What Is a Heart Valve Replacement?

Think of each heart valve as a one-way door. It swings open to let blood through, then closes tightly so nothing leaks back. When one of those doors becomes stiff and narrow, or worn so it no longer seals, the heart has to work against the fault with every beat. A heart valve replacement is the operation that takes the damaged valve out and puts a new one in its place. The video above, "Minimally Invasive Aortic Heart Valve Replacement" from Detroit Medical Center, runs about three minutes and follows a minimally invasive replacement of a defective aortic valve — a useful place to start, because it shows one of two quite different routes to the same goal.

When a valve can no longer do its job

Valves are usually replaced rather than simply watched once the fault starts affecting the heart or causing symptoms. As a second video on this site puts it, surgery to replace an aortic valve is done for aortic valve stenosis — a valve narrowed and stiffened — and for aortic valve regurgitation, where a leaky valve lets blood flow backwards. The aortic valve is the one featured in both videos here, and the mitral valve is the other valve commonly involved. An ultrasound scan of the heart is often how the problem is measured and followed; our guide to an echocardiogram explains what that test shows. Whether your situation calls for repair, replacement, or continued monitoring is a judgement your cardiology team makes from those images and your symptoms together.

Two kinds of new valve, side by side

The replacement itself comes in two broad families, and the contrast between them is the heart of most pre-surgery conversations. A mechanical valve is made from man-made materials and is built to be very durable. A biological, or tissue, valve is made from animal tissue — often from a pig, as the open-surgery video below describes — and, as another video on this site notes, bioprosthetic valves generally offer working properties more similar to those of a natural valve. Neither family is simply "the better one." The choice is individual, weighing things like your age, your other health conditions, and what follow-up treatment each type would involve, and it is exactly the kind of decision to work through with your surgical team rather than from an article.

Two routes in: smaller incisions or the open operation

How the surgeon reaches the valve also comes in two broad styles. The anchor video follows the minimally invasive approach for a defective aortic valve, and its description presents that approach as having many advantages over traditional open-heart surgery. The traditional operation is shown in "Aortic Heart Valve Replacement Surgery," a video of just over five minutes. In that open approach, the surgeon makes a large incision in the chest, and blood is circulated outside the body through a machine that adds oxygen to it — cardiopulmonary bypass, also called a heart-lung machine. The heart may be cooled to slow or stop the heartbeat, so it stays protected while the damaged valve is removed and the artificial valve is put in. Not every patient or every valve suits the smaller-incision route, which is why both styles remain in use.

After the operation: what recovery centres on

Whichever route and whichever valve you have, the aims afterwards are much the same: let the chest and heart heal, build your activity back up gradually, and keep the follow-up appointments where your team checks how the new valve is working and how you are feeling. Report new breathlessness, chest pain, palpitations, fever, or increasing redness or pain around the wound promptly rather than waiting for the next scheduled visit — those are the kinds of changes your team will always want to hear about early. And if any part of the plan — your medicines, your activity limits, your review dates — is unclear, ask. Understanding your own valve, and which type you received, is part of living well with it.

Frequently Asked Questions

Which heart valves get replaced?

The videos on this page feature the aortic valve, which is replaced for problems such as stenosis (narrowing) and regurgitation (leaking). The mitral valve is the other valve commonly replaced; the tricuspid and pulmonary valves are involved less often.

What is the difference between a mechanical and a tissue valve?

A mechanical valve is made from man-made materials and built for durability. A tissue (biological) valve is made from animal tissue, often from a pig, and behaves more like a natural valve. Which suits you depends on your own circumstances, and the choice is made with your surgical team.

Is valve replacement always open-heart surgery?

No. The traditional operation, shown in the second video linked above, uses a large chest incision and a heart-lung machine. The anchor video instead follows a minimally invasive replacement of an aortic valve, an approach its description presents as having many advantages over traditional open-heart surgery — though not every case is suitable for it.

What is cardiopulmonary bypass?

It is the technique, described in the open-surgery video, in which blood is circulated outside the body through a machine that adds oxygen to it while the heart is worked on. It is also called a heart-lung machine. The heart may be cooled to slow or stop the heartbeat, protecting it during the operation.

How will I know if something is wrong after surgery?

Contact your care team promptly about new breathlessness, chest pain, palpitations, fever, or increasing pain or redness around the wound. Those changes are always worth reporting early rather than waiting for a routine follow-up appointment.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician and researcher.

Educational only — this article is general information about heart valve replacement, not medical advice and not a diagnosis. Decisions about valve surgery, valve choice, and surgical approach belong with your own cardiology and surgical team, who can assess you in person.