March 1, 2022

It’s a matter of repairing vs. replacing a valve.

Different problems can affect heart valves. The right surgical treatment depends on the nature of the problem someone is experiencing. Your doctor will talk with you about treatment that’s best for your situation. 

In some cases, though, the plan may need to change once surgery has begun. If the surgeon finds that the dysfunctional valve will not hold up well after repair, the surgeon would switch strategies and instead replace the valve.

There are three ways to treat heart valve problems surgically:

  • Repair the valve. Whenever they can, surgeons prefer to fix a valve rather than replace it. For the most common type of repair, a ring is sewn around the entrance to a valve to improve its size or shape. Another type is done by cutting tissue to let leaflets open or close better. After a repair, there is more than a 90% chance that the valve will be fine without another surgery. 

If repair isn’t possible, however, the valve will be replaced. 

  • Replacement with a mechanical valve. Mechanical valves are made of metal or hard carbon. There are many designs. Valves can last for decades. But blood tends to stick to them, forming clots. So if you get a mechanical valve, you have to take a medicine (warfarin) for life. This is an anticoagulant medicine that prevents blood clots. Often aspirin is advised in addition to warfarin. 
  • Replacement with a tissue valve. A tissue valve usually comes from a pig or a cow. But it may also come from human tissue. Blood doesn’t clot as easily on tissue valves. So people getting tissue valves may need to take warfarin for only a short time. Aspirin is sometimes used instead. Tissue valves may wear out faster than mechanical valves. They may have to be replaced sooner.

The surgeon will discuss the types of valves in advance, so you know which type of valve you prefer to receive.

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Vanderbilt University Medical Center is a leader in treating heart valve disease with the newest transcatheter techniques. Vanderbilt’s team includes general cardiologists, interventional cardiologists and cardiac surgeons, all with advanced training and expertise in structural heart and valve disease. They treat patients with diseases of the aortic, mitral or tricuspid valve, from the routine to the complex.

Download a free treatment guide