Heart valve repair or replacement procedures are performed by our team of professionals to improve your heart circulation by fixing the existing heart valve or replacing it with a mechanical (man-made) or porcine (pig) valve. This surgery may be done in combination with coronary artery bypass surgery.

Diagnosis and treatment of heart valve disease

There are four valves in the heart that open and close to help direct blood flow through the heart: aortic valve, mitral valve, tricuspid valve and pulmonic valve. Each heart valve has two or three sections called leaflets. Treatment of heart valve disease includes careful monitoring, medicine therapy or heart valve surgery (repair or replacement).

Our Heart Care cardiologists will diagnose heart valve disease after a careful examination and diagnostic tests.

The aortic valve is between the heart’s lower chamber on the left side of the heart and the aorta where blood flows to the body. The two diseases of aortic valve are aortic stenosis and aortic regurgitation. Aortic valves can become thick and narrowed (stenosis), and not able to open completely. Aortic regurgitation happens when leaking occurs due to irregular valve edges (aortic valve regurgitation or insufficiency), causing backflow of blood into the left ventricle.

The mitral valve is between the heart's upper-left chamber (atrium) and the heart's lower-left chamber (ventricle). A narrowing of the mitral valve is called stenosis (mitral stenosis). The valve will not open all the way and blood flow between the left chambers of the heart is decreased. This can be caused by rheumatic heart disease.

When the mitral valve does not close completely, that is called regurgitation (or mitral regurgitation). This causes blood to leak or flow backward in the heart on the left side. This happens when part of the valve flops back (prolapse). Usually this is mild but can develop into a severe condition. This happens over years and you may not know you have this disease until you have symptoms of heart failure.

When surgery is needed

The most common reason for surgery is aortic stenosis and valve replacement is commonly necessary. The second most common reason is mitral regurgitation. When a mitral valve leaks it can be repaired the majority of the time and our team of HealthEast Heart Care physicians have extensive experience with mitral valve repair.

When surgery is needed for heart valve stenosis (narrowing), the valve is most often replaced with an artificial valve. Sometimes a narrowed valve can be repaired in surgery by cutting and shaving back the misshapen leaflets.

Heart valve replacement requires removing the diseased valve and replacing it with a prosthetic (artificial) valve that is sewn into the opening of the natural valve. This can be done with either a mechanical valve or a biological valve:

• Mechanical valves are made of synthetic carbon material. These are sturdy and last for many years. Blood can stick to mechanical valves and cause blood clots. If you have a mechanical valve, you will need to take blood-thinning medicines (anticoagulants) for the rest of your life, but the mechanical valve will also last the rest of your life.
• Biological valves are made from animal tissue or come from a donated human heart. Sometimes your own tissue can be used for valve replacement. If you receive a biological valve, you will not need to take blood-thinning medicine unless other conditions are present. Biological heart valves do not last as long as mechanical heart valves and may need to be replaced later after an average of 15 to 18 years of artificial valve function.

Assessment for transcatheter aortic valve implantation (TAVI)

Transcatheter aortic valve implantation (TAVI) is currently an experimental method of treating severe symptomatic aortic stenosis (narrowing of the aortic valve opening). This percutaneous method replaces the aortic valve by means of a catheter. Although TAVI is not offered at HealthEast Heart Care, our program is one of very few in the Twin Cities that can advise and recommend with experience. Our physicians have expertise in TAVI assessment and can evaluate you for candidacy. Call HealthEast Heart Care for more information: 651-232-4500.