Heart Valve Re-Operations

Heart valve surgery is a life-saving procedure. Today there are minimally-invasive mitral valve and aortic valve surgeries, so the patient has a shorter recovery period. However, the possibility of re-operations on the heart valve does occur. Why? Leaking can occur. Also, the valves are not everlasting and are subject to wear and tear over the years.

A mechanical valve can last inside a person’s body for more than 20 years. The valves are made from pyrolytic carbon. Most likely, you will need valve surgery only once, and never have to replace the valve. That is, unless you get this surgery done at a younger age. A biological tissue valve often has to be replaced because it lasts only 10 to 18 years. A patient’s life expectancy is strongly considered with this valve, since he or she will most likely need another surgery when the first tissue valve degenerates. This type of valve is recommended for patients 60 years old or older.

Nothing is perfect; sometimes, patients have leakage again just a few months after their surgery while others may never have a leak. Some patients will need a repair while others will need a whole new replacement. If a patient leaks soon after the surgery, this is called an “early failure.” How the doctor will fix this new leak will depend on what type of valve disease the person had to begin with. For example, mitral valve prolapse is almost always re-repairable. The doctor will examine you and do a workup to see if the time is right to do a re-operation. Mitral valves are living pieces of tissue, so the surgeon aims to preserve them whenever possible.

Re-operations have become safer in the last decade. You want to make sure you’re working with a heart valve surgeon who is experienced in re-operations. Re-repairs require extensive experience. It is a “super” specialty. Re-operations are challenging because after the first operation, the heart and tissues healed with scarring and tissues are stuck together, so the risks of injury to the heart and blood vessels when getting into the chest is higher. Also, scarring makes re-operating on the valves more challenging.

Re-repairs are done on:

• Patients who had a previous heart operation unrelated to the heart valves, but now need heart valve surgery.
• Patients who had a mitral valve repair who developed a new leak in the valve or the valve was unable to be fully corrected in the first operation.
• Patients who had a valve replacement who now need a new valve replacement, because the previous valve is worn out, not working properly, or is infected.

If you’re looking for a cardiac surgeon to perform your heart valve surgery and discuss valve replacement or repair options, book a consult with Dr. Peter Mikhail who is based in New Port Richey, Florida. Dr. Mikhail is one of the foremost authorities and specialists in mitral valve surgery and he also performs mini-AVR and TAVR. To book a consultation, click here or call his office at 727-312-4844.