At the Washington University and Barnes-Jewish Heart & Vascular Center, heart valve specialists review all possible treatment options for you. We work with you to choose the path that will improve your quantity and quality of life.
Why Choose Barnes-Jewish Hospital for Heart Valve Treatment?
Heart valve problems are common, but for many people, they don’t cause symptoms. In a smaller group of people, valvular heart disease requires treatment. We treat all types of valvular heart disease, offering:
- Dedicated cardiologists: The cardiologists (heart specialists) on our valve team primarily focus on diagnosing and managing valvular heart disease. This focus gives them a high level of expertise. You can be confident that you are receiving appropriate recommendations for medical care or surgery, at the right time.
- Complete range of options: We consider all options, from medical management to catheter-based heart valve disease treatment (minimally invasive surgery). If more than one option will work for you, we choose the least invasive one.
- Care for patients with multiple conditions: We treat patients who have both coronary artery disease and valvular heart disease. Our experienced medical team can treat these two co-occurring conditions in high-risk patients.
Our Approach to Heart Valve Disease Treatment
In the past, valve repair often required open-heart surgery that left a large scar. Today, we offer many catheter-based options. In these procedures, we repair or replace a valve using a narrow tube inserted through a blood vessel, with no incision. Even many traditional valve surgeries no longer require surgeons to split the breastbone. Instead, we can go through the ribs, with a much smaller incision.
At our multidisciplinary center, you see a heart surgeon and a cardiologist in the same visit. At your visit, we formulate a plan and discuss your options. If we think we can get an equivalent result with any of those three techniques — catheter-based, minimally invasive surgery or traditional open surgery — we always choose the least invasive option of the three. Read about your options for heart valve replacement and repair.
Nonsurgical Treatment of Valve Problems
For mild heart valve disease, medicines and lifestyle changes often relieve symptoms and delay complications. Nonsurgical treatment of valvular heart disease may include:
- Healthy lifestyle: Taking good care of yourself is important. Getting regular exercise, eating well and quitting smoking can strengthen your heart. Manage your stress, too, with meditation, relaxation or spending time with friends and family.
- Infection prevention: You may need to take antibiotics before a dental or surgical procedure to reduce the risk of valve infection.
- Medication: Your doctor may prescribe medications to reduce the load on the heart so it can get stronger. Drugs may include diuretics (water pills) to reduce fluid loss and blood thinners to help prevent clotting. Other medicines, such as beta-blockers, can help control your heart rate.
- Surveillance: “Watchful waiting” means your doctor monitors your leaking heart valve problems. We use regular echocardiograms (heart ultrasounds) to keep an eye on your condition. We watch for further weakening of your mitral valve and an increase in backward blood flow. These signs tell us when and if you need other care.
Heart Valve Repair and Replacement
For many people, valvular heart disease gets worse as time goes on, affecting your quality of life. Your doctor may recommend heart valve surgery to prevent complications, even if you aren’t having symptoms.
Types of heart valve surgery we offer
We consider your risk and your anatomy to make a recommendation about the most appropriate treatment for you. Learn more about heart valve replacement and repair.
Heart valve surgeries we perform include:
- Heart valve repair: For many people, repairing a damaged valve is the best option. Heart valve repair can restore a leaking heart valve’s function without the need for lifelong blood thinners. Aortic valve repair may be an option for some congenital aortic valve problems. We also have experience repairing mitral valves, pulmonary valves and tricuspid valves.
- Heart valve replacement: If repair isn’t an option, we may be able to replace a faulty valve with a tissue valve or an artificial valve. For some people, traditional open surgery is the best approach for valve replacement. But in many cases, we can replace a diseased valve with a catheter-based procedure, using a long, thin tube threaded through your blood vessels, without an incision.
- Aortic valve replacement through mini-sternotomy: This less-invasive approach involves making a smaller incision in your chest. Using this smaller incision, the surgeon replaces your damaged valve with an artificial one.
We are proud of our deep involvement in research studies and clinical trials. This work has helped develop many advances in care for valvular heart disease.
Some of our innovations include:
- Transcatheter aortic valve replacement (TAVR): Our team was the first in St. Louis to perform the TAVR procedure to replace the aortic valve without surgery. TAVR has made valve replacement available to many more patients, with faster recoveries. We have continued to be involved in ongoing trials that resulted in Food and Drug Administration (FDA) approval to expand TAVR use for patients at all risk levels.
- Transcatheter mitral valve repair: We took part in trials that led to FDA approval of transcatheter mitral valve repair using mitral valve clip therapy. This minimally invasive procedure stops blood from flowing backward in the heart by repairing your existing mitral valve.
- Transcatheter mitral valve replacement: We are involved in ongoing trials to study new procedures that can replace a faulty mitral valve without open-heart surgery.
- Transcatheter tricuspid valve replacement: Because of our expertise in many types of transcatheter heart valve procedures, we can confidently perform innovative procedures. In some cases we do transcatheter tricuspid valve replacement.
- Valve-in-valve procedures: We are part of clinical trials for valve-in-valve procedures for patients at low or intermediate risk from surgery. These procedures insert an artificial valve inside an existing, diseased valve, using a catheter-based procedure.
- Procedures not widely available: We can offer procedures that require compassionate use approval from FDA. Sometimes, the right option for you is an investigative therapy or device that is not yet FDA-approved. We have the experience to request approval to use these options to repair leaking heart valves.
Our Team Approach to Heart Valve Treatment
Our heart valve team meets weekly to discuss all of our patients and their treatment paths. This team works to develop the best care plan for you, involving our:
- cardiologists, doctors with specialized training in evaluating and treating heart valve disease
- heart surgeons, who perform hundreds of valve procedures each year
- interventional cardiologists, specialists in minimally invasive transcatheter procedures
- cardiac sonographers, medical professionals who take ultrasound images of your heart
- nurses and nurse coordinators, many with advanced training in caring for patients with heart disease
To make an appointment with a Washington University heart valve specialist at Barnes-Jewish Hospital, call 888-230-8832 .