Heart valve disease involves one or more of the four heart valves (the aortic and mitral valves on the left side of the heart, and the pulmonary and tricuspid valves on the right). Valve disease causes problems in blood flow to and from the heart. There are two basic categories of heart valve disease: valvular stenosis (stenosis means an abnormal narrowing) occurs when a valve opening is smaller than normal; and valvular regurgitation, or a “leaky” valve, occurs when a valve doesn’t close tightly, allowing some blood to leak backwards (regurgitate).
At MMC, we treat all types of valve disease, including:
- Congenital (present from birth) conditions including bicuspid aortic valve disease
- Mitral valve prolapse
- Mitral valve stenosis
- Mitral valve regurgitation
- Aortic valve stenosis
- Aortic valve regurgitation
- Tricuspid valve disease
- Pulmonary valve disease
- Fibro-calcific degeneration
- Dilation of the valve annulus
The purpose of treating heart valve disease is to protect the valves from further damage, to prevent or relieve the symptoms of other related heart conditions and, when symptoms become severe or life-threatening, to repair or replace faulty valves.
Some valve problems, depending on how severe they are, may involve treatment with medication, or surgery to repair or replace the valve. At MMC, a team of medical cardiologists, cardiac surgeons, interventional cardiologists, electrophysiologists, echocardiographers, and other experts provides comprehensive care for all types of heart valve disease. They perform some of the most complex and advanced surgical and non-surgical procedures currently available. No other hospital in northern New England offers all the advanced treatment options for valve disease that are available at MMC:
Surgical Treatment Options
Surgical options include heart valve repair or replacement with traditional open-heart surgery. MMC’s cardiac surgeons have unparalleled experience in heart valve surgery, performing more of these surgical procedures than any other hospital in Maine.
For appropriate patients, valve repair is the optimal treatment, and MMC’s cardiac surgeons are some of New England’s most experienced and respected in this procedure.
Minimally Invasive Treatment Options
Minimally invasive approaches offer appropriate patients an alternative to traditional open surgery, and the benefits of smaller incisions, less blood loss and faster recovery. For example, a procedure called percutaneous valvuloplasty (or transcatheter valve repair) is an option for carefully selected patients who have stenosis (narrowing) of the mitral, pulmonary or aortic valve. Performed in the hospital, this procedure involves inserting a balloon catheter through a blood vessel in the groin and guiding it to the heart where it is positioned inside the narrowed valve. By inflating and deflating the balloon, the valve opening can be widened. MMC was the first hospital in Maine to perform this cutting-edge procedure in 2009, and is among an elite group of U.S. hospitals offering this technique.
A minimally invasive approach for treating mitral valve regurgitation is available as part of a national clinical trial that MMC is participating in. During this procedure, a special metal clip (MitraClip®) is delivered via catheter and attached to the flaps (leaflets) of the mitral valve. The doctor adjusts the clip placement to achieve optimal blood flow and pressures through the valve, then releases the clip and withdraws the catheter. The clip holds the valve leaflets in place, limiting leakage. This procedure is complex and involves echocardiographers, interventional cardiologists, anesthesiologists, and other team members – a collaborative approach that is the hallmark of cardiac care at MMC. Patients who are candidates for traditional open mitral valve surgery at MMC are carefully evaluated to see if this non-surgical approach is appropriate for them.
Patients with heart valve disease may be prescribed medications to treat symptoms and reduce the chance of further valve damage. Some medications may be stopped after heart valve surgery to correct the problem; others may need to be taken indefinitely. MMC cardiologists provide careful, ongoing medical management to ensure the best possible outcomes.