Pulmonary Valve Replacement Surgery
Pulmonary valve surgery is a procedure that replaces a dysfunctional pulmonary valve -- which is part of the heart. When the heart beats, blood is pumped throughout the body. The pulmonary valve closes to allow the heart to fill up with blood, and when the heart is stretched the pulmonary valve opens and allows blood to flow into the lungs. When the pulmonary valve closes again, blood is prevented from flowing backwards to the heart. The lungs provide this blood with oxygen and it returns to the heart ready to be pumped to the rest of the body. A defect of the pulmonary valve is a serious condition and can require surgery to fix the problem.
Why Do Patients Need Pulmonary Valve Replacement Surgery?
There are two main ways that the pulmonary valve can lose function: stenosis and regurgitation. Pulmonary stenosis is the shrinking of the valve opening. This allows less blood to flow through the valve and get to the lungs. Pulmonary regurgitation is when the valve cannot close completely and this allows blood to flow backwards. Again less blood can get to the lungs with this condition.
Sometimes this pulmonary valve disease is congenital. People may be born with valves that are too thick which can cause stenosis. Sometimes valves are not able to separate and this can cause regurgitation. Certain diseases are also related to development of pulmonary valve impairment. Rheumatic fever is caused by a bacterial infection that can damage the heart valves. Carcinoid syndrome causes an increase in the chemical serotonin. Excessive amounts of this chemical can damage the heart.
What Is My Pulmonary Valve Replaced With?
Pulmonary valve replacement is required for valves that are too damaged to be repaired. This requires the surgeon to replace the damaged pulmonary valve with a tissue valve or a mechanical valve. Tissue valves, also known as biological valves, are made from other animals, such as pigs or cows, and are not quite as stable as other valves.
Mechanical valves are the more durable valves. These are made from synthetic materials like plastic, carbon and titanium. These have been shown to last much longer than tissue valves. The surgeon should discuss with the patient which procedure would be best for them.
What Happens During The Surgery?
Every patient will receive general anesthesia so they will not feel pain. Open heart surgery typically involves the surgeon making a large incision through the sternum -- although minimally invasive and trascatheter approaches do exist.
Patients will be connected to a bypass machine which acts like the heart and circulates blood throughout the body while the heart is stopped. This procedure is the most invasive of the surgeries for pulmonary valve replacement. Other surgeries that involve smaller incisions include: laparoscopic, percutaneous, or robot assisted surgery. Aside from the size of the incision, these surgeries are similar to the traditional open heart surgery.
After surgery a full recovery is expected. Antibiotics may be prescribed to prevent infection. It is important to discuss with the doctor what signs of infection to look for so immediate action can be taken.
Adam Pick is a patient, author of The Patient's Guide To Heart Valve Surgery and the founder of HeartValveSurgery.com.