A failed surgical heart valve refers to a prosthetic heart valve (either mechanical or bioprosthetic) that has been surgically implanted to replace a diseased heart valve but has stopped functioning properly over time. This failure can occur due to various factors such as valve degeneration, infection, blood clots, or mechanical issues, and it may lead to symptoms similar to those of the original valve disease, like heart failure, fatigue, or shortness of breath.
Several factors can contribute to the failure of a surgical heart valve, these include:
- Structural valve deterioration (SVD): Over time, tissue valves can break down, become calcified, or stiffen, leading to reduced valve function. This is the most common cause of bioprosthetic valve failure.
- Thrombosis (blood clots): Blood clots can form on mechanical valves, leading to valve malfunction. Patients with mechanical valves are typically on blood thinners to reduce this risk.
- Endocarditis: Infection of the heart valve, known as infective endocarditis, can damage both mechanical and tissue valves. It may cause the valve to malfunction and lead to life-threatening complications.
- Paravalvular leak: This occurs when blood leaks around the edges of the implanted valve, usually because of improper seating of the valve during surgery or due to infection.
- Pannus formation: Scar tissue (pannus) can grow on or around the valve, impairing its ability to open and close properly.
- Mechanical failure: For mechanical valves, wear and tear over many years can cause the moving parts to malfunction.
- Mismatch or malpositioning: If the valve size is not ideal or if it is improperly positioned during surgery, it may not function well, leading to early failure.
When a surgical heart valve fails, it can cause symptoms similar to those of the original valve disease, including:
- Shortness of breath, particularly during physical activity or when lying down
- Fatigue and reduced exercise tolerance
- Heart palpitations or an irregular heartbeat
- Swelling in the legs, ankles, or abdomen (edema)
- Chest pain or discomfort
- Dizziness or fainting
- Heart murmur (an abnormal heart sound heard through a stethoscope)
