Heart valve replacement

Heart valve replacement surgery treats a damaged or diseased heart valve. Your heart’s 4 valves control blood flow, and if one isn’t working properly, it can reduce your heart’s efficiency. Surgery restores normal flow, relieving symptoms like breathlessness, fatigue, chest pain, or swelling.

During the procedure, the faulty valve is replaced with either a mechanical valve (long-lasting but may require blood-thinning medicine) or a biological valve (made from animal or human tissue, and usually doesn't need long-term medication).

Heart valve replacement can be life-saving and is often recommended when valve disease causes significant symptoms or affects heart function.

Why you might need a heart valve replacement

Heart valve replacement is a common and well-established procedure that can relieve symptoms and help your heart work more efficiently.

Your doctor might recommend this surgery if you have:

• Congenital valve problems — some people are born with heart valve abnormalities
• Valve damage from infection — conditions such as endocarditis can affect a valve
• Valve regurgitation — a valve leaks, allowing blood to flow backwards
• Valve stenosis — a valve has become narrowed, making it harder for blood to flow through
• Worsening symptoms — breathlessness, chest pain, fatigue or swelling may indicate the valve isn’t functioning well

Heart valve replacement improves your long-term heart health and quality of life, giving you confidence that your heart is supported and cared for.

Is heart valve replacement right for you?

A heart valve replacement operation is often recommended when a valve isn’t working properly and is affecting your day-to-day life.

Our experienced heart consultants will look at several factors before recommending surgery. These include:

• Your symptoms — breathlessness, fatigue, chest pain or swelling that makes daily activities harder
• Test results — scans and heart checks, such as echocardiograms, showing how well your valve and heart are working
• Overall health — general fitness and other medical conditions that could affect recovery
• Surgical safety — your age, health history and any risks related to surgery

Your consultation is a chance to talk openly about your symptoms, concerns and expectations. Your cardiologist or cardiac surgeon will guide you through your options, explain the benefits and risks in a clear and balanced way, and help you understand what surgery and recovery would involve.

Throughout the entire process, you can rest assured that you’ll be supported by a highly experienced team, using modern facilities and up-to-date cardiac technology. Our aim is to help you make a decision that feels informed, reassuring and right for you.

When might heart valve replacement not be the best option? 

Replacement heart valve surgery is a well-established and effective treatment, but it isn’t suitable for everyone. If this surgery isn’t the safest or most beneficial option for you, your specialist will explain why and talk you through alternative options.

You may not be advised to have this surgery if:

• You have a serious underlying illness that could affect healing
• You’re frail, making recovery more challenging
• Your surgical risk is very high

Some clinical factors can also affect eligibility for surgery, such as:  

• Being better suited to less invasive options, such as transcatheter aortic valve insertion (TAVI), which can be safer for some patients
• Certain heart conditions that increase the risks of open surgery
• Severe or uncontrolled infection

A heart valve replacement procedure is a planned operation carried out under general anaesthesia, so you’ll be fully asleep throughout. Most people stay in hospital for several days so we can closely monitor recovery.

Once you’re asleep, your surgeon opens the chest to reach the heart. Your blood is temporarily routed through a heart-lung machine, which maintains circulation while the heart is still.

The damaged valve is then removed and replaced with a new mechanical or biological valve, stitched securely into place to restore normal blood flow. After the valve is fitted, your heart is restarted, and your chest is closed.

The procedure usually takes 2–3 hours, and you’ll be supported by an experienced team at every stage of your treatment and recovery.

Before the procedure

Before your surgery, you’ll meet your consultant to go through the procedure, discuss your symptoms and medical history, and ask any questions. This is an important opportunity to address any concerns and ensure your care is personalised.

Your consultant may recommend further tests, such as scans or blood tests, to ensure your treatment is carefully planned and tailored to you. Any additional costs will be discussed before further tests are carried out.

You’ll also receive clear instructions on preparing for surgery, including practical steps for the day and any lifestyle adjustments that can support a smooth recovery, helping you feel informed and confident before your procedure.

Pre-operative appointments and tests

In the weeks leading up to your heart valve replacement, you’ll be invited to attend one or more pre-operative appointments to confirm that heart valve replacement is appropriate for you. This may include blood tests, imaging (such as X-rays or heart scans) and cardiac tests. Your team will explain each step clearly, letting you know why the tests are needed and how to prepare.

Food and drink

Replacing a heart valve is performed under general anaesthesia, so it’s important to fast before your surgery. Your care team will give you clear instructions about when to stop eating and drinking ahead of your operation.

Medications

It’s important to tell your doctor about all medications, supplements and herbal remedies you’re taking. Some may need to be adjusted or temporarily stopped before surgery to reduce the risk of complications.

Lifestyle changes

Before your heart valve replacement, your care team may recommend following a healthy diet, taking gentle exercise, weight management, stopping smoking and limiting alcohol. These changes can support your heart, reduce surgical risks and help your recovery.

Who will be involved?

Your heart valve replacement will be performed by a highly skilled consultant cardiac surgeon. They work alongside skilled nurses and support staff in modern hospitals, combining expertise, advanced equipment and personalised care to make your treatment as safe and comfortable as possible.

Every member of your care team brings years of experience in complex heart procedures, combining skill with a personal approach. Many hold senior NHS positions and are recognised internationally for their research and expertise.

The procedure

During the procedure

During heart valve replacement surgery, your surgeon will make a cut along the middle of your chest to access the heart. Your heart may be temporarily slowed or stopped, while a heart-lung machine takes over the job of pumping blood and supplying oxygen throughout your body.

When your heart is still, the surgeon opens the heart chamber, removes the damaged valve, and carefully places the new valve. After the valve is secured, blood flow is returned to the heart and it’s restarted. Finally, the chest is closed, usually with wires and sutures, allowing your breastbone and skin to heal safely.

How long does the procedure take?

The time for heart valve replacement depends on the type of procedure. Traditional open-heart valve replacement usually takes 2–3 hours, while minimally invasive surgery can be similar or slightly longer. TAVI is a less invasive option, where the new valve is inserted via a catheter, usually taking 1–2 hours and often allowing a faster recovery.

Anaesthesia

Heart valve replacement is usually performed under general anaesthesia, so you’ll be fully asleep and won’t feel anything during the procedure. Your anaesthetist will monitor you closely throughout surgery to keep you comfortable.

Pain during and after surgery

You won’t feel pain during the procedure because you’ll be under general anaesthesia. After surgery, some chest discomfort is normal, especially around the wound site. Your care team will help you to manage your pain with medication and support, and it usually eases steadily after the first few days.

What happens straight after surgery

After your heart valve replacement, you’ll be moved from the operating theatre to the ICU, where trained nurses will monitor you closely. This helps ensure your heart, breathing and other vital signs are stable.

Most patients spend around 24 hours in the ICU. Once your consultant is confident you’re recovering well, you’ll be transferred to a private room or comfortable ward until you’re ready to go home.

Heart valve replacement recovery takes time, and it is completely normal to feel tired or sore in the first few weeks.

Short-term side effects

• Chest discomfort or stiffness
• Hoarse voice or sore throat from the breathing tube used during surgery
• Mild swelling or bruising around the wound
• Tiredness

These usually improve over the first days and weeks.

First 24 hours recovery

After your heart valve replacement, you will spend time in the ICU for close monitoring of your heart, breathing, and blood pressure. You may feel drowsy or sore as you wake.

A physiotherapist will give you daily physical and deep breathing exercises and after a few days you will gradually increase your activity.

Managing your recovery at home  

Once you’re home, it’s important to keep moving and continue the exercises recommended by your physiotherapist. Light walking and gentle activity will help your body heal, while more strenuous tasks should be avoided until your consultant confirms it is safe.

You may need to continue wearing compression stockings and take blood-thinning injections or anticoagulant medication, which may be required long-term for mechanical valves, to reduce the risk of blood clots.

Cardiac rehabilitation

Most patients benefit from cardiac rehab; a supervised programme that helps you rebuild strength, improve heart health and regain confidence. You’ll learn exercises, lifestyle tips, and strategies to support your long-term recovery.

Wound care

Your wound will be covered with a dressing. Keep the area clean and dry, and follow instructions on caring for stitches or staples. Contact your care team if you notice redness, oozing, increased pain or fever.

Pain relief 

Mild chest pain is normal after surgery. Your care team will provide pain relief in hospital and supply medication to take home for up to 14 days. Taking it as advised helps you move, breathe and recover comfortably.

Smoking

Stopping smoking improves lung function, supports healing and reduces complications.

Driving

As you won’t be able to drive immediately following surgery, you’ll need someone to take you home. Your consultant will advise when it’s safe to resume driving.

Time off work

Most people need several weeks off. Physically demanding jobs may require a longer recovery period.

Resuming normal activities

Light day-to-day tasks are usually manageable after a couple of weeks, but you’ll still need support from loved ones during the first few days at home. They can help with physical chores, such as shopping, cooking and household tasks, while you regain your strength. More strenuous activity, heavy lifting, and vigorous exercise should be avoided until your consultant confirms it’s safe.

Heart valve replacement is generally safe, but, as with any major surgery, there are some risks. These depend on the type of procedure you had and overall health. Your consultant will explain which risks are relevant for you.

General risks of surgery and anaesthesia can include bleeding, infection, allergic reactions, or complications related to the anaesthetic.

Risks specific to heart valve replacement include:

• Blood clots, which can cause swelling, cramping, fainting, or coughing up blood
• Infection of the heart lining or valve (endocarditis)
• Irregular heartbeat (arrhythmia)

Seek urgent medical attention if you notice high temperature, chills, shortness of breath, muscle or joint pain, irregular heartbeat, leg swelling, fainting, or coughing up blood.

Not everyone needs surgery straight away. Mild or moderate valve problems can often be monitored through regular check-ups, and medication may help manage symptoms.

For those who aren’t suitable for open-heart surgery, less invasive options such as TAVI or edge-to-edge repair (mitral valve clipping) may be considered.

Your specialist will explain which approach is safest and most appropriate for you.