When parts of the heart, such as the valves, do not work properly, it is possible to repair or replace them. The heart has four valves. The aortic and mitral valves are the ones that most commonly need replacing.

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Heart valves are flap-like structures that prevent blood from flowing backward in the heart. They ensure that the blood is moving in the right direction.

When a person’s heart valves are damaged, the heart will have trouble pumping blood. Symptoms of heart valve problems may include:

Heart valve replacement surgery carries some risks, such as infection and bleeding.

Keep reading to learn more about heart valve replacement surgery, including when it may be necessary, how much it may cost, what to expect, and what risks come with it.

A heart valve replacement may be necessary if a person’s heart valves are not working properly and are too damaged for a repair to be successful.

People may need surgery to replace the:

  • aortic valve
  • mitral valve
  • pulmonary valve
  • tricuspid valve

Sometimes, people may need a replacement for more than one valve. According to the American Heart Association (AHA), aortic and mitral valve replacements are the most common.

A valve may need replacing if it has narrowed — a condition called stenosis — or if it is leaky, letting blood flow backward.

Learn more about common heart valve disorders.

When a person needs a heart valve replacement, doctors may use one of the following types of valves for the procedure:

  • mechanical valves
  • allografts, which are made from tissues harvested from a donor’s heart
  • pig valves
  • cow valves

Surgery

A doctor may also recommend the Ross Procedure for a damaged aortic valve. This procedure involves swapping the person’s damaged aortic valve with their pulmonary valve and replacing the pulmonary valve with a donor valve.

Replacing a heart valve often involves open-heart surgery.

However, another option is transcatheter aortic valve implantation (TAVI), a less invasive procedure. Newer surgical techniques are emerging, such as robot-assisted procedures, which are also less invasive.

Doctors may consider the following before recommending a procedure:

  • a person’s age
  • a person’s health status
  • the severity of symptoms
  • the risks of surgery
  • which valve needs replacing

According to a 2020 study, the average cost of aortic valve replacement surgery is about $59,000.

Preparation for a valve replacement depends on the type of procedure a person is having.

Prior to open-heart surgery, people will typically meet with the medical team performing the procedure to discuss the steps involved and any possible risks and complications.

People will likely have to stay in the hospital the night before surgery to have blood work and other testing done. They must not eat after midnight before the surgery.

Before the surgery, a hospital employee will shave the surgical area and direct the person to put on a hospital gown. They may administer a sedative to help the person relax. They will then move the person to the operating area, where the person will receive general anesthesia.

What happens during the surgery depends on the type of procedure.

Open-heart valve replacement

This type of replacement procedure involves opening up the chest to replace a damaged valve. To replace a valve, the medical team will have to stop the heart for 1 hour and use a heart-lung machine to continue circulating blood in the person’s body.

Once the surgeons close the incision, the person will go to the intensive care unit (ICU).

TAVI

This minimally invasive procedure involves inserting a catheter through the damaged artery and placing the new, healthy one inside it. This procedure does not require open-heart surgery. Surgeons insert the catheter either through the femoral artery in the groin or through a small chest incision.

According to the AHA, the benefits of TAVI and other minimally invasive procedures include:

  • less physical trauma to the heart and surrounding tissues
  • reduced risk of infection
  • shorter hospital stays
  • shorter recovery periods

After open-heart surgery, a person will wake up in the ICU and remain there for observation for up to 2 days. They will then go to the regular surgical unit for up to 5 days.

Recovery generally takes several months. The speed of a person’s recovery may depend on several factors, including their general health and age.

While it is usually safe to resume typical activities not long after surgery, a doctor will likely advise a person to avoid high intensity activities and take several weeks off from work.

It is typical to experience weakness and fatigue after this invasive surgical procedure. Most people will find that they regain their strength as they resume daily physical activities.

Risks of open-heart valve replacement surgery can include:

Most valve replacement procedures are successful. However, people may need to have valves replaced again in the future.

According to a 2021 Swedish study involving 33,018 people who underwent aortic valve replacement surgery, people who had this type of surgical procedure had a lower life expectancy than the general population. However, not all those who died within the follow-up period died as a result of heart problems.

In 2019, a study published in the Journal of Cardiothoracic Surgery, involving 324 people who underwent mitral valve replacement, found that:

  • 1.9% of people died during the procedure
  • 9% of people died after 30 days
  • people who received a biological valve had a survival rate of 62.4% at 10 years
  • people who received a mechanical valve had a survival rate of 77.1% at 10 years

When a person’s heart valves become damaged, the person may benefit from valve replacement surgery. For example, if a surgeon cannot repair the damaged valve, they may recommend replacing it.

Whether a person has open-heart surgery or a less invasive procedure to replace a valve depends on several factors, including their overall health.

Like other surgical procedures, valve replacement surgery comes with several risks, including the possibility that the new valve will fail.