Heart Valve Procedures Can Improve Quality of Life January 10, 2024 The heart’s four valves open and close continuously throughout our lives, directing blood through the chambers of the heart. When working normally, each valve opens fully allowing blood to flow freely and closes tightly preventing blood from leaking backward. “If these valves are damaged and prevented from working as they should, they may need to be repaired or replaced. Some can live for years with a faulty heart valve without symptoms, while others experience serious issues that make repair or replacement imperative to improve quality of life,” explained Ashwat Dhillon, MD, of Samaritan Cardiology – Corvallis. Common Heart Valve Issues Heart valve disease can be caused by congenital issues (being born with it), infections, degenerative problems (wearing out), and conditions linked to other types of heart disease. For many, age plays a primary role. “With age, heart valves can calcify or degenerate, leading to the two most common problems – an inability of the valve to open fully, called stenosis, or a leaking of blood backwards into the heart, called regurgitation,” Dr. Dhillon said. These issues can occur in any of the heart’s valves. Aortic valve stenosis is the most common and most serious form of heart valve disease as it restricts blood flow from the heart to the rest of the body. When the Valve Doesn’t Work Right When the aortic valve restricts blood flow, people can have some or all of these symptoms. Chest pain. Rapid, fluttering heartbeat. Trouble breathing or feeling short of breath. Difficulty walking short distances. Dizziness or fainting. Swollen ankles or feet. Decline in activity level or ability to do normal activities. An echocardiogram and other tests help diagnose valve problems and direct treatment. Fixing the Problem Most heart valve issues can be treated successfully. Sometimes, medication can relieve symptoms and keep the heart pumping well. However, medication does not stop a valve from leaking or open a valve that is restricted. When those issues begin to affect one’s quality of life, your doctor will most likely recommend that you see a cardiologist to get evaluated and to determine if the affected heart valve needs repair or replacement. Treatment options vary depending on which heart valve is affected, and whether it is leaking or narrowed. Mitral Valve “For mitral valve regurgitation, we start with valve repair when possible because it preserves the original valve,” explained Dr. Dhillon. Repair is done either through traditional open-heart surgery or a minimally invasive, nonsurgical procedure in which a long, thin, hollow tube called a catheter is inserted through a vein in the leg – a procedure called transcatheter edge-to-edge repair of the mitral valve with a device called MitraClip. The MitraClip procedure is available at Good Samaritan Regional Medical Center in Corvallis. If repair is not feasible, mitral valve replacement may be required. For mitral stenosis, or narrowing of the valve, surgical valve replacement is usually the best option. Aortic Valve The most common problem of the aortic valve is aortic stenosis. Treatment involves replacing the diseased aortic valve with a new prosthetic heart valve. This can be done either through open heart surgery or with a minimally invasive technique called transcatheter aortic valve replacement or TAVR. How TAVR Works “In the past, open-heart surgery was the only option for patients with severe aortic stenosis, but over the last 5 to 10 years, especially for older patients for whom major heart surgery would be too risky, a TAVR can be safer,” said Dr. Dhillon. “TAVR is FDA approved for patients with severe aortic stenosis across all risk profiles. We have an excellent heart valve team involving general cardiologists, interventional and structure cardiologists and cardiac surgeons who take a team-based approach for each patient and decide what treatment option is best for each individual patient.” The TAVR procedure is done through the skin without the need for open heart surgery using a catheter, which is usually inserted through a blood vessel in the groin. The new prosthetic valve is moved through the catheter into the heart and deployed under X-ray guidance. The new valve is then functional immediately. “With TAVR, the patient can be under less anesthetic, and the recovery time is much faster — patients are usually up and about within a few hours after the procedure on the same day, and the vast majority of our patients go home the very next day after an overnight stay in the hospital,” noted Dr. Dhillon. Recovery After TAVR Most patients notice improvements soon after TAVR. “Many patients start feeling better immediately after TAVR because they now have a functional aortic valve, which allows their heart to pump blood efficiently,” Dr. Dhillon said. In most cases, patients can return to normal activities of daily life the very next day, with a few restrictions. Most patients can start an exercise program within two weeks after TAVR. You may need to take medications for some time after the procedure to prevent infection and blood clots. Most likely, a patient will need to schedule regular follow-up visits with their doctor to monitor their new valve’s overall function. “Overall, success rates are high for heart valve procedures, and people can add not only years to their life but also life to their years with successful treatment of valvular heart disease,” said Dr. Dhillon. If you have questions about your heart health and whether valve surgery may be right for you, contact your primary care provider. Ashwat Dhillon, MD, FACC, FSCAI, is an interventional and structural cardiologist who sees patients at Samaritan Cardiology – Corvallis. Contact him at 541-768-5205.
