Rheumatic Heart Disease: Life Expectancy After Valve Replacement Surgery

Rheumatic heart disease (RHD) is a type of structural heart condition caused by repeated episodes of rheumatic fever. This condition primarily affects the heart valves, most commonly the mitral valve, followed by the aortic and tricuspid valves. The damage typically results in valve stenosis or regurgitation, both of which can severely impair heart function. In advanced cases, surgical valve replacement becomes a necessary treatment option.

Types of Artificial Heart Valves

There are two primary types of prosthetic heart valves used in valve replacement surgery: mechanical valves and biological valves. Each has its own set of advantages and potential drawbacks, and the choice between the two often depends on the patient's age, overall health, and lifestyle.

Mechanical Valves: Durability with Anticoagulation Requirements

Mechanical heart valves are known for their long-term durability and are designed to last a lifetime. However, patients who receive mechanical valves must take anticoagulant medication, such as warfarin, for the rest of their lives. Regular blood tests are essential to monitor clotting levels and adjust medication dosage accordingly. One of the major risks associated with mechanical valves is the increased likelihood of bleeding complications, including potentially life-threatening internal or cerebral hemorrhages.

Biological Valves: Shorter Lifespan with No Long-Term Anticoagulation

Biological valves, often made from animal tissue, do not require lifelong anticoagulation therapy, making them a safer option for patients at higher risk of bleeding. However, these valves have a limited lifespan, typically lasting between 10 to 30 years, depending on the manufacturer and patient factors. For this reason, biological valves are generally recommended for older patients, particularly those over the age of 60, who may not require a second valve replacement during their lifetime.

Life Expectancy After Valve Replacement

The life expectancy of patients following heart valve replacement surgery has significantly improved over the past few decades due to advances in surgical techniques, better post-operative care, and improved valve technology. With proper medical management and regular follow-up, many patients can live a near-normal lifespan. Factors such as age at the time of surgery, pre-existing health conditions, and adherence to prescribed medications and lifestyle modifications play a crucial role in long-term outcomes.

Conclusion

Valve replacement surgery remains a life-saving intervention for individuals suffering from severe rheumatic heart disease. Choosing the right type of valve—mechanical or biological—should be based on a thorough evaluation of the patient's individual circumstances. With appropriate care and adherence to medical advice, patients can expect a meaningful improvement in both quality of life and longevity.