The heart valves play a critical role by regulating blood flow through the heart and preventing blood from flowing the wrong way. When the valves are formed abnormally or stop functioning as they should, blood flow to the body can be restricted or can flow backwards. Over time, heart valve disease can cause heart failure or predispose a patient to abnormal heart rhythms.
Understanding Valvular Heart Disease
There are two main types of valvular heart disease:
- Valvular stenosis: The heart valves are stiff and don’t open completely. Over time, they can become too narrow and can interfere with heart function, limiting blood flow to the body.
- Valvular regurgitation: The valves do not close properly or completely, and blood flows backwards or regurgitates.
Some people are born with abnormal heart valves. Others develop valvular disease as a consequence of:
- infections such as rheumatic fever and endocarditis
- coronary heart disease
- myocardial infarction
- other diseases that lead to their deterioration, such as Marfan syndrome.
Some people may suffer from mitral valve prolapse, a type of valve disease in which the valves are abnormally shaped and do not close properly. With time, as the valve problem worsens, the heart cannot compensate and symptoms begin to occur. Symptoms can include unusual tiredness or fatigue, shortness of breath, chest pain during exertion, passing out, dizziness, irregular heartbeat and swelling of the ankles, feet and sometimes the abdomen.
Treating Valvular Heart Disease
People with slightly damaged valves may not require any treatment except medications and close follow-up with their physicians. They may need to take medications to control cardiac risk factors to lower the risk of developing other heart problems. When treatment is needed, medicines and lifestyle changes often can relieve symptoms. However, surgery may eventually be needed to repair or replace a malfunctioning heart valve.
Washington University cardiac surgeons at Barnes-Jewish Hospital perform aortic and mitral valve repairs, as well as valve replacement, using conventional and minimally invasive approaches when appropriate. Together with the interventional cardiologists, new catheter-based techniques like valvuloplasty, mitral valve clip or transcatheter aortic and pulmonary valve implantation are performed as well.
- Ross Procedure: Surgery that involves replacing the aortic valve with the patient's own pulmonic valve. It has proven effective in patients with reasonable life expectancy.
- Valve repair: Repair is more surgically difficult than replacement, but allows patients to avoid blood-thinners and the complications of prosthetic valves.
- Valve replacement: When repair is not viable, replacement is another option. The valves are replaced with metallic or bioprosthetic (tissue) valves in order to optimize the longevity of the prosthesis, improve the flow (hemodynamic profile), and limit the risks of anticoagulation (blood thinners).
- Minimally invasive surgery: Cardiac surgeons now perform valve procedures using smaller-than-normal incisions.
- Catheter-based aortic valve implantation: Cardiac surgeons and interventional cardiologists work together to place a new aortic valve in a malfunctioning one through the leg or the tip of the heart in a procedure that does not require the use of the heart-lung machine.
- Mitral valve clip: A procedure that places a clip in the mitral valve leaflets through a catheter. This may be used to treat some patients with severe mitral regurgitation.
A high volume of valve surgeries are performed at the Heart & Vascular Center. Our surgeons have a high skill level, resulting in excellent clinical outcomes and death rates that are consistently below the national average. In addition, the collaboration between cardiology and surgery promotes a thorough evaluation of surgical and catheter-based treatments that help improve our patients' health. Our physicians actively participate in research to make better, less invasive treatments available.
To make an appointment with a Washington University heart or vascular specialist at Barnes-Jewish Hospital, call [Dynamic_Phone_Number].