How are heart valve diseases treated with surgery?

The recommended treatment method in heart valve surgeries is to try to repair the problematic valve by preserving the patient's own valve tissue as much as possible (heart valve repair surgery). Thanks to the preservation of the patient's own valve tissue, the patient's need for long-term blood thinner treatment is eliminated. Thus, the patient is protected from possible complications of blood thinning treatment. If it is not possible to repair the problem in the patient's valve during the evaluation during the surgery, the diseased valve tissue is cut out and a prosthetic valve is sewn in its place (heart valve replacement surgery).

What are heart valve prostheses and how are they different from each other?

Today, there are two types of prosthetic heart valves (mechanical and biological). Both types of prosthetic heart valves have advantages and disadvantages against each other. Long-term durability and thrombogenic properties of the valve are two important problems of prosthetic heart valves. Mechanical heart valves are quite durable, but they are prone to clotting. In a patient with a mechanical valve, if an infection anywhere in the body does not affect the valve, if a clot does not develop that prevents the valve from working, or if the patient's own tissues do not move towards the valve and impair the functioning of the valve, there is no need for surgery again. However, these patients must use anticoagulant drugs (which prevent blood clotting) for the rest of their lives. Patients using anticoagulant medication are kept under close monitoring to ensure that the blood is at the desired level of fluidity. There is a risk of drug-related bleeding or clot formation on the prosthetic valve, especially in elderly patients and patients who are not compliant with medication use. Bioprosthetic valves are generally obtained from cattle pericardial tissue or pig heart valves. The use of valves obtained from human donors is extremely rare. The main advantages of bioprosthetic heart valves are that the risk of clot formation in the valve tissue is much lower. There is generally no need for long-term use of anticoagulant medication in these patients, but durability is a serious problem in bioprosthetic heart valves. Structural deteriorations occur in bioprosthetic heart valves within 10-15 years. Patients may need to have surgery again in the future.

When the valve needs to be replaced, how is it decided what type of prosthetic valve will be used?

Before the planned surgery, the patient and his/her relatives are informed in detail and a joint decision is made on choosing the right type of prosthetic valve. In general, bioprosthetic valves are preferred whenever possible in patients who are over the age of 70 or who are not comfortable using anticoagulant medication following surgery. In younger patients, mechanical prosthetic valves are mostly considered.