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The heart is a pump that is made of muscle tissue. It has four pumping chambers- two uppers, the atria, and two lower chambers, the ventricles. Valves located between each pumping chamber help the blood flow forward from the heart. There are four kinds of valves,
The tricuspid valve located between the right atrium and the right ventricle
The pulmonary valve located between the right ventricle and the pulmonary artery
The Mitral valve located between the left atrium and the left ventricle
The aortic valve located between the left ventricle and the aorta
These valves get damaged, diseased, stiff, or narrowed, putting an additional burden on the heart. Conditions that will cause the heart valve to malfunction will prompt your physician to take corrective action. Depending on your condition, the physician at the time of valve repair and replacements in Hebbal, Bangalore will suggest the corrective action needed to repair or replace your valve.
Preparing for a heart valve repair or replacement surgery
The physician will speak to you and check your complete medical history to conduct a thorough medical examination. This is to make sure that you are in good health. Patients will be required to undergo blood tests and other diagnostic tests.
Patients will be required to fast for about 8 hours before the procedure.
Any allergies to medications will be considered, and any history of bleeding disorders will be considered. Patients may be required to stop this medication for the period of surgery.
Doctors will also check if you have implanted cardiac device or a pacemaker.
Procedure
Procedures may vary according to a patient’s condition. Generally, valve repair and replacement surgeries follow the below process,
1. Any jewelry or metal objects will be removed from your body.
2. Patients will be changed into a hospital gown and asked to empty their bladder.
3. The patient will be positioned on the operating table on their back.
4. An intravenous line in the arm or hand will be injected to administer medication and IV fluids. Catheters will be attached to the blood vessels in the neck and wrist to monitor the status of the heart and check blood pressure and blood samples.
5. An anesthesiologist will monitor your heart rate, pulse rate, blood pressure, breathing and oxygen levels during the surgery.
6. A breathing tube will be inserted through the mouth into the lungs and connect the patient to a ventilator. A machine will do the breathing for the patient during the surgery.
7. A transesophageal echocardiogram will make a probe into the esophagus so the valves can function.
8. A Foley catheter, a flexible tube, will be put in the bladder to drain urine.
9. A tube will be inserted into the mouth or nose to the stomach to drain stomach fluids
10. The surgeon will clean the skin over the chest with an antiseptic solution, and if there is a lot of hair, it will be shaved off.
11. An incision will be made down the center of the chest, starting from Adam’s apple to just above the navel. Smaller incisions will be made if it is a less invasive procedure.
12. The doctors will cut the sternum in half lengthwise. The doctor will separate the breastbone's halves and spread them to expose the heart.
13. The doctor will stop the heart and put tubes in the heart so that blood can be pumped into the body by a heart-lung bypass machine.
14. Once the blood has been completely diverted, the doctor will stop your heart by injecting it with a cold solution.
15. Once the heart stops, the doctor will remove the diseased valve and replace it with an artificial valve. A valve repair will change according to the type of valve problem.
16. Post-surgery, the doctor will shock the heart with waves to restart the heartbeat. The doctor at Manipal Hospitals will then allow blood circulation through the bypass machine to the heart and remove the tubes connected to the machine.
17. Doctor will insert tubes into the chest to drain blood and other fluids around the heart area.
18. The doctor will sew the skin to stitch the sternum back together and seal the incisions with sutures or surgical staples.
19. Sterile bandage or dressing will be applied.
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