Heart valve disease can affect people of all ages, but becomes more prevalent as you age. More than one in eight people aged 75 or older have moderate or severe valve disease. In many cases, age-related changes in the body can lead to deterioration of heart valves. Fortunately, there are a number of ways to treat heart valve disease, including several noninvasive options.

What is heart valve disease?

The heart has four valves, which are responsible for keeping blood flowing in the correct direction through the heart and out to the rest of the body. These are the mitral valve, the tricuspid valve, the aortic valve and the pulmonary valve. Valve disease occurs when a valve is damaged, and it is not opening or closing properly, causing an abnormality in blood flow. When a valve does not fully open, the condition is called stenosis. When a valve does not fully close and blood leaks backwards, it is called regurgitation. Regurgitation is also described as having a leaky valve.

Each of the heart’s valves can be affected, but the valve most commonly affected by disease is the mitral valve. Positioned between the left atrium and the left ventricle, the mitral valve opens to allow oxygen-rich blood to flow from the atrium to the ventricle and then closes when the ventricle contracts to send blood out to the body.

The most common symptom is shortness of breath

Heart valve disease is frequently diagnosed following a complaint of shortness of breath doing an activity that requires minor effort. A person with valve disease might also experience fatigue, palpitations or dizziness. A heart murmur, an abnormal sound heard during a heartbeat, is often harmless, but can be a sign of valve disease.

It is possible for a person to have severe valve disease and for the symptoms to initially go unnoticed. If left untreated, heart valve disease can lead to other heart problems, including heart failure and stroke. Noninvasive diagnostic imaging, such as an echocardiogram, can help determine if the valve can be repaired or if it needs to be replaced.

A full spectrum of treatments

Treatment options for valve disease include an open, traditional procedure; a robotic approach; medicine alone; and, increasingly, minimally invasive options through an artery or a vein, called transcatheter procedures.

Robotic repair

Open-heart surgery is the standard for low-risk patients, but robotic valve repair can be a surgical alternative. It is a less invasive technique that offers a smaller incision, less pain, a shorter hospital stay and a quicker recovery. The hospital stay is typically three to four days, and the recovery time averages less than three weeks. People who get open-heart surgery usually spend eight days in the hospital and the recovery time is eight to 12 weeks.

MitraClip

MitraClip® is a minimally invasive transcatheter treatment option for people who are at high risk or inoperable for open-heart surgery. This procedure attaches a dime-sized clip to the leaking mitral valve leaflets to reduce the backflow of blood. Froedtert & the Medical College of Wisconsin physicians have experience in MitraClip dating back to the first human U.S. implant more than 15 years ago.

Valve-in-valve

Valve-in-valve is a catheter-based procedure for people with failing surgical tissue valves and who are at high risk for a second surgery. The patient receives a new valve and goes home the following day. Doctors practicing in the Froedtert &MCW health network teach this technique to others nationwide.

Paravalvular leak closure

This procedure is for people who have had a valve replacement and develop a leak next to the artificial valve. Instead of open-heart surgery, our team has special expertise in steering catheters to the holes and delivering plugs to solve the problem.

Transcatheter Aortic Valve Replacement (TAVR)

TAVR offers people with aortic valve disease a minimally invasive alternative to open-heart surgery. The physician inserts a new valve with a catheter through an artery in the groin. The TAVR procedure takes less than an hour, does not require general anesthesia and most of our patients go home the following day.

As an academic health network, we often offer our patients access to treatments and devices not readily available at other institutions. For TAVR patients, this includes the Sentinel Cerebral Protection System, which provides an added level of protection from stroke during the procedure.

Preventing heart valve disease

Heart valve disease can be congenital or acquired. You can help control your risk of heart valve disease by maintaining a healthy weight, consuming a diet low in salt and cholesterol, not smoking and promptly treating any bacterial infections, which can damage tissues in the heart.

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Dr. Michael Salinger 2018
About the Author

Michael Salinger, MD, is an interventional cardiologist with the Froedtert & MCW health network. Dr. Salinger specializes in the treatment of structural heart disease, including heart valve repair and replacement. He sees patients at Froedtert & MCW Froedtert Hospital.

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