Pulmonary Valve Replacement

Overview

• Pulmonary valve replacement is an option to treat pulmonary valves that are not functioning correctly. The goal of the procedure is to help restore regular blood flow, reduce symptoms, preserve heart function, and prolong life.
• The pulmonary valve is between the right ventricle (lower chamber) and pulmonary artery and is one of the four valves that regulate the heart's blood flow.
• When the pulmonary valves become diseased, they can disrupt blood flow from the heart to your lungs. This could be caused by congenital heart defects or, over time, as people age.

Candidates for pulmonary valve replacement

Patients diagnosed with pulmonary valve stenosis, pulmonary valve regurgitation , or an infant born without a functioning pulmonary valve may need a pulmonary valve replacement.

Many patients with mild pulmonary valve disease and are not experiencing symptoms may not need a pulmonary valve replacement. As the disease progresses and symptoms intensify, your doctor may recommend this option. He or she will also take into consideration your age, overall health, and whether you need heart surgery to correct another heart issue. 

Preparing for pulmonary valve replacement

In preparation for pulmonary valve replacement, your care team will explain what to expect before, during, and after surgery. 

Guidelines may include:

• Discuss any care you may need when you return home after the procedure. 
• Instructions on when you can eat and drink the night before surgery.
• Instructions on when and what medications you can take before surgery.
• Bring a list of your current medications, a copy of your advance directive or will, items to help you relax, and any other personal care items such as a toothbrush or brush.
• Avoid wearing eyeglasses, jewelry, contact lenses, dentures, or nail polish to the hospital.

Risks associated with pulmonary valve replacement 

Risks can include bleeding, blood clots, heart rhythm problems, infection, heart attack, stroke, or death. Complications can be minimized by choosing an experienced cardiac surgery at a medical center which performs a high volume of pulmonary valve replacements.

Expectations during pulmonary valve replacement

Pulmonary valve replacement is performed under general anesthesia, so you will not feel anything during surgery. You will also be connected to a heart-lung bypass machine to keep your blood moving through the body during the procedure. The procedure can be done through open-heart surgery or through minimally invasive techniques, which require smaller incisions. In many cases, minimally invasive pulmonary valve replacement is preferred to improve recovery time and limit the number of open-heart surgeries a person needs in a lifetime.

During the procedure, your surgeon will remove the damaged pulmonary valve and replace it with an artificial or biological valve made from cow or pig valves.

Transcatheter pulmonary valve replacement, also known as percutaneous pulmonary valve replacement, is the most common type of minimally invasive method to replace a damaged pulmonary valve. During this procedure, your surgeon will guide a catheter from the groin into the heart. A replacement pulmonary valve is positioned at the end of the catheter and put in the correct place. 

Recovery from pulmonary valve replacement

• You will be moved to the intensive care unit for monitoring after surgery.
• Your care team will give you oxygen, fluids, nutrition, and medications through an IV and monitor your vital signs. 
• Once stabilized, you will be moved to a regular room. Your care team will monitor your vital signs and for signs of infection and help you gradually increase your activity level.
• Recovery time will vary depending on your age, overall health, and any complications you may have experienced after surgery.
• Patients who have a mechanical pulmonary valve will need to take blood-thinning medications for life to prevent blood clots.
• Patients with a biological valve may eventually need to have the valve replaced if it degenerates over time.