Heart valve repair surgery

Why you would have surgery

Your heart valves help control the direction of your blood flow. If one or more of your heart valves is not working properly it can put extra strain on your heart.

If this happens you may need surgery to repair your heart valve.

Heart valve repair surgery is different from heart valve replacement surgery because you keep your own heart tissue. Your heart valve is repaired, not replaced with a new valve.

Heart valve repair is more common if you have a leaky heart valve (blood leaks backwards when your heart beats) and it’s your mitral or aortic valve.

Risks and benefits

You may have heart valve disease for months or years before you have surgery. Your doctor will check your heart closely and recommend surgery when they think it will benefit you most.

Having your heart valve repaired can:

• improve your quality of life, giving you more energy for everyday tasks
• reduce how hard your heart needs to work
• reduce the risk of getting other heart conditions, like heart failure
• improve symptoms.

Like any surgery, there are risks with the procedure. Your doctor or surgeon will talk to you about the risks and benefits of surgery.

Will I need more surgery in the future?

You may need more surgery in the future after having a heart valve repair, like a valve replacement. This depends on your individual circumstances.

In some cases, during surgery your surgeon may find that your heart valve cannot be repaired. Your surgeon will talk to you about this before you have surgery, and what will happen if they cannot repair your heart valve.

If you do not have surgery

If your heart valve needs repairing, it will not get better without surgery. You may also have a higher risk of getting an infection to your heart (endocarditis).

If you choose not to have surgery, your doctor can talk you through other options.

This could include medicine to reduce the work your heart has to do and improve any symptoms you have. They may also talk to you about care and support, including palliative care.

Preparing for surgery

Before you have surgery, you will have appointments to help you and your healthcare team prepare. It’s very important to go to your appointments, even if you feel well.

They’ll ask about your medical history, if you’ve had surgery before, if you have allergies or take any medicine.

You may also have tests, including:

• ECG
• chest X-ray
• echocardiogram
• CT scan
• cardiac MRI
• blood tests
• tests to check for MRSA
• tests to check your lungs.

You’ll be asked about your teeth, and you’ll need to see a dentist for a check-up before surgery. This is to help prevent an infection to your heart (called endocarditis).

Before surgery you may need to stop doing certain things, such as strenuous exercise. Talk to your doctor about your daily activities, they can tell you if you need to stop any or do less.

If your symptoms get worse before your surgery speak to your doctor.

Tips to help you prepare for surgery:

• take clothes that are loose, especially around your chest area
• wear clothes that fasten at the front as they’re easier to get on and off
• take things to keep you busy and comfortable, like books, music or games
• do a food shop before and prepare a few healthy freezer meals
• arrange child and pet cover while you’re in hospital
• sort support for when you’re home, such as a partner, friend or family.

Speak to your doctor or nurse specialist about what to expect during recovery and whether there are support services you can use. For example, if you need help with childcare or extra support when you go home.

Can I keep taking medicine before having surgery?

Keep taking your medicine unless your doctor tells you to stop.

Take a list of your medicine to any surgery appointments. If you’re taking warfarin, take your yellow book with you.

Types of heart valve repair surgery

There are different types of surgery to repair a heart valve.

• Making the valve stronger using a man-made ring to stop it leaking (called an annuloplasty).
• Clipping parts of the valve (the leaflets) together to stop it leaking (called an edge-to-edge repair).
• Repairing the chords that help support your valve to work properly (called a chord repair).
• Widening the valve if it’s become narrow (called a valvuloplasty).

The surgery you have will depend on:

• what valve is affected
• your current health and heart health
• any other medical conditions
• recovery time and how it will affect your daily life
• if you need other surgeries or procedures.

The way the surgeon gets to your heart to fix it is different depending on the type of surgery you’re having. You may have open heart surgery or a minimally invasive procedure.

Open heart surgery

During open heart surgery, the surgeon will work directly on your heart to fix your heart valve.

Before surgery you’ll be given general anaesthetic. This is like being asleep and you do not feel any pain.

There will be monitors to check your heart rate, blood pressure and oxygen levels. You’ll also be put on a bypass machine, also known as a heart and lung machine. This helps pump blood around your body during surgery.

The surgeon will cut the bone in your chest so they can see your heart (called a sternotomy). They will then repair your heart valve.

If you need surgery for other heart conditions you may be more likely to have these at the same time as open heart surgery. This is to reduce the chances of you needing another sternotomy.

Minimally invasive and transcatheter procedures

Minimally invasive surgery or transcatheter procedures are done using small cuts and few stitches. There are different types of procedures.

• Mini thoracotomy, the most common surgery. A cut is made in the right side of your chest to get to your heart.
• Partial sternotomy, part of the bone in your chest is cut to get to your heart. It’s usually cut at the bottom.
• Multiple small cuts, cameras are used to guide the procedure and get to your heart. 
• Transcatheter procedures, a tube (called a catheter) is guided to your heart through a small cut in your arm, leg or chest.

Your doctor or surgeon can give you more information about the type of surgery you’re having, and what to expect.

Recovery after surgery

Find out more about recovery in hospital and when you go home on our heart surgery webpage. 

If you’re struggling with any side effects or symptoms speak to your doctor or nurse specialist. Your GP may also be able to recommend ways to support you.

Living with a repaired heart valve

It’s normal to worry about your heart after having surgery, and how it will affect your daily life.

If you’ve had a minimally invasive procedure, you should be able to do most of your normal activities after about 6 weeks, including working, driving and sex. If you’ve had open heart surgery it’ll take longer, usually up to 12 weeks.

Talk to your doctor or nurse specialist about living with a repaired heart valve. It’s ok to ask questions, even things that feel difficult or uncomfortable to talk about.

More information and support

It’s normal to feel worried about heart surgery. It can help to talk about how you feel with your partner, a friend, relative or healthcare professional.

• Speak to one of our cardiac nurses by calling the Heart Helpline.
• Read our recovery tips after surgery.
• Join our online support community HealthUnlocked.
• Talk to other people with heart valve disease on the Heart Valve Voice group.
• Find more information and support from the British Heart Valve Society.
• Read about our research into heart valve disease and treatments.