What is pulmonary valve replacement surgery?
Pulmonary valve repair and pulmonary valve replacement surgery are used to treat patients with damaged pulmonary valves. The pulmonary valve is located between the left ventricle and the pulmonary artery and works to regulate flow of blood to the lungs. As the right ventricle contracts, the pulmonary valve opens, allowing oxygen-depleted blood into the pulmonary artery. The blood will travel through the pulmonary artery into the lungs to reach the oxygen.
When a pulmonary artery becomes damaged, the blood may not flow through the valve effectively and the heart may have to work harder to supply oxygen-rich blood to the body.
The goal of a pulmonary valve repair or pulmonary valve replacement is to restore normal blood flow into the lungs, reduce symptoms and extend your life span. Pulmonary valve replacement or pulmonary valve repair surgery is not as common as aortic or mitral valve repair or replacement surgery.
Who is a candidate for a pulmonary valve replacement?
Patients who suffer from pulmonary valve stenosis, pulmonary valve regurgitation or children born without a well-defined pulmonary valve are candidates for pulmonary valve repair or pulmonary valve replacement.
- The pulmonary valve becomes hardened or thickened, narrowing the opening from the ventricle into the pulmonary artery.
- The pulmonary valve leaks and blood flows back into the heart instead of moving to the lungs.
- Some children are born without a well-defined pulmonary valve, affecting the flow of blood into the lungs from the heart.
What to expect from pulmonary valve repair surgery?
Pulmonary valve repairs or pulmonary valve replacements are typically performed during open-heart surgery. In open-heart surgery, your surgeon will cut a large incision in the breastbone and place you on a heart-lung bypass machine to repair or replace the damaged valve.
Your doctor may repair pulmonary valves in cases where:
- Leaflets have fused together
- Leaflets need reconstruction
- Need patches removed from procedures such as tetralogy of Fallot
- Leaflets need to be brought together to make a working valve
- Valves need tightening Excess tissue needs to be removed to allow the valve to close more tightly
What to expect from pulmonary valve replacement surgery?
During a pulmonary valve replacement surgery, your doctor will remove your failing pulmonary valve and replace it with a mechanical or biological valve. Mechanical valves are made from man-made materials, while biological valves are made from cow or pig valves. Biological valves need to be replaced after 15 to 20 years. If you have a mechanical valve, you will have to be on blood thinning medication. Your surgeon will discuss the pros and cons of both valves and determine the most appropriate option for you.
In some cases, the surgery may be done minimally invasively. Percutaneous pulmonary valve replacement is the most common minimally invasive procedure for replacing the damaged pulmonary valve. During this procedure, your surgeon will guide a catheter to the heart from an incision in the groin or chest. When in position, a replacement pulmonary valve is placed within the failing pulmonary valve or the failing pulmonary valve is removed, and the new valve replaces the old valve.
Risks of pulmonary valve replacement
Complications associated with pulmonary valve repair or pulmonary valve replacement include:
- Severe bleeding
- Blood clots that could lead to a pulmonary embolism, stroke or heart attack
- Infection at incision site
- Arrhythmias
- Valve abnormalities in replacement valves
Recovery from pulmonary valve replacement
After pulmonary valve repair or pulmonary valve replacement surgery, you will spend a day or more in the ICU before moving to a regular hospital room to recover. You will be closely monitored by your Mercy Health care teams during your hospital stay. They will ensure you do not have an infection at the surgery site, will evaluate your heart valve function and encourage light activity before discharging you from the hospital.
Most people can return to their day-to-day activities after pulmonary valve repair or replacement surgery. Your Mercy Health cardiac team will outline your medication schedule and follow-up appointment schedule in your discharge plan. Your doctor may also recommend follow-up tests to evaluate how your heart valve is functioning.
In many cases, your doctor may recommend incorporating healthy lifestyle habits into your recovery plan.
This could include:
- Incorporate physical activity
- Eat a healthy diet
- Manage stress
- Quit smoking
When appropriate, your Mercy Health cardiac team may recommend entering a cardiac rehabilitation program to help you recover after heart surgery.