Valvular Surgery

Valvular surgery refers to the surgical procedures performed to repair or replace damaged or diseased heart valves. Heart valves are responsible for ensuring proper blood flow through the chambers of the heart. Valvular surgery aims to restore normal valve function and improve overall heart function.

Pathology :

Valvular disease can occur due to various factors, including congenital abnormalities, infection, degenerative changes, or damage caused by conditions such as rheumatic fever. Valvular diseases can lead to valve stenosis (narrowing) or regurgitation (leakage), which can result in symptoms such as shortness of breath, fatigue, chest pain, or heart failure.

Types of Surgery:

  1. Valve Repair: In some cases, a damaged valve can be repaired by techniques such as valve leaflet repair, annuloplasty (reshaping the valve ring), or chordal reconstruction. Valve repair is typically preferred over replacement, as it preserves the patient’s own valve and avoids the need for lifelong anticoagulation therapy.
  2. Valve Replacement: When a valve cannot be effectively repaired, it may need to be replaced. This involves removing the damaged valve and replacing it with a mechanical valve or a biological tissue valve (usually from human or animal sources). Mechanical valves are durable but require lifelong anticoagulation therapy, while biological valves do not necessitate anticoagulation but may have a shorter lifespan.

Pre-Surgical Care:

Prior to valvular surgery, comprehensive pre-surgical care is provided, including:

  1. Diagnostic Testing: Various tests such as echocardiogram, electrocardiogram (ECG), cardiac catheterization, and imaging studies are conducted to assess the severity and type of valve disease and determine the most appropriate surgical approach.
  2. Medication Management: Your healthcare team will review your current medications and provide guidance on which ones to continue or temporarily stop before surgery. Anticoagulants or antiplatelet medications may be adjusted.
  3. Evaluation and Optimization: Your overall health will be assessed, and any underlying medical conditions such as hypertension or diabetes will be managed and optimized to ensure the best possible outcomes.

The Surgical Procedure:

During valvular surgery, the general steps include:

  1. Anesthesia: You will be administered general anesthesia to ensure a pain-free and unconscious state during the surgery.
  2. Incision and Exposure: The surgeon will make an incision in the appropriate location, such as the chest or the side of the chest (minimally invasive approach), to access the heart and the affected valve.
  3. Repair or Replacement: Depending on the specific condition, the surgeon will perform either valve repair techniques or valve replacement using mechanical or biological valves.
  4. Closure: After the repair or replacement is complete, the incision is closed using sutures or staples, and the chest is carefully dressed.

Post-Surgical Care:

Following valvular surgery, comprehensive post-surgical care is provided, including:

  1. Intensive Care: Initially, you will be closely monitored in the intensive care unit (ICU) to ensure stable vital signs, pain management, and specialized support.
  2. Recovery and Rehabilitation: You will gradually transition to a regular hospital room, where you will receive support and guidance on post-operative care, pain management, mobility exercises, and breathing exercises.
  3. Medications: Medications, such as antibiotics, pain relievers, and anticoagulants, will be prescribed to manage pain, prevent infections, and prevent blood clots, if necessary.
  4. Cardiac Rehabilitation: Similar to coronary surgery, cardiac rehabilitation plays a crucial role in the recovery process. It involves a structured program of exercise, education, and lifestyle modifications to promote healing, improve cardiovascular fitness, and optimize long-term outcomes.
  5. Follow-up Appointments: Regular follow-up appointments will be scheduled to monitor your progress, assess valve function, review medications, and address any concerns or complications.

It’s important to note that the specifics of valvular surgery and post-surgical care may vary depending on the individual patient’s condition, the type of valve involved, and the surgeon’s expertise. Your healthcare team will provide personalized guidance and instructions throughout the entire process to ensure the best possible outcomes and a smooth recovery.

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