When is valve surgery needed?
The heart has four valves that keep blood flowing in one direction. When a valve becomes too narrow (stenosis) or leaks (regurgitation), the heart has to work harder, and over time this can cause breathlessness, fatigue, swelling, and damage to the heart muscle. Surgery is considered when valve disease becomes severe or begins to affect heart function.
In Pakistan, rheumatic heart disease remains a common cause of valve damage, particularly of the mitral valve, often affecting younger patients.
Repair or replace?
Wherever possible, repairing your own valve is preferred — it preserves natural tissue and may avoid long-term blood thinners. When a valve is too damaged to repair, it is replaced. Dr. Zain Subhani assesses which is appropriate based on the valve affected, the type of damage, and your age and lifestyle.
Valve repair
Common for leaking mitral valves. The valve is reshaped and reinforced, often with a supporting ring, so it closes properly again.
Valve replacement
The damaged valve is removed and replaced with one of two types:
- Tissue (biological) valves — made from animal tissue; usually no lifelong blood thinner needed, but may wear out over time and need replacing later.
- Mechanical valves — very durable and long-lasting, but require a lifelong blood-thinning medicine with regular monitoring.
The operation and recovery
Valve surgery is open heart surgery, usually performed through a chest incision with the support of the heart-lung machine. Hospital stay is typically five to eight days, including time in the cardiac ICU, with full recovery over six to eight weeks.
Risks
Valve surgery is well established and generally very successful. As with any heart operation, risks include bleeding, infection, irregular rhythm, and rarely stroke. Long-term, replaced valves require follow-up — tissue valves for possible wear, mechanical valves for blood-thinner control. Your individual risk is discussed before surgery.
Frequently asked questions
Should I get a tissue valve or a mechanical valve?
It depends on your age, lifestyle, and whether you can take a blood thinner reliably. Mechanical valves last longer but need lifelong warfarin and INR monitoring; tissue valves usually avoid blood thinners but may need replacing later. Dr. Zain Subhani helps you weigh this.
Can a damaged valve always be repaired?
Not always. Repair is preferred when feasible, especially for leaking mitral valves, but a heavily damaged or calcified valve usually needs replacement. The decision is made after assessing the valve.
Is valve surgery done at PIC?
Yes. Valve repair and replacement are performed at Punjab Institute of Cardiology with full cardiac surgical support. Consultations are available there, privately, and online.