Heart valve surgery

Heart valve surgery has made significant advances over the last six decades. The development of the heart lung machine in 1953 allowed surgeons to operate on the heart by separating it from the rest of circulation. Treatment of valve disease ranges from transcatheter implantation (TAVI) to full standard operative replacement. In the last decade, there has been a shift towards heart team decision making regarding valve intervention. This enables high-risk patients to be offered life-changing treatment. The heart team should include cardiac surgeons, interventional cardiologists and imaging cardiology specialists. There have been further advancements in minimally invasive repairs and replacements (including percutaneous approaches to valve therapies). Anatomical and physiological knowledge is paramount to the decision making process regarding indications, reparability and outcomes following surgery. This article discusses the anatomy of each valve, the aetiology of the pathological processes and the surgical methods for addressing these disease processes.