Valve Repair and Replacement

Surgery may be necessary to repair or replace the malfunctioning valve(s). Surgery may include:

Heart valve repair: In some cases, surgery on the malfunctioning valve can help alleviate symptoms. Examples of heart valve repair surgery include cutting scarred flaps so they open more easily; remodeling valve tissue that has enlarged; or inserting prosthetic rings to help narrow a dilated valve. In many cases, heart valve repair is preferable, because a person's own tissues are used.

Heart valve replacement:When heart valves are severely malformed or destroyed, they may need to be replaced with a new mechanism. Replacement valve mechanisms fall into two categories: tissue (biologic) valves, which include animal valves and donated human aortic valves, and mechanical valves, which can be metal, plastic, or another artificial material.

  • Mechanical valves have greater durability. The downside is that it requires the patient to remain on anticoagulation for the rest of their life. They are traditionally recommended for patients:
            - < 60 years old
            - want to avoid reoperation
            - are already on long-term anticoagulation for another reason

  • Tissue valves do not require long-term anticoagulation, but they are less durable. They are traditionally recommended for patients:
            -  > 60 years old
            -  who prefer to avoid the need for anticoagulation for lifestyles reasons, (eg extremely active lifestyle, recent GI bleed, childbearing age)
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