Dr Ainol Shareha Sahar has over 25 years of experience as a Cardiologist and Resident Consultant Physician. she has a subspecialty in Internal Medicine and specialises in Cardiac MRI. She is currently working at Pantai Hospital in Penang, Malaysia. Dr Ainol Shareha Sahar is fluent in English, Malay, and Hokkien.
Dr Ainol Shareha Sahar graduated from Universiti Sains Malaysia in 1991, completed her horsemanship in Kuantan in 1991, and served as a Medical Officer in Taiping from 1992 to 1995. In 1999, she earned a master's degree in internal medicine from Universiti Kebangsaan Malaysia. Following that, she obtained her FRCS from the Royal College of Surgeons of Edinburgh and a Fellowship from Austin Hospital in Melbourne, Australia. She has worked as a Consultant in Pantai Hospital Penang and Hospital Seberang Jaya in Perai for several years. She is registered with 126726 (National Specialist Register of Malaysia, 2010) and 29754 (Malaysian Medical Council, 1992).
Know about heart valve surgery
The heart is a muscle tissue pump. It has four pumping chambers: two upper chambers known as atria and two lower chambers known as ventricles. Blood flows forward through the heart due to valves that connect each of the heart's pumping chambers. When valves become damaged or sick and no longer function properly, they may need to be repaired or replaced. Valve stenosis (stiffness) and valve regurgitation are two conditions that can cause heart valve malfunction (leaky valve).
When one (or more) of the heart's valves becomes stenotic (stiff), the heart needs to work harder to push blood through the valve. Infection (such as rheumatic fever or staph) and age can cause narrowing and stiffening of the valves. When one or more valves become faulty, blood flows backwards, resulting in less blood being pushed in the proper direction. Your healthcare practitioner may determine that the defective valve(s) must be surgically repaired or replaced based on your symptoms and the overall state of your heart.
Types of heart valve
- The tricuspid valve. It is situated between the right atrium and the right ventricle.
- The pulmonary valve The pulmonary artery is located between the right ventricle and the pulmonary artery.
- The mitral valve. It is situated between the left atrium and the left ventricle.
- The aortic valve. The aorta is located between the left ventricle and the aorta.
Types of Valve Replacement Surgery
Aortic Valve Replacement
The aortic valve is an outflow valve on the left side of the heart. Its function is to allow blood to exit the heart's primary pumping chamber, the left ventricle. Its role is also to keep blood from leaking back into the left ventricle. If you have a congenital problem or illness that causes stenosis or regurgitation, you may need surgery on your aortic valve. A bicuspid valve is the most frequent form of a congenital defect. The aortic valve normally contains three pieces of tissue known as leaflets. This is known as a tricuspid valve. Because a faulty valve has only two leaflets, it is referred to as a bicuspid valve.
Mitral Valve Replacement
The mitral valve is found on the heart's left side. It functions as an inflow valve. Its function is to enable blood to flow from the left atrium into the left ventricle. If the valve does not fully open or close, surgery may be necessary. When the valve is excessively thin, blood may have difficulty entering. This can cause it to back up, resulting in pulmonary hypertension. Blood might flow back into the lungs if the valve fails to seal correctly. This might be caused by a congenital abnormality, an infection, or a degenerative illness. The faulty valve will be replaced with a metal artificial valve or a biological valve. The metal valve will last a lifetime, but it will necessitate the use of blood thinners. The biological valve will last between 15 and 20 years, and you will not be needed to take blood-thinning medication.
Double Valve Replacement
A double valve replacement involves replacing both the mitral and aortic valves, as well as the complete left side of the heart. This form of surgery is less prevalent than others and has a somewhat greater fatality rate.
Pulmonary Valve Replacement
The pulmonary valve is a valve that connects the pulmonary artery, which transports blood to the lungs for oxidation, with the right ventricle, one of the heart's chambers. Its function is to allow blood to pass from the heart to the lungs through the pulmonary artery. The necessity for pulmonary valve replacement is typically caused by stenosis, which reduces blood flow. A congenital abnormality, illness, or carcinoid disease can all induce stenosis.
What occurs during heart valve replacement or repair surgery?
Under general anaesthesia, heart valve replacement surgery is performed using either traditional or less invasive methods. A wide incision from your neck to your navel is required for traditional surgery. If you undergo less invasive surgery, the length of your incision will be shorter, and your risk of infection will be lower.
Your heart must be motionless for a surgeon to effectively remove the damaged valve and replace it with a new one. During surgery, you'll be placed on a bypass machine, which maintains blood flowing through your body and your lungs working. Incisions will be made into your aorta by your surgeon to remove and replace the valves.
What happens after heart valve repair or replacement surgery?
Following surgery, a member of the surgical team will transport you to a recovery room and then to the intensive care unit (ICU), where you will be closely watched for many days. A nurse will link you to devices that will display your electrocardiogram (ECG) trace, blood pressure, other pressure measurements, breathing rate, and oxygen level at all times. In most cases, open-heart valve repair or replacement surgery necessitates a hospital stay of several days or more.
Most likely, you will have a tube in your neck linked to a ventilator to assist you to breathe until you are stable enough to breathe on your own. Your doctor can modify the breathing machine to allow you to take over more of the breathing when you wake up from anaesthesia and begin to breathe on your own. Your doctor will remove the breathing tube once you are awake enough to breathe entirely on your own and can cough. At this point, he or she may also remove the stomach tube.
You may begin to consume liquids once your doctor has removed the breathing and stomach tubes and you are stable. As soon as you can tolerate solid meals, you can begin eating them.
When your doctor determines that you are ready, you will be transferred from the ICU to a surgical or acute care unit. There, your rehabilitation will continue. As you get out of bed and move around for longer periods, your activity level will progressively increase.
A member of your healthcare team will make arrangements for you to return home and set up a follow-up appointment with your healthcare provider.
At home
Once you've returned home, it'll be critical to keeping the surgery area clean and dry. Bathing instructions will be provided to you. If the sutures or surgical staples were not removed before leaving the hospital, your doctor will remove them at a follow-up office appointment.
Returning to your routine
At first, you'll need to take things slowly. When you feel up to it, begin with easy activity such as walking, but don't attempt to do too much too soon.
Your doctor or surgeon can give you precise instructions on when you can resume normal activities, but in general:
- You may be unable to drive for up to six weeks — wait until you are confident in your ability to make an emergency stop.
- After 4 to 6 weeks When you may return to work depends on the sort of job you have - it might be as soon as 6 to 8 weeks if you do only light work, but it could take up to 3 months if you perform physical labour.s, you can have sex - just make sure you're strong enough first.
- For the next three months, avoid intense exercise, abrupt straining, and heavy lifting.
Dr Ainol Shareha Sahar is the best Cardiac Surgeon in Penang, Malaysia . She has treated thousands of patients and improved the lives of a large number of patients. her dedication and experience helped the patients to make the right decision. she practices at Pantai Hospital Penang which is one of the best hospitals in Malaysia.