When you have symptoms from valvular heart disease, heart valve replacement or repair can restore your heart’s function. The Washington University and Barnes-Jewish Heart & Vascular Center offers leading expertise in the region to treat every type of valve problem.
Today’s procedures are a significant improvement over those offered a decade ago or longer. Surgery now has smaller (or no) incisions and a faster recovery. Ultimately, surgery’s goal is not only to help you live longer — it is to empower you to feel better while living longer.
Heart Valve Replacement and Repair: Why Choose Us?
Our surgeons and interventional cardiologists have extensive experience in successful valve procedures using both natural and mechanical valves. We offer:
- Extensive valve surgery experience: Our team is experienced in both open-heart and minimally invasive surgery techniques to repair or replace heart valves damaged by valvular heart disease. We have excellent outcomes for transcatheter aortic valve replacement (TAVR) and aortic valve surgery, according to U.S.News & World Report rankings.
- Minimally invasive heart valve replacement and repair options: Minimally invasive procedures often use a transcatheter approach to repair or replace leaking heart valves. Our specialists thread a long, narrow tube called a catheter through an artery or large vein to the heart. Using this method, doctors make tiny incisions to repair or replace your heart valve.
- Innovation in TAVR and other procedures: We were one of the first programs in the world to learn and teach others how to perform transcatheter aortic valve replacement (TAVR). We continue to pioneer new approaches and devices to repair and replace leaky heart valves. Learn more about our innovation.
- Surgical expertise: Our heart surgeons can perform other procedures along with valve surgery, including high-risk or reoperative surgeries. We may reconstruct the aorta on its own or along with surgery to replace the aortic valve. We can also do a procedure that includes the Cox-Maze procedure for atrial fibrillation.
- Multidisciplinary approach: You receive care from cardiologists, heart surgeons and interventional cardiologists who perform catheter-based procedures (minimally invasive surgeries using long, thin tubes threaded through a vein to your heart). You can be sure that you have access to all available options.
Your Heart Valve Surgery Options
When your heart valve no longer functions as it should, surgery may be the best option. You can rely on our surgeons and interventional cardiologists for knowledge and skill that isn’t available elsewhere in St. Louis or the surrounding region.
We consider your risk and your anatomy to make a recommendation about the most appropriate treatment for you. Heart valve surgeries we perform include:
Heart valve repair
When we have the option of repairing your existing valve instead of replacing it, we often recommend this approach. Valve repair is most common for mitral and tricuspid valves.
Valve repair can be a viable option because it:
- doesn’t need reoperation to replace a worn-out implant, even after 10 to 15 years
- doesn’t require you to take blood-thinning medications (as artificial replacement valves do)
- improves your heart function after surgery
- increases your likelihood of a longer life
- lowers your risk of future strokes or valve infections
Open-heart valve replacement
Through an incision in your chest, your surgeon removes the faulty valve and replaces it with an artificial one. Open-heart surgery, whether it's minimally invasive or traditional, offers the ability to get excellent results and treat multiple valves.
Aortic valve replacement through mini-sternotomy
This less-invasive approach involves a smaller incision in your chest. In a mini-sternotomy, your surgeon makes an incision about 3 inches long. Through this smaller incision, the surgeon replaces your damaged aortic valve with an artificial one.
Mitral valve repair
When a leaky mitral valve allows too much blood to flow backward, your heart must work harder to pump blood. Eventually, your heart can’t keep up. This condition can lead to heart failure.
Ideally, it’s best to treat the condition before it causes irreversible damage to the heart. Our specialists recommend mitral valve repair based on the severity of your heart’s mitral valve regurgitation and your symptoms.
Mitral valve repair is now an option for nearly every patient who needs surgery to correct mitral valve regurgitation. We can perform:
- Open mitral valve repair: For patients who are strong enough to have open-heart surgery, we use traditional techniques to repair the mitral valve. Open mitral valve repair now has a less than 1 percent mortality rate for patients who have degenerative mitral valve disease, meaning 99 percent of patients come through well.
- Minimally invasive transcatheter mitral valve repair: For patients at high risk, we can repair your mitral valve through a very small incision. The only Food and Drug Administration (FDA)-approved repair technique uses mitral valve clip therapy, which clips two flaps of the valve together.
Pulmonary valve repair and replacement
Our team provides pulmonary valve repair and replacement using the open or minimally invasive procedure that is best for you. For some patients, we perform a less-invasive procedure called balloon valvuloplasty that opens the valve.
TAVR for aortic valve disease
Transcatheter aortic valve replacement (TAVR) offers a minimally invasive alternative to open-heart surgery to treat aortic stenosis. In aortic stenosis, the aortic valve is partially blocked, reducing blood flow. TAVR is an option for replacing the aortic valve.
Doctors perform the TAVR procedure using a catheter inserted through an artery or vein. The surgeon places an artificial valve inside your existing valve. The TAVR procedure requires only a small incision and is less invasive than traditional surgery. That means you will likely experience a more comfortable recovery with less pain and a shorter hospital stay.
Doctors from the Heart & Vascular Center trained with the surgeon who invented TAVR. We were the first in Missouri to offer TAVR, and we have taken part in numerous clinical trials to make it available to more patients.
Our team’s experience means our doctors have the option of accessing the heart from any of five different points to perform the TAVR procedure. The ability to choose among several routes to the heart is not available at every heart center. This flexibility means we can offer this minimally invasive procedure to people who might not otherwise have this option.
Tricuspid valve repair and replacement
Blood returning from your body to your heart goes through the tricuspid valve. This heart valve helps control the amount of blood flowing toward your lungs. Most often, surgeons repair the tricuspid valve during open-heart surgery. We also perform tricuspid valve replacement procedures.
Transcatheter mitral valve replacement
We use a minimally invasive procedure, similar to TAVR, to route an artificial valve to your heart through an artery or vein. This newer procedure is not available at all heart centers. The mitral valve is complex, and this repair demands skillful heart specialists with specialized expertise not available at centers that treat a lower volume of patients.
Recovering From Heart Valve Surgery
Following a catheter-based heart procedure, you may go home after about a day. If you have open-heart surgery, you’ll stay in the hospital for several days.
You see your surgeon a week after you leave the hospital to check on how you are doing. At this visit, we adjust your medications as needed. We see you again after one month and one year. For other follow-up care, you see your primary care physician or cardiologist.
After valve repair or replacement, you are eligible for cardiac rehabilitation. This coordinated exercise program helps you rebuild your strength and endurance. Learn more about cardiac rehabilitation.
To make an appointment with a Washington University heart valve specialist at Barnes-Jewish Hospital, call 888-230-8832.