Heart Valve Surgery in Turkey: Procedures, Recovery & Care

What is a heart valve replacement?

Heart valve replacement involves removing a damaged or malfunctioning valve and replacing it with a new one to restore normal blood flow through the heart. The most commonly replaced valves are the aortic and mitral valves, although the tricuspid or pulmonary valve may also need replacement.

There are two main types of replacement valves:

• Mechanical valves: very durable and designed to last many years, but they require lifelong blood-thinning medication.
• Biological valves: made from animal or human tissue; they usually do not require lifelong anticoagulation, but they last a shorter time, especially in younger patients.

The choice of valve depends on your age, overall health, and the specific nature of your valve disease.

Minimally invasive heart surgery and TAVI (transcatheter aortic valve replacement, limited mainly to the aortic valve and selected patients) can be less invasive than traditional open-heart surgery, with shorter hospital stays and a more comfortable recovery.

Indications: When is heart valve replacement needed?

Heart valve replacement is recommended when a valve is severely damaged (it does not open or close properly) and causes symptoms or affects heart function. This is often detected through tests such as echocardiography or cardiac catheterization. In some cases, especially mitral regurgitation, repairing the native valve may be preferable to replacing it.

Common warning signs include:

• Shortness of breath, especially during activity or when lying down.
• Swelling in the legs or abdomen.
• Palpitations or irregular heartbeat.
• Persistent fatigue, even after adequate rest.
• Chest pain or dizziness.

Common causes that may require valve surgery:

• Aortic stenosis: narrowing of the aortic valve that restricts blood flow.
• Age-related valve degeneration or calcification.
• Congenital valve defects: malformations present from birth.
• Mitral regurgitation: leakage of the mitral valve, allowing blood to flow backward into the atrium.

Identifying these signs early makes it possible to choose the most appropriate approach (open-heart surgery, minimally invasive surgery or TAVI) and to reduce the risk of complications.

Heart valve replacement techniques in Turkey

Several techniques are available to replace a heart valve. The choice depends on which valve needs to be replaced, the patient's overall health, and the surgical risk involved:

How is the procedure performed in Turkey?

Heart valve replacement is a complex surgery that follows several stages, from preoperative preparation to recovery.

Before the surgery

Careful preparation is needed to check that the heart and body are ready. This typically includes echocardiography and, depending on the case, a CT scan, blood tests, adjustment of blood-thinning medications as directed by your doctor (never stop them on your own),and consultations with the cardiologist and the anesthesiologist.

During the procedure

Surgery often takes 3 to 6 hours; TAVI is generally shorter. The steps vary depending on the patient's condition and the technique used (open-heart surgery, minimally invasive surgery or TAVI):

1. General anesthesia (sedation may also be used for TAVI, depending on the case).
2. Access to the heart via a full chest opening or a small incision, depending on the technique.
3. Cardiopulmonary bypass to maintain blood circulation during the surgery (not required for TAVI).
4. Removal of the damaged valve and implantation of a mechanical or biological replacement valve.
5. Verification of the valve's function before closing the incision.

Recovery & life after heart valve surgery

After heart valve surgery, follow-up is essential to prevent complications. Each patient recovers at their own pace, but the process generally follows common stages:

• 1 to 2 days in intensive care after open surgery, with close monitoring of the heart and the new valve.
• A total hospital stay of about 5 to 7 days after open surgery, depending on progress; with TAVI, often 1 to 3 days.
• A gradual return to daily activities: convalescence usually lasts 6 to 12 weeks after open surgery, and is shorter after minimally invasive surgery or TAVI.
• Regular cardiology check-ups, including medication adjustments and echocardiograms, to confirm that the valve is working properly.

Risks, possible complications & success rate

As with any heart surgery, complications can occur: bleeding during or after the operation, infection of the wound or of the prosthesis (endocarditis),arrhythmias (often temporary),stroke (uncommon),kidney problems, and deterioration or malfunction of the implanted valve. After TAVI, a pacemaker may be needed. Mechanical valves require lifelong anticoagulants, with a risk of bleeding or clots if control is insufficient, so treatment must never be stopped on your own.

The outcome depends on the valve involved, the technique, age and general health, and there is no single figure valid for every case: your cardiologist and surgeon will explain the risk and the expected result in your situation.