During the heart valve procedure

This section applies to heart valve procedures completed through an open-heart surgery. After the patient is asleep, a device called the Swan-Ganz catheter is often inserted into the jugular vein (in the neck) and threaded to the pulmonary artery (which goes from the heart to the lungs). The catheter can be used to give medication, measure the oxygen levels in the blood and measure pressures in the heart. A breathing tube (endotracheal tube) will also be inserted into the mouth and guided down the windpipe (trachea) to maintain an airway. A urinary catheter is also inserted and connected to a collection bag to measure the patient’s urine output.

An incision is made through the chest and breastbone (sternum). The functions of the heart, including blood flow and oxygenation, are rerouted through a heart-lung machine via tubes (cannulas) that are placed in the body. While this machine takes care of the heart’s functions, the heart can be carefully stopped with a cardioplegic solution so the surgeon can perform the very delicate work. While stopped, some surgeons further protect the heart by decreasing its temperature (hypothermia). The heart will remain stopped for about 30 to 90 minutes during surgery.

Next, the surgeon will either repair or replace the damaged valves. Once the procedure is completed, the heart incision is closed and the heart is restarted. When the surgical team is satisfied that the heart is beating strongly again, the patient is weaned from the heart-lung machine and the chest incisions are closed. The procedure may take up to five hours.

Blood transfusion may be needed during any type of open-heart surgery, including a heart valve repair or replacement. Blood banks test blood to make sure it is free from any diseases, such as hepatitis or AIDS.