Heart valve replacement at Spire Bristol Hospital

It's understandable to worry when we hear that there is something wrong with any part of our heart, such as heart valve disease. As well as being worried when told you have a heart problem you may well have been experiencing angina-related chest pain and breathlessness.

Heart valves open and close to allow blood to flow in and out of the four chambers of the heart in the correct direction. If they are damaged through infection or disease they either do not open properly or do not close tightly enough. Both problems mean the heart has to pump harder.

During a valve replacement operation, your surgeon will replace the diseased valve with either a tissue valve made from human or animal tissue or a mechanical valve. The new valve will relieve the strain and eases the symptoms of breathlessness and chest pain due to angina. This treatment helps to improve the condition of your heart and overall health.

You'll be asleep during this procedure as you'll have had a general anaesthetic and you usually need to be in hospital for around six days.

Since 2007 we've invested £500 million into our hospitals and staff; all of our patients can gain rapid access to some of the latest generation equipment and treatment.

If you decide to have this procedure with us, you’ll be looked after by an expert consultant and an experienced and dedicated team who understand what you’re feeling and who are committed to your wellbeing.

All our consultant cardiac surgeons and cardiologists are at the top of their profession. To work for us, they have to demonstrate their expertise in complex cardiac surgery and their chosen sub-specialty. A number of our expert consultants also have international reputations in their specialised fields.

Our patients are at the heart of what we do and we want you to be in control of your care. To us, that means you can choose the consultant you want to see, and when you want. They'll be with you every step of the way.

All of our consultants are of the highest calibre and benefit from working in our modern, well-equipped hospitals.

Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.

You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.

We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.

We've tried to make your experience with us as easy and relaxed as possible.

For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.

Our dedicated team will also give you tailored advice to follow in the run up to your visit.

Our experienced and caring medical staff will be there for you, holding your hand, every step of the way.

This operation typically requires a hospital stay of six days and is performed under a general anaesthetic, which means you'll be asleep during the procedure.

Your surgeon will make a cut, about 25cm long, down the middle of your breastbone and open your ribcage to reach your heart. Your heart is slowed or stopped (using medication) and blood is re-routed to a heart-lung machine. This takes over the pumping action of the heart and lungs, adding oxygen to the blood and maintaining the circulation.

Next, your surgeon will open the heart chamber, remove the faulty valve and sew in a replacement. Blood is then redirected back to your heart and your heart is restarted. The breastbone is re-joined using wires and your chest is closed using dissolvable sutures, stitches or staples. The operation usually takes between two and three hours.

After your operation, you will be taken from the operating theatre to the intensive care unit where you will be closely monitored by highly-trained intensive care nurses. Once your consultant is happy with your progress, probably after around 24 hours, you will be taken to your room or comfortable area where you can rest and recuperate until we feel you’re ready to go home.

 Pain relief

It’s likely that your chest will be painful for these first few days. Your anaesthetist will discuss pain relief with you and we will provide you with a supply of all the medicines your consultant feels you need to take home with you after you've left hospital, up to 14 days. This may be at an additional cost to some patients.

 Recovery

A physiotherapist will visit you daily while your are in hospital and encourage you to do gentle exercises and to take deep breaths and cough up any fluid in your lungs. These exercises will help speed up your recovery and prevent chest infections. After four or five days, you will need to increase your activity and may be shown exercises in the gym. The physiotherapist will also show you exercises to do at home.

Once you've gone home, it's important you try to move around - including doing the exercises our physiotherapist will talk to you about.

You will have tests on your heart for a few days and you will be asked to continue wearing your compression stockings to help prevent blood clots forming in your legs. You may also have a daily injection of heparin or warfarin to help prevent blood clots.

Stitches or staples are usually removed before you leave the hospital or during a follow-up appointment.

Before you go home, a nurse will advise you on diet and caring for the healing wound, hygiene and bathing.

End results

The symptoms such as shortness of breath and chest pains should stop affecting you after the operation, apart from surgery-related pain that we will provide pain relief for.

You should be able to enjoy normal life activities again within two to three weeks.

Mechanical valves are made of a hard material so you may hear a clicking sound as it opens and shuts. You will also have a permanent scar down the length of your breastbone and the wires holding your chest together are permanent. Your breastbone will take about 12 weeks to heal.

If you have a mechanical valve, you will need to take anticoagulants (blood-thinning) medicine daily, possibly for life. If you have a tissue valve replacement, according to the British Heart Foundation (BHF), it’s possible you’ll only need to take such medication for a few weeks or months. Your consultant will talk to you about this.

How your loved ones can help

Once you’re ready to be discharged from hospital, you’ll need to arrange a taxi, friend or family member to take you home as you won’t be able to drive.

You will also need help, particularly during the first few days at home, with most physical chores - including shopping.

Looking after you

Even after you’ve left hospital, we’re still looking after you every step of the way. We will provide you with all the appropriate medication, physiotherapy exercises, advice on what to do and not to do as you recover and follow-up support.

Typically your consultant will want to see you after your treatment to see how you’re doing. An appointment will be made for you before you leave the hospital.

On rare occasions, complications following heart valve replacement surgery can occur. If you have an irregular heartbeat call us straight away. You should do the same if you have a high temperature, chills, shortness of breath, headaches and muscle and joint pains(as these can be symptoms of endocarditis - inflammation of the endocardium. Similarly, if you have cramping pains, swelling in your legs or you're fainting or coughing up blood you should contact us as these can be symptoms of a blood clot.

The chance of complications depends on the exact type of procedure you are having and your general health. You should ask your surgeon to explain how these risks apply to you. Your consultant will talk to you about the possible risks and complications of having this surgery and how they apply to you.

If you have any questions or concerns, we’re ready to help.

We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.

Important to note

The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.