The Difference Between Heart Valve Repair and Replacement Video

In this medical health video learn what is the difference between heart valve repair and replacement.
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What is the difference between heart valve repair and replacement? Dr. Allen Graeve: Valve repairs and replacements, they are totally different. Value repairs generally leave the valve in place or some portion of the valve in place, an attempt to correct the problem without using a man-made substitute can be the definition. Dr. John Puskas: Valve replacement of course means that we take out the patient's on diseased valve and replace it with another valve. We can either replace it with the man-made valve, what we call a mechanical valve or valve that is derived from an animal heart from typical cow or pig heart and those are called biological valve replacements. Dr. Allen Graeve: In the mitral position, I probably repair about 3 out of 4 of the valves that have what's called regurgitation purely and that's not uncommon. Many surgeons try first to repair valve in the mitral position if it's purely a leaking valve. Dr. John Puskas: Valve repair is much more commonly done for the mitral valve or tricuspid valve, then it is for the aortic valve or the pulmonary valve. Dr. Allen Graeve: The advantage is that if you can repair it then you can get a durable result in that position. Then the patient doesn't have to have for example, coumadin if it's a mechanical valve for the rest of their life. There are some advantages to repairing a mitral valve in terms of mortality. There seems to be a lower mortality for valve repair in the mitral valve than for a valve replacement. Some people argue that the reason for that is that you are looking at totally different subsets of patients, but there might be some benefit simply to repairing the valve because it leaves certain things intact in the heart that have to be destroyed when you do the replacement. Dr. John Puskas: Repairs imply leaving in most of the native valve in the heart and working on the valve itself to reshape it, remove parts that are very dysfunctional and reconfigure the shape of the valve so that it will not leak. Dr. Allen Graeve: We always attempt to replace the valve and mimic the repair if we can. We try to save as much as we can of the underline valve apparatus. I am getting into technical issues, but there is huge difference between repair and replacement, both in terms of the ease of doing it. Repair is generally harder than replacement.

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