Double Valve Replacement


The left side of the heart—the left atrium and the left ventricle—have a tough job to do. The left side of the heart is responsible for pumping blood everywhere in the body except for the lungs. Oxygenated blood from the lungs is drawn into the left atrium, crosses the mitral valve, enters the left ventricle, crosses the aortic valve and leaves the heart through the aortic to supply the body. The mitral and aortic valves are extremely important in this critical process. Each valve needs to open and close at just the right time in order to develop the pressures necessary to supply blood to the body.

But what happens if the valves on the left side of the heart do not open fully or do not close properly? The result is a more or less direct communication between the lungs and the aorta. The strong muscles of the left side of the heart may pump blood back toward the lungs or the blood from the lungs cannot expel blood from them. The end result can be extremely damaging on the whole system. The body does not get the blood that it needs, the heart muscle becomes damaged, and the lungs become overloaded and filled with fluid.

A double valve replacement usually refers to the replacement of both the mitral and aortic valves. Double heart valve replacement surgery can be accomplished in a number of ways but is usually an open heart surgery procedure because it is so extensive. Open heart surgery requires that the chest be opened at the rib cage and the ribs separated so that the heart can be accessed directly. This usually means that the blood is diverted through a heart lung bypass machine and the beating of the heart is stopped temporarily, usually with ice and drugs.

During a double valve replacement, the mitral valve and aortic valve are replaced. The replacement valves can be from a human cadaver, certain animals (usually a pig), or can be mechanical. There are certain advantages and disadvantages of each type of heart valve. If a human or even pig heart valve is used in a double valve replacement, the patient may be required to take anti-rejection immunosuppressants so that the body does not reject the heart valves. If a mechanical heart valve is used, then the blood must be kept thin with anticoagulants and/or antiplatelet drugs. Otherwise, blood will tend to clot on the mitral or aortic valves, which could lead to stroke.

Double valve replacement is a very major procedure and is not entered into without verifying medical necessity. With improvements in cardiac surgery, the complication rate of double valve replacement has improved over the years, but it is still associated with a risk of death and disability. Anyone that is contemplating a double valve replacement should speak with a number of cardiologists and cardiac surgeons to discuss various options. In those that need double heart valve replacement, it can be a life saving and life extending procedure.

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