What are the 4 heart valves and where are they located?
To help the heart work efficiently, there are 4 valves inside the heart, 2 on right side (Tricuspid and Pulmonary valves) and 2 on left side (Mitral and Aortic valves). These valves open in only one direction and make sure that blood flows through the heart smoothly and does not leak back. These maintain the efficiency of the heart function.
Sometimes these valves can be defective at the time of birth. But most of the times, they are normal at birth but latter get damaged due to reasons like rheumatic fever, degeneration from old age or infections. Commonly left side valves are affected more than right side valves. When patients get valve problems, they present with breathing difficulty, swelling of feet or feeling of one’s own heart beat (palpitations). Initially they are managed by drugs. But some of them need surgery-repair or replacement of valves.
For a long time, these valve surgeries are done through a 20-25cm incision on the front of the chest and then dividing the breast bone (median sternotomy). Patients take long time (3 months) for the healing of the breast bone and for normal mobility.
Now a days most of these patients have an alternative. Valve surgeries can be done without a big incision and without cutting the breast bone through what is called key hole valve surgery (minimal access valve surgery). A 5-6cm cut is given on the right side of the chest below the breast for mitral valve or above the breast for aortic valve. Heart is approached through the space between the ribs without cutting any bones. With this approach, pain is less, bleeding after surgery is less and infections are also minimal. These patients can go back to work in 3-4 weeks time and scar is small and hidden below the breast. Recovery is very satisfying to the patient as well as to the surgeon.