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Neuroscience Institute

Heart Valve Center

The Heart Valve Center at the Louis and Peaches Owen Heart Hospital is designed to help patients determine the best treatment options available for their heart valve disease. When a patient has an appointment at the Heart Valve Center, they are seen by a cardiologist and cardiothoracic surgeon all in the initial visit. The cardiologist and cardiothoracic surgeon collaborate during the patient's appointment to determine their treatment plan and pathway. Typically these appointments occur over a 2-3 week time span, but at the Heart Valve Center, we ensure all of this happens the same day.

What are heart valves?

What are the different kinds of heart valve disease?

What causes heart valve disease?

What are some of the risk factors for heart valve disease?

What are some of the signs and symptoms of heart valve disease?

How are heart valve diseases diagnosed?

What treatment options are available?

What are the different types of heart valves for heart valve replacement?

About the Heart Valve Center team

What are Heart Valves?

The heart is a muscle that pumps blood through your body. It’s divided into four chambers. Valves are one-way gates in the heart that keep blood flowing between the chambers in the same direction. The chambers and valves work together to keep blood flowing in one direction.

  • There are four valves in the heart
    • Tricuspid, Pulmonic, Mitral, and Aortic
  • The two most common valves subject to disease are the Mitral and Aortic Valves located on the left side of the heart

What are the different kinds of Heart Valve Disease?

  • Stenosis (“narrowed”)
    • Means the valve does not open completely or it is narrowed. When the valve doesn’t open fully, blood flows through a smaller opening, so the heart muscle has to work harder to push the blood through the valve. Stenosis can be caused by scarring of the leaflets, joining of the leaflets or by calcium deposits that make the leaflets stiff and hard to open
  • Regurgitation (“leaky”)
    • Means the valve does not close tightly. The valve itself may be described as leaky. Your heart valves contain flaps known as leaflets. The sole purpose of your leaflets are to open and close tightly. This tight seal ensures that blood flows through your heart in one direction. In regurgitation the heart valve leaflets do not close completely and this leads to backflow of blood. Your heart then has to pump some of your blood twice. This can be caused when chords or muscles that are normally attached to the valve tear, stretch or shorten.

Causes of Heart Valve Disease

  • Congenital  Valve Disease (Before Birth)—heart valves do not always develop properly before birth;  they may be the wrong size, have deformed leaflets, or have leaflets that are not attached correctly
    • Bicuspid Aortic Valve Disease—a congenital heart valve disease that affects the aortic valve. The aortic valve normally has three leaflets or cusps; the bicuspid aortic valve only has two. Over time the valve may become stiff (narrowed opening) or leaky (not able to close tightly) without the third leaflet
  • Sclerosis due to Increasing Age—as you age, your heart valves thicken and become stiff due to calcium deposit build up associated with aging
  • History of—infective endocarditis (IE), rheumatic fever, heart attack, or heart failure—or previous heart valve disease
    • Rheumatic Fever is an inflammatory disease that is caused by an untreated bacterial infection, usually strep throat or scarlet fever. This usually occurs in children and the heart valve complications may not be seen until years later.
    • Infective Endocarditis (IE)—Occurs when bacteria  enters the bloodstream and attacks the heart valves
  • Other Causes—Aortic Aneurysms, Cardiomyopathy, Coronary Artery Disease, Heart Attack, Hypertension, and syphilis

Risk Factor for Heart Valve Disease

  • Male Gender
  • Hypertension / High Blood Pressure
  • Smoking
  • Elevated Lipoprotein A—Elevated amounts of LP(a) are associated with inflammation in the walls of arteries
  • You are at a higher risk for heart valve disease if you have risk factors for coronary artery disease.
    • Risk factors for coronary artery disease include high cholesterol, high blood pressure, diabetes, insulin resistance, sedentary lifestyle, obesity, and family history of heart disease

Signs and Symptoms of Heart Valve Disease

  • Chest Pain (Angina), Tightness, or Pressure
  • Dizziness, Weakness, Feeling Faint, or Fainting
  • Shortness of breath, especially with exertion
  • Fatigue, especially during times of increased activity
  • Heart Palpitation—This may feel like a rapid fluttering heart beat / rhythm, irregular heartbeat, or skipped beats
  • Heart Murmur
  • Swelling of your ankles or feet, called edema

How Are Heart Valve Diseases Diagnosed?

  • Physical Exam—during a physical exam your primary care doctor or heart doctor, cardiologist, will listen to your heart and will determine if you have a murmur, swishing sound made by blood flowing through a diseased heart valve.  Your primary care doctor or your heart doctor will also screen you for symptoms of heart valve disease
    • (Please refer to signs and symptoms)
  • Diagnostic Test—Echocardiography, Transesophageal Echocardiography, Cardiac Catheterization (angiogram), and / or Magnetic Resonance Imaging (MRI).

What treatment options are available?

  • Surgical Options Available—surgical options include heart valve repair or replacement. Heart Valves can be repaired or replaced with traditional heart valve surgery or a minimally invasive heart valve surgical procedure
    • Minimally Invasive Heart Valve Surgery—State of the art, minimally invasive heart valve surgery is available at the Louis & Peaches Owen Heart Hospital. This approach requires a 1.5 inch incision that is performed through the rib space; without breaking or sawing through the breast bone. That means shorter recovery time and fewer complications; decreased risk of infection, reduced trauma and pain, decreased wound infection, improved cosmetics (less scarring), patient satisfaction, and shorter hospital stay.
      • Average recovery time following a “MINI” Valve Surgery is 10—14 Days
      • Average recovery time following the traditional Open Heart Surgery is 1.5—2 months
    • Traditional Open Heart Surgery (Median Sternotomy)
    • Medical Management—with referral to the Heart Failure Clinic
      • Medications can help relieve the symptoms of valve disease, but medications can’t correct the underlying condition. Medications used to relieve symptoms and complications of valve disease:
        • ACE inhibitor—Used to treat high blood pressure and heart failure
        • Antiarrhythmic—Used to treat irregular heart rhythms associated with valve disease
        • Anticoagulant—Used to prolong the clotting time of your blood and is used if you are at risk for developing blood clots
        • Diuretic—Also known as “water pills” helps your body get rid of excess fluid and salt. Diuretics are used to decrease symptoms of valve disease such as swelling in your extremities and shortness of breath.
        • Beta Blocker—Treats high blood pressure and lessen the heart’s work by helping the heart beat slower and less forcefully

 

What are the different types of heart valves for heart valve replacement?

  • Mechanical Valves
    • Advantages
      • Mechanical valves are designed to last forever
    • Disadvantages
      • Mechanical valves place a patient at risk for  blood clots therefore anticoagulation is required for the duration of the implant
  • Tissue Valves
    • Bovine (Cow) Valve
      • Tissue valves last about 10-15 years
      • No anticoagulation required

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