McAllen Heart Surgeons performs the highest volume of valve surgery in the Rio Grande Valley. In addition, both mitral valve and aortic valve repair/ replacement -- surgeries to correct defective mitral valves or open narrow aortic valves -- can be performed through openings that are half the size of traditional incisions. In addition to the cosmetic benefits of a smaller incision, patients experience a shorter hospital stay and faster recuperation.
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Aortic Valve Replacement
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Mitral valve repair by quadrangular resection of posterior leaflet
resection
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Minimally invasive mitral valve repair surgery
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Minimally invasive
aortic valve repair surgery
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Heart valve surgery is a procedure used to repair or replace diseased heart valves. Over the past few years, there have been great advances in the surgical treatment of diseased heart valves by heart valve surgery. The diagnostic tests your heart doctor orders help to identify the location, type and extent of your valve disease. The results of these tests, the structure of your heart, your age, and your lifestyle will help your cardiologist, surgeon, and YOU decide what type of heart valve surgery procedure will be best for you.
- Minimally invasive approaches to heart valve surgery
- Valve repair surgery
- Valve replacement surgery
- Valve videos
Valve disease can be treated by protecting your valve from further damage, taking medications, seeing your doctor for regular visits and having heart valve surgery.
McAllen Heart Surgeons continues to perform the largest number of valve procedures in the Rio Grande Valley.
Heart Valve SurgeryTraditional heart valve surgery
During traditional heart valve surgery, a surgeon will make an incision down the center of your sternum (breastbone) to get direct access to your heart. The surgeon then repairs or replaces your abnormal heart valve or valves. While this approach remains in use, today most patients with isolated valve disease can be treated with minimally invasive techniques.
Minimally invasive heart valve
surgery
Minimally invasive surgery is a type of surgery
performed through smaller incisions. This type of
surgery reduces blood loss, trauma, and length of
hospital stay. Heart valve surgery is the most common
minimally invasive procedure. Your surgeon will review
your diagnostic tests prior to your surgery to see if
your are a candidate for minimally invasive valve
surgery. Click
here to learn more about minimally invasive heart
surgery
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Traditional heart surgery incision: median sternotomy |
Minimally invasive approach: partial upper sternotomy |
Often, the heart surgeon and cardiologist will use transesophageal echocardiography during the operation to help determine the functioning of the valve before and after surgery.
There are two types of heart valve surgery: valve repair surgery and valve replacement surgery
Heart valve repair surgery
Valve repair allows the surgeon to fix your faulty heart
valve, often without the use of artificial parts. The
advantages of heart valve repair are:
- lower risk of infection
- decreased need for life-long blood thinner medication
- preserved heart muscle strength
The mitral valve is the most commonly repaired valve, but the aortic and tricuspid valves may also undergo some of these repair techniques.
Common valve repairs include:
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Commissurotomy
Mouse over illustration to view repaired opening |
Commissurotomy
Fused valve leaflets are separated to widen the valve
opening.
Decalcification
Calcium deposits are cleaned off the valve leaflets,
allowing them to be more flexible and close properly.
Triangular resection
If a portion of the mitral valve leaflet is flail
(floppy), and bows back into the left atrium, a segment
may be cut out and the leaflet sewn back together,
allowing the valve to close more tightly.
Click here to learn more.
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Ruptured chords at free edge of posterior
leaflet. Region to be resected is indicated.
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Abnormal segment has been removed. Leaflet
edges are sewn together
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Annuloplasty completes the repair.
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Annulus support
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Patched leaflets
Mouse over illustration to view repaired leaflet |
If the valve annulus is too wide, it may be reshaped
or tightened by sewing a ring around the annulus (annuloplasty).
The ring may be made of tissue or synthetic material.
Patched leaflets
The surgeon may patch leaflets with tears or holes with
tissue patches.
Click here to learn more about mitral valve
repair
When you have aortic or pulmonic valve disease, heart surgery most often requires replacement of the valve. In some cases, the aortic valve can be repaired.
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Annulus support
Mouse over illustration to view repaired aortic valve |
Bicuspid aortic valve repair
If you have a bicuspid aortic valve (two leaflets
instead of three), the surgeon may be able to repair the
valve by reshaping the aortic valve leaflets, allowing
the valve to open and close more easily.
Mechanical valve replacement
Mechanical valves are made totally of mechanical parts which are tolerated well by the body. The bileaflet valve is used most often. It consists of two carbon leaflets in a ring covered with polyester knit fabric. There are advantages and drawbacks to mechanical valves.
St. Jude Medical® Mechanical Heart Valves
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St. Jude
Medical® Mechanical Heart Valve
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SJM
Regent® Valve
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The St. Jude Medical® Regent valve is available for aortic valve replacements, and the standard St. Jude Medical® valve is used in the aortic and mitral valve positions.
The St. Jude heart valve was the first bileaflet mechanical heart valve (St. Jude Medical® (SJM)). This valve has a track record spanning 3 decades of excellent results. This bileaflet mechanical heart valve is designed and manufactured of pyrolytic carbon.
Photographs posted with permission from St. Jude Medical®
The CarboMedics Prosthetic Heart Valve
(CPHV™)
Photographs posted with
Permission from CarboMedics
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Top Hat™
Supra-Annular
Aortic Valve |
Standard Mitral Valve
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CarboMedics manufactures a variety of bileaflet mechanical heart valves. The Top Hat Supra-Annular valve is used for aortic valve replacement and the standard valve in the mitral position. A third valve, the Reduce R Aortic Valve may also be used for aortic valve replacement.
The valve housing and leaflets are made of Pyrolite carbon, a unique form of carbon which Carbomedics engineers discovered in the sixties. Attached to the carbon housing is a reinforcing band of titanium and attached to the titanium band is a suture ring of PET fabric. A metallic nitinol wire holds the titanium ring to the housing with an interference groove system. Pyrolite is biocompatible.
Advantages: Mechanical valves are very durable. They are designed to last a lifetime.
Disadvantages: Due to the artificial material involved, patients who receive these valves require lifelong treatment with a blood-thinning (anticoagulant) medication. Blood-thinners are medications (such as warfarin or Coumadin) that delay the clotting action of the blood. They help prevent clots from forming on the mechanical valve, which can cause a heart attack or stroke.
Tissue
valves (also called biologic or bioprosthetic valves):
Tissue valves (also called biologic or bioprosthetic valves) are made of human or animal tissue. Some valves may have some artificial parts to help give the valve support and to aid placement.
There are two types of tissue valves: pig tissue (porcine) and cow tissue (bovine).
There are advantages and drawbacks to biologic valves. Advantages: Most patients do not need to be on lifelong blood-thinner medication, unless they have other conditions (such as atrial fibrillation) which warrant it. Drawbacks: Biologic valves, traditionally, were not considered as durable as mechanical valves, especially in younger people. Previously available biologic valves usually needed to be re-replaced after about 10 years However, recent studies on the PERIMOUNT aortic valve, show that these valves may last at least 17 years without decline in function. This represents a new milestone in durability of biologic valves. |
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