Heart Valve Disease
Your heart has four valves: mitral, tricuspid, aortic, and pulmonary. These valves ensure your blood flows in one direction as it travels through your heart. Common types of heart valve disease include narrowing (stenosis), backward blood flow (insufficiency), and not closing properly (prolapse).
What is heart valve disease?
When one or more of the valves in your heart stops working correctly or efficiently, it causes damage to the heart. This is known as heart valve disease.
What causes heart valve disease?
The causes of heart valve disease vary as do the types of the disease. Some types of heart valve disease are present at birth (congenital), others may develop later in life, over time. Additional causes include:
- Normal aging process
- Damage from a previous heart attack
- Damage by rheumatic fever
- Buildup of calcium on the valve or calcific degeneration
- Infection in the lining of the heart walls and valves
What are the signs and symptoms of heart valve disease?
Many symptoms of heart valve disease look similar to congestive heart failure. These symptoms include shortness of breath after limited physical exertion and swelling of the feet, ankles, hands, or abdomen. Other symptoms you may experience consist of:
- Palpitations
- Chest pain
- Fatigue
- Dizziness or fainting
- Fever
- Rapid weight gain
How is valvular disease treated?
When heart valve disease symptoms begin to affect your daily life, your doctor may consider surgical options. Common forms of heart valve disease typically requiring surgery include:
- Stenosis: when a valve narrows, reducing blood flow through the valve
- Insufficiency: when the valve does not close fully and allows blood to flow backward
- Mitral valve prolapse: when the heart’s left chambers do not close properly
What is heart valve replacement surgery?
During a heart valve replacement, the defective valve is replaced with a new mechanical or biological valve. Heart valve replacement is a viable option for treating aortic valve disease and mitral valve disease, including stenosis or regurgitation.
- With valve stenosis, the valve will not completely open, limiting blood flow through the heart and the rest of the body.
- With valve regurgitation, the valve will not completely close, enabling leakage backward into the heart.
While valve repair surgery is preferred, it isn’t always possible, especially in cases of aortic valve disease. For heart valve replacement, your doctor will recommend one of two procedures: standard open-heart surgery or minimally invasive valve replacement surgery.
Open-heart valve replacement surgery:
The traditional valve replacement surgery is an open-heart procedure that requires a large, 8-10 inch, cut through the breast bone to open your rib cage. During the surgery, a heart lung machine, or cardiopulmonary bypass, takes over the function of your heart and lungs, allowing the surgeon to work on your heart without blood flowing through it. The surgeon will remove your diseased mitral or aortic valve, select the correctly sized replacement and position the new valve. Once the new valve is in place, your heart is restarted.
Minimally invasive valve replacement surgery:
Minimally invasive valve replacement is performed through a few 2-3 inch incisions instead of one larger cut. In qualified patients, this can result in reduced scarring of the chest, decreased postoperative bleeding, less pain, a shorter hospital stay, and faster recovery time. In fact, patients can often go back to their full activity level after 3-4 weeks. In addition you’re also less likely to need a blood transfusion after surgery.
Heart valve replacement is more complex than valve repair. Patients get heart valve replacement surgery when a repair is not recommended. For example, valve repair surgery is the preferred choice for mitral valve stenosis when the valve can be properly mended, but the aortic valve requires valve replacement surgery because it usually cannot be repaired.
With valve replacement, the surgeon removes the entire diseased valve and replaces it with a new mechanical or biological valve. Mechanical valves are made of titanium, stainless steel or ceramic materials and are designed to last a lifetime; however, they require lifelong blood thinners to prevent clots from forming on the valve. Biological valves come from human or animal tissue and do not require medication, but they typically only last between 10 and 15 years.
What is heart valve repair surgery?
Heart valve repair is a procedure used to treat heart valve disease. Heart valve disease can be caused by either valve stenosis, valve insufficiency, or mitral valve prolapse. These are conditions that disrupt the flow of blood between the left ventricle and atrium of the heart.
Valve repair surgery is most often a solution for mitral valve disease rather than aortic valve disease, which usually necessitates valve replacement. Symptoms like chest pain, shortness of breath, fainting spells, or heart failure may require surgical treatment for your heart valve disease.
Open-heart valve repair surgery:
Traditional valve repair is an open-heart surgery procedure. While performed less commonly than the minimally invasive approach, it is still used when circumstances require it.
Minimally invasive valve repair surgery:
The minimally invasive option is one of the top choices for nearly all valve repair procedures. With the minimally invasive approach, the need to crack open the chest to reach your heart is completely eliminated. Smaller incisions are used to access the heart, leaving minimal scars after surgery. This approach also reduces blood loss during surgery while also lowering your risk of infection and speeding up the recovery process.
Valve repair is almost always the option chosen for patients who have either a leaking or narrow mitral valve. The repair consists of mending the diseased valve rather than replacing it entirely. Mitral valve repair can be performed through tiny incisions or robotically, making it less invasive and more precise.