There are two kinds: mechanical and biological. And there are two kinds are biological valves: one made of pig heart valve or the other made of pericardium, a leathery structure that surrounds the heart of all mammals. They treat it with chemicals to strengthen it and remove all of the animal proteins on it, and then mount it on struts. Once you put these valves in, they should last 10 to 20 years. And most people need to just take an aspirin, not blood thinners. The mechanical valves are made of metal and will last forever, but you have to take a blood thinner after the operation. That makes the postoperative care more complicated.
How do you determine who gets which kind of valve?
We look at the overall health and age of the patient. Older patients tend to get biological valves. Younger patients tend to get mechanical valves. You don't want to have to do the surgery again.
After surgery, can a person resume normal activities?
Not right away. The length of time will depend on the approach that is used. If I divide the breastbone completely, the patient cannot drive for a month and activity is restricted for eight weeks. If I do a partial, they are back to full activity in four to six weeks.
What is the prognosis for recovery after surgery?
The overwhelming majority of patients do very well. It is the second most common thing heart surgeons do. Thousands of these procedures are done every year.
What is the risk of the surgery?
The risk of any cardiac surgical operation runs the gamut from serious things like heart attack, stroke, kidney failure and dying to minor things like wound infections and needing a blood transfusion. For a healthy 65- to 70-year-old patient, the risk of having a major complication is in the low single digits. Unless you're sick and have a lot of risk factors, the risk is very, very low.
