Four valves in the heart open and close to help direct blood flow through the chambers of the heart. When working properly, the heart valves open and close fully. Some people are born with abnormal heart valves, while others experience damage to one or more of the valves by infections, such as rheumatic fever, and other problems. Some valves can be repaired by surgery, and severely damaged valves can be replaced by an artificial valve. Valve replacement and repair are very often performed through small incisions to lessen pain and post-operative discomfort.

Valvuloplasty is the term used for techniques to repair a valve. One technique, used when a valve has become stiffened involves the insertion of a balloon-tipped catheter into the diseased valve, then inflating the balloon to enlarge the opening required for blood flow.

Valvulotomy is another technique used to repair heart valves, but it is performed as an open chest surgery. The valve may be reshaped or a ring may be placed at the base of the valve to improve its function.

Valve replacement, using a tissue, metal, or plastic prosthesis, has been used successfully for many years. In the past, the procedure required an open-chest procedure and use of the heart bypass machine to maintain the circulation of blood while the heart was stilled. A relatively new technique is being used increasingly to lessen the trauma and recovery period associated with an open procedure. Referred to as minimally invasive valve replacement, it involves use of a scope which is guided into the heart from a small incision in the chest.

Specific factors that may affect whether or not an open or “closed” operation is performed include the following:

• Patient’s age

• Type of valve problem

• Size of valve to be replaced

• Patient and physician preferences (for example, anticoagulation, or anti-clotting, medication must be taken for life when a mechanical valve serves as the replacement).