Dr. Jeffrey Morgan Explores the Life of an Adult After a Heart Valve Replacement
With an aging population along with advances in biomedical sciences, patients with heart diseases that require valve replacements can get them quicker, and more efficiently than ever before. Dr. Jeffrey Morgan, a cardiothoracic surgeon, has seen the changes in the field throughout the past 2 decades. He specializes in left ventricular assist devices (LVAD), as well as heart transplantation, and has led a team at the Texas Heart Institute and Baylor College of Medicine since 2016 in transplantation and mechanical circulation.
Heart Valve Replacement
The human heart has 4 main valves: the tricuspid, pulmonary, bicuspid, and aortic valves. They are responsible for controlling the flow of blood throughout the heart and help divide the heart into its 4 chambers (both left and right atria and ventricles). Valve replacements are done to help treat a variety of medical conditions, usually a regurgitation or stenosis. A regurgitation can be caused by leaky valves, or ones that have become incompetent, allowing blood to flow in the opposite direction it should be, often causing increased pressure and strain on the heart. On the other hand, stenosis is due to stiffening, or narrowing of the valves, which decreases the amount of blood flow, consequently increasing the pressure in the heart chambers directly before the valve. Valve issues can arise due to congenital defects (present from birth) or can be acquired due to an illness (ex. rheumatic heart disease), as well as due to aging (ex. aortic valve stenosis).
Types of Valves
Dr. Jeffrey Morgan explains that there are two main types of valves that are used as replacements, mechanical and biologic. Mechanical valves are usually made of metal and are designed to act just like regular heart valves to allow for the proper flow of blood. They are very durable, and can last for 20+ years, usually allowing patients to only ever have one replacement. Biological valves can either be derived from humans (allograft), or other animals, with bovine (cows) or porcine (pig) valves being the most common. These valves are sometimes reinforced with man-made material to help support the valve and allow for proper positioning. They last between 10–15 years before having to be replaced, however some patients prefer this option as it does not require the use of lifelong blood thinners.
Outcomes
Valve replacement outcomes are generally dependent on the type of disease, which valve, and what prosthetic valve is implanted, as well as the procedure type. However, valve replacements in general are relatively safe, and most patients can return to their normal daily activities within a week. Patients with complications, or those with multiple medical disorders tend to take longer to recover, and the procedure can cause more adverse effects as well. Dr. Jeffrey Morgan notes that this can sometimes warrant ICU stays immediately post-operatively. The heart itself will adapt quickly, sometimes being able to reverse any damaging effects that were caused by the faulty valve. Some patients may experience rhythm disturbances such as atrial fibrillation as a result of valve replacement, with mitral valve replacements being the most common cause.
Quality of Life
With many patients having breathing issues, palpitations, or a general sense of un-wellness prior to replacement, Dr. Jeffrey Morgan’s patients have been able to return to a quality of life that is suitable for them following their procedures. Life after a valve replacement is relatively unchanged from before for most patients, with some adjustments in lifestyle and diet. Patients that receive a mechanical valve may hear a clicking noise occasionally, which is the sound of the valve opening and closing. These patients are also required to take life-long anti coagulation medication (blood thinners), to help prevent clots from forming on the valve. For this reason, some patients must adjust their recreational activities to decrease the risk of trauma, and risk of major bleeding. Blood thinners also require close monitoring by a healthcare professional, who will do blood tests to check for levels of the blood thinner, as well as clotting factors. Dr. Jeffrey Morgan has found that physical stamina returns to baseline for most patients, with some doing greater post-operatively, as their heart is now able to keep up, and they feel less lethargic. Overall, the life of an adult after heart valve replacement is very favorable, and the benefits of the operation outweigh the risks for most patient, allowing for an improvement in quality of life.
