See How A

Heart Valve Works

Heart Valve Replacement

If your heart valve cannot be repaired, it may be replaced. Advances in technology, improved valve design and surgical technique make heart valve replacement a common procedure at most major hospitals.

With heart valve replacement, your surgeon will remove your heart valve and implant an artificial (prosthetic) valve in its place. There are two types of prosthetic valves used for replacement: tissue and mechanical.

When heart valve replacement is necessary, the decision to implant either a tissue valve or a mechanical valve will be made based on several factors:

Health conditions (in addition to your heart issues)
Medications
Life expectancy and your age
Lifestyle

Several studies have shown that heart valve recipients report the same quality of life whether they have a mechanical or a tissue valve.^1-4

Tissue Heart Valves

Tissue valves are made with tissues from porcine (pig) heart valves or bovine (cow) cardiac tissue because they function like human heart valves. Once the tissue is removed from the animal, it is chemically treated to preserve the tissue and prevent immulogic reactions once it is placed in a patient.

A homograft or allograft is a heart valve obtained from a human donor. While tissue valves may not last as long as mechanical heart valves, they do not require the lifetime use of anticoagulation medication (blood thinner).

Mechanical Heart Valves

A mechanical valve is carefully designed to mimic a native heart valve. Like your own natural heart valve, it has a ring to support leaflets. The mechanical valve opens and closes with each heart beat, permitting proper blood flow through the heart. Mechanical valves are designed to last a lifetime, but they do require the use of anticoagulation medication (blood thinner). The anticoagulation medication is taken daily and you will be monitored to ensure the dosage is appropriate for you.

More than 2 million St. Jude Medical mechanical valves have been implanted worldwide,* making them the most widely used and well-studied valves available.

Anticoagulation (Blood Thinners) for a Mechanical Heart Valve

To prevent blood clots from developing on the mechanical valve, you must take anticoagulation medicine (blood thinners) daily. The dosage of this medication is different for each person, so you will have regular blood tests at your doctor's office, an anticoagulation clinic or at home with a specialized testing kit to monitor your international normalized ratio (INR). The INR test measures the time it takes for your blood to clot and compares it to an average.

Benefits and Risks

Heart valve replacement surgery can offer several key benefits. The procedure is designed to help your heart function more effectively, which means you may begin to feel better immediately once your replacement valve has been implanted. Others will feel better gradually, regaining energy and strength over the first few weeks following the surgery. Be sure to talk to your doctor about your progress and get advice on the exercises and activities you can do to feel stronger and regain your energy.

As with any surgical procedure, there are risks with heart valve replacement. The risks may include, but are not limited to the following:

Blood cell damage (hemolysis)
Low red blood cell count (hemolytic anemia)
Bleeding
Infection
Clotting in or on the valve (thrombus formation)
Tissue on the valve (valvular pannus)
Loose clots in the blood stream that may block an artery in your arms, legs or brain (thromboembolism)
Valve failure (which may include structural damage)
Leakage around the edge of the valve (paravalvular leak)
Need for reoperation
Explantation (removal of the valve)
Arrhythmia
Stroke
Angina
Heart failure
Death

Individual risks are best evaluated by your heart surgeon and cardiologist. Generally, risks depend on age, general health, specific medical conditions and heart function. Talk to your doctor to better understand the potential benefits and risks of your clinical situation.

*Data on file at St. Jude Medical

¹Koertke H, Kirchberger I, Minami K, et al. Quality of Life after Heart Valve Replacement – A Comparison of Patients with Biological Versus Mechanical Heart Valves, Society of Heart Valve Disease 1st biennial meeting, London, 2001, abstract 85.

²Perchinsky M, Henderson C, Jamieson WR, et al. Quality of life in patients with bioprostheses and mechanical prostheses. Evaluation of cohorts of patients aged 51 to 65 years at implantation. Circ. 1998 Nov 10;98(19Suppl):1181-6; discussion 1186-7.

³Myken P, Caidahl K, Larsson P, et al. Mechanical Versus Biological Valve Prostheses: A Ten-Year Comparison Regarding Function and Quality of Life. Ann of Thorac Surg. 1995 Aug; 60(2 supplement);s447-s452.

⁴Goldsmith I, Lip G, Patl R. A retrospective study of changes in patients’ quality of life after aortic valve replacement. J Heart Valve Dis, 2001; 10(3):346-353.

Last Reviewed: January 19, 2010 2506