VALVE REPLACEMENT

DEFINITION
Heart valve replacement is a surgical procedure in which surgeons remove a damaged or diseased valve from the heart and substitute it with a healthy one.

2 types: Natural valves/ tissue valves/bioprosthetic valve 1. Heterograft valves or xenografts- from pigs (porcine) or cows (bovine) 2. Homografts or allografts- removed from human cadavers 3. Autografts are live valves transferred from one position to another in the same individual.

Porcine Stented Valve

Aortic Valve Allograft - the Homograft Valve

 Mechanical Valve/ Prosthetic ValveMechanical valves are made totally of mechanical parts that are tolerated well by the body.

Supra-Annular Aortic Valve

Standard Mitral Valve

PURPOSE
Heart valve replacement is only resorted to when the faulty valve interferes greatly with the pumping capacity of the heart and when valve repair is not possible such as when the leaflets of the valve are immobilized by calcifications.

 The major reason for valve replacement surgery is to replace valves that are narrow (stenotic) or leaky (insufficient).

INDICATIONS
Individuals with coronary artery disease or rheumatic heart disease or who have had rheumatic fever or bacterial endocarditis are at a higher risk for requiring heart valve replacement.

NURSING RESPONSIBILITIES
PRE-OPERATIVE - Vital signs monitoring - Assist in laboratory exams: electrocardiogram (ECG or EKG), blood tests, urine tests, and a chest x-ray

Nursing Responsibilities:
POST-OPERATIVE - VS monitored every 5 to 15 minutes until recovery from sedation, then every 2 to 4 hours and PRN - Wound care, Exercise therapy: Aerobic Exercise - Lifting heavy object not allowed - Health teaching: Long-term anti-coagulant therapy (especially Mechanical), limit fat, cholesterol, sodium intake

 Watch out for complications: bleeding, arrhythmias, infection, dehiscence of the sternum, thrombophlebitis, pulmonary emboli, stroke, acute myocardial infarction, and respiratory and kidney failure.