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Your heart works like an engine that keeps blood moving through your body. Its valves open and close to keep blood flowing in the right direction. When a valve becomes damaged or stops working well, you may need a heart valve replacement to help your heart pump properly again.
For people living with diabetes, this can be especially serious. Over time, high blood sugar can damage blood vessels, raising the risk of heart disease and even heart failure. If you need a heart valve replacement, it’s normal to feel worried or confused about what lies ahead.
In this article, we’ll discuss what happens during a heart valve replacement and the different types of procedures available. We’ll also share what people with type 2 diabetes should know about the risks, post-op recovery, and long-term recovery. Finally, you’ll learn practical ways to protect your heart and care for yourself after surgery.
Your heart has four valves that work like small doors. With every heartbeat, they open and close in coordination to keep blood flow moving in the right direction. Each valve has a name: aortic, mitral, tricuspid, or pulmonary.
When a valve becomes damaged or stiff, it can’t open or close properly. Diabetes doesn’t directly cause valve disease, but it is linked to conditions — such as high blood pressure, inflammation, and atherosclerosis (plaque buildup in the arteries) — that can increase the risk of heart valve problems over time.
If a valve gets too narrow to allow proper blood flow, it’s called stenosis. If it doesn’t close tightly, it causes regurgitation, which means blood leaks backward. One common problem is aortic stenosis — where the aortic valve becomes narrow or calcified (hardened by calcium deposits). This means your heart has to work harder to push blood through. Aortic stenosis can lead to:
Over time, untreated heart valve disease can cause heart failure.
Having diabetes doesn’t just affect your blood sugar. It also changes how your heart and blood vessels work. Even when you feel fine, high blood sugar can slowly damage the blood vessels that feed the heart and its valves.
One recent study found that people with diabetes have an increased risk of disease in the left-sided heart valves — the aortic and mitral valves — where blood pressure is strongest.
People with type 2 diabetes were about 1.6 times more likely to develop aortic stenosis and about 2.3 times more likely to develop mitral stenosis compared with people without diabetes. The same study found that the risks of aortic and mitral regurgitation were actually lower in people with type 2 diabetes.
Researchers believe this may happen because high blood sugar speeds up calcium buildup in the valve tissue, as well as in the rings that hold them in place. Over time, this hardening limits blood flow and strains the heart.
An aortic valve replacement involves removing the damaged valve and replacing it with a new one. This new valve restores normal blood flow and helps protect the left ventricle (chamber) — the part that pushes blood to the rest of the body. There are two main types of aortic heart valve surgery: surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR).
SAVR is a traditional form of open-heart surgery. The surgeon opens the breastbone to reach the heart. Then, the damaged valve is removed and a new one, made of metal or animal tissue, replaces it. If you are also diagnosed with narrowing of the coronary arteries (the vessels that supply blood to your heart), the doctor can bypass the blocked areas by using blood vessels taken from another part of your body during the same procedure. Because this is a major surgery, you’ll spend at least five days in the intensive care unit (ICU) for close monitoring.
TAVR is a less invasive option. In this procedure, doctors insert a thin catheter (small, flexible tube) through a blood vessel — usually in the leg — and guide it to the heart using X-ray imaging.
TAVR usually means a shorter hospital stay and quicker recovery. It’s often recommended for older adults or people at higher risk of complications — including those with type 2 diabetes or other comorbidities (co-occurring health conditions). Recent research supports this: Compared to SAVR, people with type 2 diabetes recover faster and have a lower risk of early complications or death after TAVR.
All surgical procedures come with risks. However, people with diabetes may face additional challenges. For example, high blood sugar levels can slow recovery and increase the risk of complications. Common risks and complications include:
Your healthcare team will watch closely for these issues and help prevent them whenever possible. If you notice any of these warning signs, call your doctor right away:
For people with type 2 diabetes, any kind of heart valve surgery requires additional care. Diabetes can affect how the body handles surgery by slowing healing, raising infection risk, and making blood sugar harder to control during recovery. Research shows that having diabetes may increase the overall risk for hospital complications after valve surgery. People with diabetes may be at higher risk for stroke and kidney failure compared to people without diabetes.
However, the research results on this are mixed. In several large studies, people with diabetes who had TAVR didn’t have higher mortality (death) rates compared to people without diabetes. Also, not all procedures carry the same level of risk. One major trial found that people with diabetes had a lower risk of death with TAVR than with SAVR over a one-year period after surgery.
Risks can vary based on overall health, blood sugar control, and the presence of other conditions, like chronic kidney disease or coronary artery disease.
The benefits of an aortic valve replacement can extend beyond better heart function. Research suggests that both TAVR and SAVR may lead to improvements in blood sugar control over time. In one study, people with poorly controlled diabetes saw their HbA1c (a three-month average of blood sugar levels) drop after surgery. This effect was slightly stronger with TAVR compared to SAVR. These results support the idea that restoring healthy blood flow may help improve metabolism and overall health.
Researchers believe this benefit may come from better blood flow and reduced inflammation after valve replacement. When the heart pumps more efficiently, the body receives more oxygen and nutrients. As a result, this may support insulin action and overall metabolism. In addition, many people feel stronger and more active after surgery, which can help further control blood sugar levels.
Managing diabetes and taking care of your heart go hand in hand. After valve surgery, focus on small, steady steps toward better health. This means keeping your blood sugar within the target range, taking your medications as prescribed, and attending all follow-up visits with your healthcare team.
Proper hydration is key to helping your heart and kidneys work smoothly. As you recover, begin to incorporate gentle exercise, like walking, to boost circulation and improve energy. Eat balanced meals with lean protein, whole grains, and plenty of leafy greens.
If you smoke, ask for help on how to quit. And remember — recovery takes time, so be patient with yourself. With good care, regular checkups, and healthy daily habits, most people with diabetes benefit from a better quality of life after valve surgery.
On DiabetesTeam, people share their experiences with diabetes, get advice, and find support from others who understand.
What other questions do you have about diabetes and heart valve surgery? Let others know in the comments below.
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