Heart valve surgery allows for the repair or replacement of stenotic or non-containing (insufficient) valves.
Annuloplasty or valvuloplasty can be performed to repair a stenotic mitral valve (separation of the fused commissures) or an insufficient mitral valve (implantation of an annular prosthesis or removal of the posterior leaflet and implantation of synthetic chordae). Although less common, repair can also be performed on the aortic valve.
When repair is not possible, replacement with mechanical or biological valves (animal or heterologous) is necessary. If a mechanical valve is replaced, the patient must be administered long-term anticoagulant therapy to prevent clot formation.
Anticoagulant therapy may not be necessary if a biological valve is replaced, as its duration is limited and is therefore recommended for elderly patients, women of childbearing age who are expecting a pregnancy, or patients with contraindications to anticoagulant therapy.
In selected cases, cardiac prosthesis implantation can be performed on a beating heart using a catheter through a transfemoral or transapical approach, thus avoiding the need for open-heart surgery.
The “30-day mortality after valvuloplasty or heart valve replacement” indicator measures the short-term outcome of the procedure and can be a good indicator of the quality of cardiac surgery facilities. The assessment refers to the entire hospital and post-hospital care process (30 days after surgery) and concerns the procedure not associated with coronary artery bypass grafting (CABG).
Evaluating the isolated procedure allows us to avoid considering associated procedures, which have significantly different mortality rates and risk factors.
The value of the indicator may vary between regions and facilities; This phenomenon, in addition to the varying quality of care, may be caused by the heterogeneous distribution, due to case mix, of various risk factors such as age, gender, and patient health. Specifically, the type of valve surgery, the number of procedures performed, ventricular function, hemodynamic status, and certain comorbidities such as cerebrovascular disease, diabetes mellitus, endocarditis, and renal failure may be associated with short-term mortality.
The Ministry of Health Decree No. 70 of April 2, 2015, on hospital care standards for valvuloplasty or isolated valve replacement (excluding transfemoral and transapical valve prostheses – TAVI), establishes a maximum 30-day mortality rate adjusted for severity of 4%.
Your doctor will address your concerns and guide you in making an informed decision about the treatment plan to follow. Contact him or her for all the information you need for your health needs.
Indicators 
