Urmia University of Medical Sciences

Cardiac Surgery Department

This center is equipped with three active cardiac surgery operating rooms, one of which is dedicated to emergency procedures. All operating rooms are furnished with the most advanced surgical tools and equipment and are directly connected to the ICU for seamless patient transfer. The department is staffed by 3 cardiovascular surgeons and 3 cardiac anesthesia fellows who provide dedicated care to patients.

Heart Valve Repair and Replacement

Most surgical procedures for heart valve repair or replacement focus on the mitral and aortic valves, located on the left side of the heart. The mitral valve controls blood flow into the left ventricle, while the aortic valve regulates blood flow out of the left ventricle—the heart’s most powerful chamber, responsible for pumping blood throughout the body. These two valves are more susceptible to disease and play a critical role in overall heart function.

Since valvular heart disease progresses differently in each patient, treatment timing and duration vary. If you are asymptomatic or the valve condition does not significantly impair heart function, your cardiologist may opt for close monitoring rather than immediate intervention.

For severely damaged or stenotic (narrowed) valves, treatment options include:

• Balloon valvuloplasty (a minimally invasive catheter-based procedure to widen the valve).
• Surgical repair or replacement (typically requiring open-heart surgery under general anesthesia, where the sternum is opened and a heart-lung machine temporarily takes over circulation).

A cardiologist and cardiac surgeon will collaborate to determine the best approach. In some cases, early intervention is necessary to prevent further heart damage—even if symptoms are not yet present.

Valve Replacement Options

If repair is not feasible, the surgeon may replace the damaged valve with either:

1. Mechanical Valve – Made of durable metal and plastic, these valves last a lifetime but require lifelong anticoagulation therapy (warfarin) to prevent blood clots.
2. Biological (Bioprosthetic) Valve – Made from animal or human tissue, these valves do not require long-term blood thinners but may need replacement after 10–15 years.

Warfarin Therapy for Mechanical Valves

Patients with mechanical valves must take warfarin indefinitely to prevent life-threatening clots. Warfarin works by inhibiting blood-clotting factors, and its effectiveness is monitored via PT-INR tests. Skipping doses can lead to severe complications, including stroke or valve obstruction.

Hospital Recovery (ICU & Post-Op Care)

• ICU Stay: 1–3 days for close heart monitoring. Most patients can sit within 24 hours and walk within 1–2 days.
• Potential Post-Op Issues:
• Irregular heart rhythms (managed with medications or a temporary pacemaker).
• Fatigue, pain, or swelling (especially in the legs if grafts were taken).
• Discharge: Typically 5–7 days post-surgery if recovery progresses well.

Home Recovery

Full recovery takes weeks to months, depending on sternum healing. Common post-op experiences include:

• Low appetite, constipation, or mood fluctuations (depression/insomnia).
• Muscle soreness (shoulders/upper back) and swelling (legs).
• Gradual return to activity: Short walks, light chores, and social outings are encouraged.

Key Advice:

• Report persistent symptoms to your doctor.
• Follow a step-by-step rehabilitation plan to regain strength safely.