Heart valve replacement surgery is a common procedure for individuals with diseased or damaged heart valves. These valves ensure blood flows efficiently through the heart and to the rest of the body. When a valve malfunctions, it can significantly impact heart function. In many cases, biological valves, often derived from animal tissue, are used for replacement. These bioprosthetic valves offer a valuable solution for restoring proper heart function.
Understanding Bioprosthetic Valves
Bioprosthetic valves are artificial heart valves made from animal tissue. Pig heart valves are a common source due to their structural similarity to human heart valves. These valves are chemically treated and often mounted on a frame for implantation. They are designed to mimic the natural function of native heart valves, allowing blood to flow in one direction.
An advantage of bioprosthetic valves is that they do not require patients to take lifelong blood-thinning medication, unlike mechanical valves. This reduces the risk of bleeding complications associated with long-term anticoagulant therapy. For some patients, this benefit outweighs the fact that bioprosthetic valves have a limited lifespan compared to mechanical valves.
Expected Lifespan
The lifespan of a pig valve replacement can vary, but these bioprosthetic valves are expected to last between 10 and 15 years. Some reports indicate that newer biological valves can last 17 years or longer. This duration is an average, and individual experiences may differ based on various factors. While a 10 to 15-year lifespan is a common expectation, it is not a guaranteed duration for every patient. For instance, some younger patients may require another valve replacement surgery within 4-7 years.
Factors Influencing Durability
Several factors influence how long a pig valve replacement will remain functional. The patient’s age at the time of surgery is a primary determinant of valve durability. Younger patients experience faster deterioration and a higher risk of structural valve deterioration compared to older individuals.
Medical conditions can also affect the longevity of bioprosthetic valves. Certain medical conditions can contribute to faster wear. The location of the valve within the heart also plays a role, with differences in durability between aortic and mitral valve replacements. Bioprosthetic valve durability varies by age regardless of location.
Managing Valve Deterioration
When a pig valve replacement begins to wear out, patients may experience a range of symptoms indicating valve deterioration. Common signs include increasing shortness of breath and persistent fatigue. Other indicators can involve palpitations, swelling in the ankles, feet, or abdomen, dizziness, or chest pain. These symptoms arise as the heart works harder to compensate for the failing valve.
Diagnostic methods are used to confirm valve deterioration. An echocardiogram, which uses sound waves to create images of the heart, is the most common test to assess valve function and blood flow. Other tests, such as electrocardiograms, chest X-rays, or cardiac MRI scans, may also be used to evaluate the heart’s condition and rule out other issues. Once deterioration is confirmed, treatment options are considered.
When a bioprosthetic valve reaches the end of its life, repeat open-heart surgery to replace the valve has been the traditional approach. However, repeat cardiac surgery carries increased risks. A less invasive alternative is the transcatheter valve-in-valve (ViV) procedure, where a new transcatheter heart valve is implanted directly within the failing bioprosthesis. This procedure offers a recovery time that is much shorter than open-heart surgery.