Surgical Treatment of Heart Valve Diseases

Heart valve diseases, which are seen in approximately 10 percent of people over the age of 65 worldwide, are one of the problems that increase in importance with the aging population. The cardiovascular surgery specialist drew attention to the fact that valvular heart diseases, which increase in importance with age, can pose a life-threatening risk if not diagnosed in time and treated with appropriate methods. Stating that these diseases manifest themselves with symptoms such as shortness of breath, fatigue and arrhythmia, our specialist pointed out that the quality of life increases with early diagnosis and treatment. He explained that thanks to the developments in treatment in recent years, a lifelong treatment algorithm is now applied in valvular heart diseases.

What are the Most Common Heart Valve Diseases?

Reminding that mitral and aortic valve disorders are the most common among valvular heart diseases, which constitute a very important topic in terms of heart health, Yeditepe University Hospitals Cardiovascular Surgery Specialist  Prof. Dr. Cemil İSBİR said that both the type and severity of the disease may differ depending on gender and age in valvular heart diseases. Our specialist clarified the symptoms that may be overlooked about valvular heart diseases and especially the question “When and who needs surgery?”, which patients are most curious about.

What are the Symptoms of Heart Valve Diseases?

Underlining that extremely important symptoms such as fatigue and shortness of breath in valvular heart diseases may be ignored because they are attributed to different problems, our expert continued his words as follows: "Valve diseases also manifest themselves as rhythm disturbances in advanced periods. However, ignoring the symptoms can prevent early diagnosis and the disease can progress and cause more serious problems. Valve diseases weaken the heart muscle in the later stages, resulting in heart failure."

Does Everyone with Heart Valve Disease Have to Have Surgery?

Emphasizing that drug treatment in valvular heart diseases can only slow down the progression of the disease, our expert said, "It is not possible to correct structural disorders with medication. Drug treatment does not cure valvular heart diseases, but it prevents disorders in heart functions that occur due to valvular heart diseases. However, there is no rule that every patient will undergo surgery. If the valve disorder starts to affect heart functions, especially if shortness of breath and arrhythmia are observed, surgery should be put on the agenda."

What Should Patients with Heart Valve Disease Pay Attention to?

Pointing out the importance of regular follow-up and early intervention in patients diagnosed with valvular heart disease, our specialist said, "Surgery is inevitable if the heart's contractility decreases, heart size increases or rhythm disturbances begin. Intervention before reaching this stage increases the chance of success of the surgery."

What are the Treatment Options for Heart Valve Diseases?

Reminding that the classical method is open heart surgery, our specialist said that thanks to technological developments, minimally invasive and robotic methods can be performed with smaller incisions in suitable patients. However, stating that these methods are not suitable for every patient, he said, “The important thing in heart surgery is not the size of the incision, but the selection of the safest method for the patient.”

He answered the question about valve repair and replacement, which is one of the most confusing and curious topics in the treatment of valvular heart diseases, as follows: "Valve repair is the method of repairing the valve using the patient's own tissue. The most important advantage is that since the patient's own tissues are used, heart functions are better preserved after surgery. The valves we repair most frequently and most successfully are the mitral valve on the left side of the heart and the tricuspid valve on the right side. This method should be preferred for non-calcified valves and young patients."
"Biological valves are preferred because they do not require blood thinners, but their lifespan is limited. A mechanical valve is usually used in young patients, but this also requires lifelong blood thinners. Patient-specific planning should be made and preferences should be determined according to the patient profile."

How to Make a Treatment Plan in Heart Valve Diseases?

“In the light of this information, we now apply an algorithm that we call lifelong treatment in the treatment of valvular heart diseases,” said Prof. Dr. İSBİR and continued his words as follows: "We apply a treatment scheme for patients based on their age and some other characteristics. For example, if a patient does not want to use blood thinners or if blood thinners pose a medical risk for this patient, even if the patient is young, if we cannot repair the heart valve, we use a biological valve. When this valve degenerates over time, we give this chance with non-surgical valve replacement or a second heart surgery if necessary."

What Should People Who Have Heart Valve Surgery Pay Attention To?

Stating that the average postoperative hospital stay is 5-6 days and full recovery takes about 3-4 weeks, Cardiac Surgery Specialist Prof. Dr. Cemil İSBİR concluded his words as follows: "The two factors that need the most attention in this process are infection and blood thinner treatment. Blood thinner treatment is especially vital for patients with mechanical valves. Blood levels of the drug should be checked at regular intervals and the dose of the drug should be adjusted according to the blood level. Infection is another very important factor. Patients should protect themselves against infection. Otherwise, prosthetic valves can be damaged due to infection and this can lead to life-threatening problems."