How We Treat Damaged Heart Valves

When heart valves become damaged, the heart muscle has to work extra hard, which can cause heart failure. That's why it's important to detect and treat heart valve disease early. Open-heart surgery was once the only option for repairing or replacing damaged heart valves. Today novel, less invasive approaches such as catheter-based therapies have made treatment an option for older adults and others who may not be able to undergo open-heart surgery. Depending on which of your valves is damaged and the extent of the damage, your treatment may include the options listed below.

Medical Therapy

Some people with heart valve disease don't need a procedure right away. You may have regular check-ups with your doctor and take medication (some as medicine to lower your blood pressure and reduce the stress on your heart) or make lifestyle changes (such as exercise and healthy eating).

Interventional Cardiology

  • Transcatheter aortic valve replacement (TAVR). TAVR is an option for some people with aortic stenoses, such as older adults and others who can't have traditional surgery. TAVR allows doctors to implant a device through a catheter (long, flexible tube) threaded through a blood vessel in your leg and guided to your heart.
  • Balloon valvuloplasty. During this procedure, the doctor threads a catheter with a balloon at its tip through a blood vessel in your leg and guides it to your heart. There, the balloon is expanded to open a narrowed aortic, mitral, or pulmonary valve to improve your blood flow.
  • Mitraclip. We perform implantation of MitraClip, the world’s first percutaneous mitral valve therapy for select patients with degenerative mitral regurgitation (MR). It is also available through a clinical trial (COAPT) for some patients with functional MR who cannot have mitral valve surgery.
  • Transcatheter Mitral Valve Replacement. Our clinicians are involved in the early stages of a clinical trial examining replacement of the mitral valve through a catheter-based system.
  • Left atrial appendage (LAA) occlusion. This procedure is performed using the Watchman, or Lariat device, in select patients who are at risk for stroke and are unable to receive standard blood thinning (anticoagulation) therapy. The purpose of this device is to occlude the LAA eliminating it as a potential source of clot and stroke.
  • Paravalvular leak closure (mitral or aortic). Our valve specialists repair paravalvular prosthetic regurgitation percutaneously in patients who are experiencing symptoms.
  • Tricuspid valve therapy. Our researchers are leading two national clinical trials of innovative catheter-based devices for the repair of tricuspid valve regurgitation.

Surgery

  • Minimally invasive surgery. Using this approach, your surgeon can repair or replace your damaged heart valve through small incisions, and with great precision. Smaller incisions result in less discomfort after surgery and a faster recovery.
  • Robotic valve surgery. Our teams include experts in the use of totally robotic endoscopic surgery to perform mitral valve and tricuspid valve repair or replacement. Robotic surgery is a form of minimally invasive heart surgery that uses the more dexterous robotic instruments and a robotically controlled 3D camera to perform surgery through very small incisions—with a degree of precision and visualization that would be difficult or impossible without them.
  • Open heart surgery. Our experienced team provides open-heart surgery for some people with heart valve disease, with exceptional outcomes. You may need open-heart surgery if you have more than one damaged heart valve in need of treatment.
  • "Hybrid" heart surgery. Our doctors are developing and evaluating new treatments that combine surgical with interventional cardiology therapies for some people with damaged heart valves.

Replacement heart valves may be made of man-made materials (such as metal or ceramic) or natural tissue. The choice of which specific valve will be implanted is individualized for each patient, taking into consideration their age, other medical conditions, lifestyle, and ability or willingness to take certain medications, such as blood thinners. For patients who require valve replacement, our physician's partner with the patient and their physicians to choose the most appropriate valve type, as well as surgical approach.

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