Treatments for Valve Disease
Surgical and Non-Surgical Options
Each patient is unique, and some have multiple medical conditions. That’s why our team advocates an individualized, multidisciplinary approach. Not every patient needs surgery, and there are different surgical options. Sometimes, the patient’s valve can be repaired, while others may need a valve replacement. Some patients may be appropriate for a minimally invasive procedure, while others require traditional, open surgery. We offer all treatment options, and our physicians are skilled at determining which patients are best suited for each approach.
To decide the best treatment, we hold regular meetings, called valve conferences, to draw on the experience and expertise of the whole valvular disease team, and other specialists as needed. This is a specialized approach offered by the Valvular Disease Program at Froedtert & The Medical College of Wisconsin. The collective wisdom gathered at the conferences, together with patient preferences, allows us to offer the most effective treatment for each valve patient.
Non-Surgical Treatment or Medical ManagementPatients with less severe cases of valvular disease may require only medical management. Medications such as diuretics and blood thinners may be prescribed to reduce blood pressure, remove excess fluid from the blood and less the heart’s work. For these patients, we use evidence-based, long-term monitoring to watch their condition for any changes. We believe strongly in patient education, close follow-up care and helping patients understand their condition and manage their disease.
Minimally Invasive Valve ProceduresNot always offered at other facilities, minimally invasive surgery options are performed without cutting through the patient’s sternum (breastbone.) In minimally invasive heart surgery, surgeons use small incisions, thin instruments and tiny cameras. The less invasive approach requires only a 2- to 3-inch incision on the right side of the chest and a 1.5- to 2-inch incision in the groin (for the heart-lung machine). This means less pain, fewer complications, shorter hospital stays and shorter recovery times compared to traditional open surgery. Most people with isolated valve problems are candidates for the less invasive approach.
Still, minimally invasive surgery can be more complicated than open methods. As a leading academic medical center, we have access to the latest advancements in techniques and technology. Our surgeons perform a high volume of minimally invasive heart procedures and have the training, skill and experience that can lead to optimal patient outcomes.
Traditional (Open) Valve SurgeryFor some patients, traditional surgery may be the best option. Each case is evaluated individually to ensure the best possible outcome for that patient. Underlying medical conditions, multiple heart problems and other factors may mean a patient will do better with a traditional, open procedure.
Procedures on the mitral, aortic and tricuspid valves can all be done using either a traditional, open method or a minimally invasive procedure. At Froedtert & The Medical College of Wisconsin, if it’s appropriate for the patient, our first choice is always the minimally invasive approach, which leaves the sternum intact. That’s our standard of care.
Valve Repair vs. ReplacementWhether a patient’s heart valve is repaired or replaced depends on many factors and both approaches can be highly successful. At Froedtert & The Medical College of Wisconsin, our surgeons have the skill and expertise to repair heart valves when others may only be able to recommend valve replacement.
- Minimally invasive aortic valve repair or replacement – Most people with isolated aortic valve problems requiring repair or replacement are able to take advantage of the less invasive approach.
- Minimally invasive mitral valve repair or replacement – The mitral valve can often be repaired or replaced in a minimally invasive procedure, through a small incision in the chest.
- Interventional cardiology and balloon valvuloplasty – For some patients with valvular stenosis, balloon valvuloplasty, performed by an interventional cardiologist, can open heart valves that are stuck shut. Performed in the cath lab, this procedure uses a balloon to open the problem valve and help restore normal blood flow.
- Valve-sparing aortic root replacement (David’s procedure)
- Percutaneous aortic valve replacement therapy
- Combined valve and bypass surgery
- Multi-valve surgery
Author: Joan Cotter Pike
|Medical Reviewer: ||Drs. Woods and Nicolosi|
Last Review Date: Aug. 10, 2012
Online Editor(s): Kathryn Adam