatment option. Valve replacement surgery is most often used to treat people with aortic valve disease, particularly aortic stenosis (narrowing).

Other conditions that may require a heart valve replacement include:

• Mitral, pulmonary or tricuspid valve stenosis (narrowing).
• Mitral valve prolapse.
• Aortic, mitral or tricuspid regurgitation (some blood goes the wrong way because of a leaky valve).
• Congenital (since birth) heart valve disease.