Heart valve Control the direction of blood flow through the four chambers of the heart (two atrium and two ventricles). The valves act likes one-way door and stop blood from running back wards.  

Blood that has been pumped around the body returns to the heart by large veins and flow into the right atrium then through the tricuspid valve into the right ventricle. From here, blood is pumped through the pulmonary valve to the lung to pick up oxygen. The blood then re-enters the heart into the left atrium through the Pulmonary veins and goes to the left ventricle through the Mitral Valve. From the left ventricle the blood is pumped through the aortic valve into the aorta and on to the rest of the body.

Some people are born with abnormal valve. In aortic position it can have one or two leaflet instead of normally three leaflets. These valves produce abnormal turbulence and later calcify to produce obstruction in the blood flow. These children may need attention to their valvular problem at the early age. Similarly mitral valve also can have defects from birth, which may need attention at early age.

This is mostly due to rheumatic fever. This is sequel of Group–A Streptococcal-tonsillopharyngytis infection of the throat. This involves mainly major joints and heart. Cardiac symptoms are mainly inflammatory lesions of heart valves. Eventually it will lead to cicatrisation and deformity of valve at a later date.

If it is not possible to repair the valve then it is replaced with a prosthetic material. A new valve is sewn into its place by open-heart surgery.

There are different types of valves available in market. Biological valves are made from human or animal tissue. The advantage of this valve is that there is no need for anticoagulation tablets after 3 months. However these valves have limited life span and start degenerating beyond ten years. Therefore these valves are usually implanted over the age of 65 yrs or those patients who wants to avoid anticoagulation tablets. 

Mechanical valves are made from an alloy of several metals. This alloy is called Pyrolytic Carbon. These valves last forever. However because they are not made from natural tissue it is necessary to take anticoagulation tablets life long to prevent clot formation over the valve. For maintaining adequate level of anticoagulation it is necessary to do regular blood test (called INR test) This can be done in any standard laboratory and the desired valve should be 2-2.5. Higher INR is associated with bleeding problem. It starts with gum or nasal bleeding and may lead to bleeding inside stomach and brain. Sometimes it may be fatal. Similarly low INR level < 2.0 may lead to clot formation over the valve which may then go to any organs of the body, leading to paralysis or other organ dysfunction. Therefore it is extremely important to do this test regularly and consult your doctor.

Similarly avoiding infection to any part of the body, specially teeth and oral cavity and urinary tract is very important. This may lead to infection of the heart valve called prosthetic valve endocarditis, which is very difficult to treat. Therefore it is essential to take antibiotic prophylaxis before any kind of dental manipulation or other surgical procedure.