Heart Valve Surgery | Heart Valve Disease

What is heart valve disease? 

The heart has four valves: aortic, mitral, pulmonary and tricuspid. Heart valve disease occurs when one or more of the valves isn't opening and closing properly. This condition can be congenital (present at birth) or it can develop later on in adult life as a result of other heart conditions and infections such as:

Atresia: Valve isn’t fully formed and blood flow between chambers in the heart is blocked by a sheet of tissue
Regurgitation: Valve doesn’t fully close, which causes blood to leak back into the heart
Stenosis: Valves are thick and/or fused together causing reduced blood flow

How do you treat heart valve disease?

Treatment of heart valve disease depends on how severe the condition is and whether symptoms are present. Your doctor may recommend:

  • Healthy lifestyle changes
  • Medicine to treat the symptoms
  • Regular appointments to monitor the condition
  • Surgery

Heart Valve Surgery Types

Aortic Valve Repair and Replacement

When possible, your doctor will recommend heart valve repair rather than replacement. Heart valve repair surgery may include separating valve flaps that are fused together, replacing cords attached to the valves, removing extra tissue in the valves, or patching holes in the valve. The surgeon may use an artificial ring around a valve to reinforce or tighten it.

He/she may use a thin tube to fix a valve with a narrow opening. The doctor inserts the tube with a balloon on the tip in the arm or groin, leading it to the valve. The balloon is inflated and opens the valve. At this point, the balloon is deflated and removed with the tube.

If a heart valve is too damaged for repair, the damaged valve is removed and replaced with either a mechanical valve or biological tissue valve (made of tissue from pig, cow or human heart).

Tricuspid Valve Repair and Replacement

Tricuspid valve repair and replacement are procedures that treat diseases affecting the tricuspid valve. The tricuspid valve is one of four valves that regulate blood flow through the heart. These valves keep blood flowing in the right direction through the heart. The tricuspid valve separates one of the heart's two upper and lower chambers (atria and ventricles). With each heartbeat, the atria fill with blood from the body and lungs, and the ventricles contract to pump blood to the lungs and the rest of the body.

As the atria fill to capacity, the tricuspid valve opens to allow blood to flow from the right atrium into the right ventricle. As the ventricles contract, the tricuspid valve shuts tightly to prevent blood from flowing back into the right atrium. When the tricuspid valve isn't working properly, it can interfere with the proper direction of blood flow and force the heart to work harder to supply the necessary blood to the lungs and the rest of your body. Tricuspid valve disease is often caused by a heart defect present at birth (congenital heart disease) and may require immediate medical attention in infants.

For others, tricuspid valve disease may not cause any signs or symptoms for many years, if at all. Some people may experience pulsations in the neck, abdominal or chest pain, shortness of breath with activity, fatigue, irregular heartbeat (arrhythmia), heart failure, or sudden cardiac death. Tricuspid valve repair or tricuspid valve replacement can treat tricuspid valve disease and help restore normal blood flow, reduce symptoms, improve survival in some people and help preserve the function of your heart muscle.

 

Source: https://www.mayoclinic.org/tests-procedures/tricuspid-valve-repair-tricuspid-valve-replacement/about/pac-20385087

Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter aortic valve replacement (TAVR) is a minimally invasive surgery to fix a damaged heart valve without removing it. During a TAVR procedure, a replacement heart valve is inserted into the damaged valve through a catheter. The new, fully-functioning valve takes over for the old valve. TAVR often is performed on patients who are not suitable candidates for open heart procedures. Learn more.

Mitral Valve Repair and Replacement

Mitral valve repair and replacement are procedures that may be performed to treat diseases of the mitral valve — the valve located between the left heart chambers (left atrium and left ventricle). Several types of mitral valve disease exist. In mitral valve regurgitation, the flaps (leaflets) of the mitral valve don't close tightly, causing blood to leak backward into the left atrium. This commonly occurs due to valve leaflets bulging back — a condition called mitral valve prolapse. In another condition, called mitral valve stenosis, the leaflets become thick or stiff, and they may fuse together. This results in a narrowed valve opening and reduced blood flow through the valve.

Treatment for mitral valve disease depends on the severity of your condition. Doctors may recommend surgery to repair or replace mitral valves for some people with mitral valve disease. Several surgical procedures exist to repair or replace mitral valves, including open-heart surgery or minimally invasive heart surgery.

Maine Medical Center is the only hospital in New England participating in a national clinical trial to test a minimally invasive approach for treating mitral valve regurgitation. 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. Patients who are candidates for traditional open mitral valve surgery are carefully evaluated to determine whether this non-surgical approach is appropriate for them.

 

 

 

 

Source: https://www.mayoclinic.org/tests-procedures/mitral-valve-repair-mitral-valve-replacement/about/pac-20384958

Symptoms of heart valve disease

  • Dizziness & fainting

  • Fatigue

  • Swollen feet

  • Heart murmur

  • Irregular heartbeat

Some people with heart valve disease might not notice any symptoms for years. Heart valve disease can lead to other health complications, including blood clots, stroke, heart failure, heart rhythm abnormalities and death. 

Heart valve disease risk factors

The following risk factors can increase the chances of developing heart valve disease:

  • Aging

  • Diabetes

  • High blood pressure

  • High cholesterol

  • History of heart attack or heart disease

  • History of heart infections

Heart valve disease diagnosis

The doctor will do a physical examination of the body and listen for a heart murmur. He/she will order several tests to diagnose the condition, which may include:

  • Cardiac catheterization

  • Cardiac MRI

  • Chest X-ray

  • Electrocardiogram

  • Exercise test

  • Stress test

Next Steps for Patients

While some patients are candidates for self-referral to our cardiovascular specialists, we recommend that you ask your primary care physician for help with the process. Find a Provider

Provider Referrals

If you are a provider who would like to refer a patient for MaineHealth cardiac valve services, please review our clinical guidelines and call 207-773-8161. Clinical Guidelines

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