The valves of the heart can become diseased and malfunction. Some valves become narrowed, or stenosed, and block the flow of the blood through them. Others can become leaky or regurgitant - allowing blood to flow backwards through them. During heart valve surgery, one or more heart valves can be repaired or replaced. Repair means that the structural problem with your own valve is repaired to create a valve with normal function. Replacement means your own diseased valve is removed and a new valve is inserted in its place. The decision whether to repair or replace a valve often can't be made until the time of surgery. You and your surgeon can discuss plans for surgery and the need for valve replacement.

   During valve repair, parts of a stenotic valve that are stiff or hardened may be cut and separated to help them open wider. Parts of an insufficient valve may be strengthened and shortened to help the valve close more tightly.

If a valve can't be repaired, it may be replaced with a prosthetic valve. Two kinds of prosthetic heart valves are available:

• Mechanical valves are created from manmade materials. Lifetime therapy with anticoagulant medication, to prevent blood clots on or around the valve, is necessary when these types of valves are used.
• Biological (tissue) valves are taken from pig, cow, or human donors. Biological valves don't last as long as mechanical valves. However, when biological valves are used, longterm therapy with anticoagulant medication often isn't necessary.

   You and your doctor can discuss which type of valve is best for you. Factors considered are your age, your occupation, the size of your valve, how well your heart is working, your heart's rhythm, your ability to take anticoagulant medications, and how many new valves you need.

    Valve surgery may give your heart the boost it needs so you feel better. Feeling better can let you get back to doing the things you enjoy. After your surgery, take care of yourself and your heart to keep your new valve working right. For many people, this includes taking medications called anticoagulants every day. Your doctor will talk to you about these medications and other things you can do to help keep your heart valves healthy in the future.