Risk in Surgery

[Sharad]

What is the risk in surgery for replacement of both mitral and aortic valve?
Is balloon valvuloplasty is good as compared to replacement?

[kenkeith]

Sharad,

It is difficult to assess the risk of valve surgery without further information.  It involves the conideration for individuals people who have had several prior heart surgeries, those with co-existing medical conditions, elderly and overweight individuals, etc.

If mitral valve repair is done before the heart is severely damaged by the faulty valve, most people have excellent short- and long-term results. The outcome of mitral valve replacement depends on a person's overall health, including other health conditions.

Replace: Mechanical valves, which are made of metal or plastic, tend to cause more clotting than those made of animal tissue. But mechanical valves generally do not have to be replaced and usually do not require additional surgery. A plastic or metal valve may be preferred if you are already taking long-term anticoagulants for other reasons.
Artificial valves cause less blood clotting than mechanical valves. But you will likely take aspirin for the rest of your life to lower the chance of clotting.
Bioprosthetic valves last for about 8 to 15 years.

The exact risks of mitral valve surgery vary depending on the person's specific condition and general health prior to surgery. In general, the risks include:

Effects from the operation itself (such as bleeding, infection, and risks associated with anesthesia). These risks are low.
Blood clotting caused by the new valve. Replacement with a mechanical valve requires lifelong treatment with medicine to prevent blood clots (anticoagulant).
Infection in the new valve. Infection is more common with valve replacement than with valve repair.
Failure of the new valve. Valve failure is more common with valve replacement than with valve repair. Bioprosthetic valves last for about 8 to 15 years.

Repair versus replacement:

Repair of the heart valve usually is the preferred and more common type of surgery for MVP. When the mitral valve is seriously damaged, heart valve replacement may be recommended. Examples of serious damage or complicated conditions that might lead to mitral valve replacement include:

Extensive ballooning of the mitral valve (rather than a single flap that puffs up).
Severe hardening (calcification) of the valve.
Prolapse (bulging) of the valve at an unusual location.
Damage to the valve from infection (endocarditis).
"The decision regarding whether to repair or replace a valve is based on many things, including the person's general health, the condition of the damaged valve, the presence of other health conditions, and the expected benefits of surgery. In some cases, the decision clearly may be in favor of repair or replacement".

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