Montefiore's surgeons have extensive experience with valve replacement surgery, which is performed when valve repair is not an option. During valve replacement surgery, this procedure, surgeons may remove the original valve and replace it with a mechanical or biologic valve. In many cases, this procedure is performed using a minimally invasive surgical approach that may include endoscopy or robotic-assisted valve surgery. Patients who require open-heart surgery are treated with the most advanced approaches available for their condition. Depending upon the circumstances, Heart Valve Repair Program surgeons will use incisions made between the ribs or breastbone incisions that are up to two-thirds smaller than with traditional surgical approaches.
Benefits associated with valve replacement surgery include:
The Heart Valve Repair Program at Montefiore offers the full complement of valve replacement options for individuals with complex valve disease. Prior to surgery all patients consult with senior Valve Program surgeons and cardiologists to determine the course of treatment and the type of replacement valve (either biologic or mechanical) that best suits their lifestyle and condition. Valve replacement surgery is an option for patients with valve regurgitation, valve stenosis, or certain congenital heart defects.
Montefiore offers the following replacement options for patients with valve disease:
During an aortic valve replacement, surgeons remove the native valve and sew the new valve into place. The replacement valve can be either mechanical or biological. Patients requiring an aortic valve replacement may also undergo a pulmonary autograft procedure (Ross procedure). A somewhat uncommon approach to valve replacement, the pulmonary autograft involves replacing the diseased aortic valve with the patient's healthy pulmonary valve. The pulmonary valve is then replaced with a biologic valve. This procedure is usually performed on patients under age 50 who want to avoid a lifetime use of anticoagulants after surgery or in cases of severe valve infections.
While mitral valve replacement is less common than valve repair surgery for patients with mitral replacement, it remains an effective treatment for patients with complex valve disease. During a mitral valve replacement, surgeons may remove the native valve and sew the new valve into place. The replacement valve can be either mechanical or biological.
Tricuspid valves are often repaired and rarely replaced. When a patient requires a tricuspid valve replacement, however, surgeons will remove the native valve and sew a biologic or mechanical valve into its place.
Pulmonary valve replacements may involve removing the native valve and inserting a biologic or mechanical replacement. Replacement surgery is an option for patients with pulmonary valve disease or for those with aortic valve disease who undergo a pulmonary autograft. During a pulmonary autograft the diseased aortic valve is replaced with the healthy pulmonary valve. The pulmonary valve is then replaced with a biologic valve.