Valve Repair and Replacement
Valve surgery may involve repairing or replacing one of the four heart valves. Typically,
surgery is performed for severe leakage (regurgitation) or severe blockage (stenosis). This may develop over many
years, or happen abruptly. Usually, patients will have symptoms from the valve abnormality, or demonstrate enlargement
or early failure of the heart by echo prior to surgery. A new valve may be metallic, tissue (from a pig or cow), or
homograft/allograft (from humans). Metallic valves last the longest, but are more prone to clotting and long-term
blood thinners (e.g. Coumadin) are required. Tissue valves have the advantage of not requiring blood thinners long-term,
but will sometime wear out and need to be replaced again. Sometimes a valve can be repaired, without having to be replaced.
This most commonly is possible with the mitral or tricuspid valves, such as in cases of mitral valve prolapse
or mitral annulus dilation. The aortic valve may be spared from replacement in special cases of aortic dilation from
Marfan's disease. Sometimes the dilated aortic root is replaced by a dacron tube graft, and the aortic valve is able
to be repaired.
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