Some people live long and full lives with mild valvular problems and never require surgery. But once a heart valve begins to affect the heart’s ability to pump blood, it is likely to require a repair or replacement.
Treatment for valve disease will include a plan to:
- Protect your heart from further damage.
- Assess your need for medication to help manage symptoms.
- Repair the valve problem if needed.
- Communicate steps for management, self-care and the importance of follow-up care.
Generally, once it’s determined that a diseased heart valve needs treatment, the available choices are valve repair or valve replacement:
- Valve repair — which preserves the patient’s valve and leaflets Sometimes repairs require a minimal surgery procedure and other times repairs need a more extensive surgery. Repair is most often possible for mitral valve regurgitation and tricuspid valve regurgitation.
- Valve replacement — which may include TAVR (or TAVI) or other minimally invasive procedure. In many cases, the best long-term solution may require a more involved surgery such as the Ross procedure or the insertion of a new tissue or manufactured valve.
The following provides an overview of the treatment options for valvular heart disease:
- Don’t smoke; follow prevention tips for a heart-healthy lifestyle. Avoid excessive alcohol consumption, excessive salt intake and diet pills—all of which may raise blood pressure.
- Your doctor may adopt a “watch and wait” policy for mild or asymptomatic cases.
- A course of antibiotics is prescribed prior to surgery or dental work for those with valvular heart disease, to prevent bacterial endocarditis.
- Long-term antibiotic therapy is recommended to prevent a recurrence of streptococcal infection in those who have had rheumatic fever.
- Antithrombotic (clot-preventing) medications such as aspirin or ticlopidine may be prescribed for those with valvular heart disease who have experienced unexplained transient ischemic attacks, also known as TIAs (see this disorder for more information).
- More potent anticoagulants, such as warfarin, may be prescribed for those who have atrial fibrillation (a common complication of mitral valve disease) or who continue to experience TIAs despite initial treatment.
- Long-term administration of anticoagulants may be necessary following valve replacement surgery, because prosthetic valves are associated with a higher risk of blood clots.
- Balloon dilatation (a surgical technique involving insertion into a blood vessel of a small balloon that is led via catheter to the narrowed site and then inflated) may be done to widen a stenotic valve.
- Valve Surgery to repair or replace a damaged valve may be necessary. Replacement valves may be artificial (prosthetic valves) or made from animal tissue (bioprosthetic valves). The type of replacement valve selected depends on the patient’s age, condition, and the specific valve affected.
Cardiac Surgery (Valve Surgery)
What is it? You may have had an illness or injury or been born with a problem that does not let a heart valve work the way it should. You may need to have heart surgery to repair or replace the heart valve.
Why is it necessary? You have four valves in your heart. Valve surgery is needed when one of the valves in your heart is not working, which means the blood is not flowing through your heart in the right way.
Sometimes the valve can be repaired. Other times the valve must be replaced, either with a valve from a pig or one that is manmade.
How is it done? The surgeon opens the chest by cutting through the breastbone. The surgeon then connects the heart-lung machine.
The machine “acts” as the heart and lungs so that the doctor can work on the heart. Once the surgery is done, the heart starts beating and the machine is stopped.
The breastbone is wired together to let the bone heal, which takes about four to six weeks.