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Wake Forest Baptist Approach Why Choose Wake Forest Baptist? The Heart Center of Wake Forest University Baptist Medical Center was one of the first centers in the country to offer a new "natural" valve replacement to patients with diseased or damaged aortic heart valves. The Freestyle® valve was tested extensively in six centers, including the Heart Center, before being released for general use. Developed by Medtronic, the Freestyle® is a pig valve designed to be closer to nature than some other options. More than 100 of our Heart Center patients received the Freestyle® valve during the five year clinical trial. With the new valve, patients don’t have to take anti-clotting medication for a lifetime. Heart Center surgeons have a high rate of success with mitral valve repair—thanks in part to the development of a better technique for exposing the valve during surgery.  The technique provides an up-close look at the valve, allowing repair in many cases.  When repair isn’t possible, frozen homografts are an option.  Human valves preserved by freezing have been used since 1975 to replace aortic valves; however it wasn’t until the late 1990s that a procedure for replacing the more complex mitral valve was perfected.  A Heart Center cardiothoracic surgeon was one of the first 15 doctors in the United States trained in the procedure.   Heart valve surgery Heart, section through the middle Heart, front view Heart valves - anterior view Heart valve surgery - series   Definition: Heart valve surgery is used to repair or replace diseased heart valves. Alternative Names: Valve replacement; Valve repair; Heart valve prosthesis Description: There are four valves in your heart: Aortic valve Mitral valve Tricuspid valve Pulmonary valve The valves control the direction of blood flow through your heart. The opening and closing of the heart valves produce the sound of the heartbeat. Heart valve surgery is open-heart surgery that is done while you are under general anesthesia. A cut is made through the breast bone (sternum). Your blood is routed away from your heart to a heart-lung bypass machine. This machine keeps the blood circulating while your heart is being operated on. Valves may be repaired or replaced. Replacement heart valves are either natural (biologic) or artificial (mechanical): Natural valves are from human donors (cadavers). Modified natural valves come from animal donors. (Porcine valves are from pigs, bovine are from cows.) These are placed in synthetic rings. Artificial valves are made of metal. If you receive an artificial valve, you may need to take life-long medication to prevent blood clots. Natural valves rarely require life-long medication. Indications: Heart valve surgery may be recommended for the following conditions: Narrowing of the heart valve (stenosis) Leaking of the heart valve (regurgitation) Valve problems may be caused by infections such as rheumatic fever, birth defects, calcification, or certain medications such as Fen-Phen. Defective valves may cause congestive heart failure and infections (infective endocarditis ). Risks: The risks for any anesthesia include: Reactions to medications Problems breathing The risks for any surgery include: Bleeding Infection The risks for cardiac surgery include: Death Stroke Heart attack Arrhythmia Kidney failure Temporary postoperative confusion due to the heart-lung machine It is very important to take steps to prevent valve infections. Therefore, you may need to take antibiotics indefinitely, or before dental work and other invasive procedures. Expectations after surgery: The success rate of heart valve surgery is high. The operation can relieve your symptoms and prolong your life. The death rate averages 2% to 5%, depending on the heart valve. About 2 of every 3 patients who received an artificial mitral valve are still alive 9 years after the surgery. The clicking of the mechanical heart valve may be heard in the chest. This is normal. Convalescence: You will stay in an intensive care unit for the first 2 or 3 days following the operation. Your heart functions will be monitored constantly. The average hospital stay is 1-2 weeks. Complete recovery will take a few weeks to several months, depending on your health before surgery.

Review Date:5/30/2006 Reviewed By:J.A. Lee, MD, Division of Surgery, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.