Heart valve pathologies: Annuloplasty

By Cristiano Antonino On Mar 29, 2023

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An annuloplasty is a procedure to treat a leaky heart valve. During annuloplasty, your provider places a small ring around the leaky valve

The permanent ring reinforces or tightens the valve

Often, providers use a minimally invasive approach to perform an annuloplasty.

What is an annuloplasty?

An annuloplasty is a procedure to repair or reinforce a heart valve.

With annuloplasty, a surgeon places a band around the ring that surrounds your heart valve (annulus).

This band reinforces the ring to help your heart valve close as tightly as it should.

Your heart valves open and close to send blood through your heart.

If a valve doesn’t close correctly, blood may leak backward and your heart may not pump blood as efficiently through your body.

Sometimes, leaky heart valves cause mild symptoms.

But they can also lead to complications such as heart failure or sudden cardiac arrest.

If your healthcare provider diagnoses a leaky heart valve, it’s important to get treatment.

What is an annuloplasty ring?

During annuloplasty, surgeons place a ring-like device around your heart valve.

The ring may be mesh, metal or plastic.

The ring mimics your heart valve’s natural movement and flexibility.

It stays in place permanently and helps the valve open and close properly.

Who needs to have an annuloplasty?

You may need an annuloplasty if you have a leaky heart valve (valve regurgitation).

Healthcare providers can perform an annuloplasty on any heart valve.

You may need one of several types of annuloplasty to treat valve regurgitation:

Mitral valve annuloplasty is a type of mitral valve repair.
Aortic valve annuloplasty is a type of aortic valve repair.
Pulmonary valve annuloplasty is a type of pulmonary valve repair.
Tricuspid valve annuloplasty is a type of tricuspid valve repair.

Is annuloplasty the only treatment for valve regurgitation?

No. Your provider may use other treatments for valve regurgitation.

For example, a common minimally invasive treatment for mitral valve disease is surgery to place a MitraClip®.

The MitraClip is a small clip that helps the mitral valve close tightly.

Providers place the MitraClip using small incisions and a small, hollow tube (catheter) through your groin.

What is the difference between annuloplasty and valvuloplasty?

Annuloplasty is a procedure to tighten a leaky heart valve.

Valvuloplasty is a procedure to open a narrowed heart valve (stenosis).

Healthcare providers can perform both procedures using minimally invasive techniques.

Minimally invasive treatments use tiny incisions, tools and cameras.

Compared to open surgery, they often lead to quicker recovery and a lower risk of complications.

What happens before an annuloplasty?

Your healthcare provider will give you specific instructions to prepare for an annuloplasty.

You will likely have to fast (not drink or eat) before the procedure, usually starting the night before.

If you have bleeding risks, let your provider know.

If you take blood-thinning medicines (anticoagulants) you may have to stop taking them temporarily before the procedure.

What happens during an annuloplasty?

Cardiac surgeons (surgeons specializing in the heart) perform annuloplasties.

They can use either open-heart surgery or minimally invasive techniques.

Both procedures use general anesthesia so you stay asleep during treatment.

In open-heart annuloplasty, your surgeon will:

Make one large incision in your chest.
Place a ring of plastic, metal or surgical mesh around your heart valve.
Close the incision with stitches or surgical glue.

In minimally invasive annuloplasty, your surgeon will:

Make a few small incisions in your chest.
Place a small, flexible tube with a camera (endoscope) through the incisions.
Use the camera view and tiny surgical tools to place the annuloplasty ring.
Close the incision with surgical glue or incisions.

What happens after an annuloplasty?

After the procedure, you spend a few hours in a recovery area.

If you had minimally invasive annuloplasty, you can usually return home in one to two days.

After open heart annuloplasty, you may need to stay in the hospital for up to seven days.

What are the advantages of an annuloplasty?

An annuloplasty reinforces a leaky heart valve.

It improves blood flow through your heart and helps your heart pump blood more efficiently.

For many people, the results last a lifetime.

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What are the risks or possible complications of an annuloplasty?

Annuloplasties are generally safe procedures.

As with any surgery, annuloplasty has a risk of postsurgical infection or bleeding.

Your overall risks depend on several factors, including your health and heart condition.

Your healthcare provider can help you understand the specific risks and possible complications of an annuloplasty.

What is the recovery time from an annuloplasty?

Your overall recovery time depends on several factors, including whether your healthcare provider used minimally invasive or open techniques.

After an annuloplasty, you’ll need to avoid intense activity for at least a week.

You may be able to go back to work within a week or two after the procedure.

If you have a job that includes heavy physical activity, you may need to wait longer.

Your healthcare provider will give you specific instructions for what to expect during recovery.

How long does an annuloplasty ring last?

Typically, annuloplasty rings last several decades.

Most people don’t need a replacement.

Annuloplasty rings are designed to stay in place permanently.

Over time, your heart grows around the ring, exactly like it’s supposed to. In a sense, the ring becomes part of your heart.

When should I see my healthcare provider?

After annuloplasty, contact your healthcare provider right away if you have:

Chest pain (angina).
Dizziness or fainting (syncope).
Fever or chills.
Nausea or vomiting.
Swelling or pain that doesn’t go away.

Annuloplasty is a procedure to reinforce or tighten one of your heart valves

You may need an annuloplasty if you have a leaky valve.

During annuloplasty, your provider places a ring around your heart valve to help it close tightly.

Healthcare providers may use minimally invasive or open annuloplasty.

The type of procedure you have depends on several factors, including your overall health and the condition of your heart.

Annuloplasty rings stay in place long-term and typically last several decades.

References

Merck Manual (Consumer Version). Mitral Valve Regurgitation. (https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/heart-valve-disorders/mitral-regurgitation) Accessed 12/7/2021.
Multimedia Manual of Cardiothoracic Surgery. Mitral valve annuloplasty. (https://mmcts.org/tutorial/821) Accessed 12/7/2021.
Rausch MK, Bothe W, et al. Mitral Valve Annuloplasty: A quantitative clinical and mechanical comparison of different annuloplasty devices. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3288426/) Ann Biomed Eng. 2012 Mar; (40)3: 750-761. Accessed 12/7/2021.

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