Spotlight On: Heart Valve Surgery
Heart valves keep our blood flowing in the right direction. Their life-sustaining open and close rhythm mostly goes unnoticed, even when our valves are less than perfect. This month UVA's Irv Kron, MD and Scott Lim, MD tell us more about heart valve diseases.
What are the different types of heart valve diseases?
The heart has four valves: the tricuspid, mitral, pulmonic and aortic. The mitral valve and the aortic valve are the most common culprits for problems. With damamged heart valves, a patient might have regurgitation or leakage of blood back into the heart or lungs because a valve doesn't close properly. They might have prolapse which is when valve flaps bulge or flop into the heart chamber during a beat, allowing blood to reenter. Another condition is stenosis when the valve is blocked or unable to open fully, keeping blood out of the heart. Finally, a patient may have atresia, a type of birth defect in which a valve lacks an opening for blood to pass through.
What are the symptoms of a heart valve problem?
Not until heart valve defects become serious do symptoms arise. At first, the only clue might be a detected murmur or shortness of breath when exercising. Over time there may be dizziness, fainting, or swelling of the ankles, feet or belly. Untreated, heart valve disease can lead to heart failure, stroke or blood clots. Significant leakage can shorten someone's life, not to mention making it tough to go about the activities of daily living.
What treatments are available for heart valve disease?
Such series problems often require repair or replacement with mechanical or biological valves. Biological valves don't last as long as mechanical devices, but mechanical devices mean a patient must be on blood thinners. In patients older that age 75, biological valves are commonly used. While open heart surgery has been the standard procedure to replace heart valves, less invasive options are now available.
Can you tell us more about the less invasive options?
An implanted device - known as a MitraClip - is a new treatment for repairing leaky mitral valves without major surgery. The clip is threaded through a small catheter inserted in blood vessel in the patient's groin and hooked onto the damaged valve. It's available to participant's in a national clinical trial at UVA. The advantage is that this is less invasive that open-heart surgery and patients can heal quicker.
