The benefits of heart valve replacement surgery may include a longer life and relief of symptoms. Most people can return to normal levels of activity after the procedure.
Mechanical valves last longer than tissue valves but you’ll need to take blood-thinning medication for the rest of your life. On the other hand, most tissue valves only last 10 to 20 years, so if you’re relatively young you may need a repeat surgery.
As with any medical procedure there are some potential risks. The chance of complications depends on the type of procedure you’re having and factors like your general health.
Common conditions that may affect your outcome include diabetes, obesity and infection. Smokers are also at a higher risk of complications following surgery. You won’t be able to smoke during your hospital stay so this could be a good opportunity to quit.
Your risk will also be affected by your age and the severity of the problem with your valve. If you’re having another procedure at the same time, such as coronary artery bypass graft surgery, your surgical risks will also increase.
There is a low but definite risk of dying during or after heart valve surgery. This risk depends on the severity of your condition, the complexity and duration of the surgery, the experience of your surgeon and their team, and any complications.
The most common complications of heart valve replacement are:
Some bleeding can be expected during and after surgery and you may need a blood transfusion. You may be able to donate your own blood several weeks before the surgery in preparation. Occasionally, more surgery is required to control bleeding or to remove blood from around your heart or in your chest.
These can potentially cause stroke or a pulmonary embolism (PE) in your lungs.
After surgery, there’s a risk of infection in the incision or around the new valve and a risk of contracting pneumonia or septicaemia (blood infection). After recovery, you’ll have an ongoing risk of infective endocarditis, an infection in the lining of your heart. This occurs when a bacterium enters your bloodstream and can be caused by something as simple as brushing your teeth or having a dental procedure. You’ll need to tell your dentist that you’ve had a heart valve replaced and take an antibiotic before any dental procedure. Strong antibiotics are administered around the time of your surgery to minimise the risk of infection in your wound.
Abnormally rapid heartbeats, known as atrial or ventricular arrhythmias, can follow heart valve surgery and may require emergency treatment. They are usually temporary.
This is a collection of symptoms including fever and chest pain that can last for up to 6 months after valve replacement surgery. It’s caused by inflammation in the tissue around your heart.
People who’ve been on a heart-lung machine frequently experience confusion and cognitive decline. This is known as post-perfusion syndrome, which may be temporary or long-term. Some scientists believe the syndrome isn’t actually caused by the heart-lung machine, but the cardiovascular disease itself.
Heart attack, heart failure, kidney failure and delayed wound healing can also occur.
Ask your surgeon about the results and risks associated with your procedure. Also ask about their own rates of patient satisfaction and the rate of complications following the procedures they’ve performed.