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Patients who are diagnosed with heart valve disease need answers about their ​treatment options. Led by some of the most highly regarded cardiologists and valve surgeons in the country, The Heart Valve Center of Texas offers a multidisciplinary and comprehensive approach providing optimum therapy opportunities for patients with complex heart valve disorders.

Heart Valve Surgery

Your doctor may recommend repairing or replacing your heart valve(s), even if your heart valve disease isn't causing symptoms. Repairing or replacing a valve can prevent lasting damage to your heart and sudden death.

The decision to repair or replace heart valves depends on many factors, including:

  • The severity of your valve disease
  • Whether you need heart surgery for other conditions, such as bypass surgery to treat coronary heart disease. Bypass surgery and valve surgery can be performed at the same time.
  • Your age and general health

When possible, heart valve repair is preferred over heart valve replacement. Valve repair preserves the strength and function of the heart muscle. People who have valve repair also have a lower risk of infective endocarditis after the surgery, and they don't need to take blood-thinning medicines for the rest of their lives.

However, heart valve repair surgery is harder to do than valve replacement. Also, not all valves can be repaired. Mitral valves often can be repaired. Aortic and pulmonary valves often have to be replaced.

Repairing Heart Valves

At The Heart Valve Center of Texas, we offer several kinds of mitral valve repair procedures to restore mitral valve functioning. Traditionally, mitral valve repair​ is performed through open heart surgery. In open heart surgery, the surgeon opens the chest at the breastbone, stops the patient's heart, and connects the patient to a heart-lung machine. Although safe and effective, this method is invasive and requires a longer recovery period.

In addition to expertise in open valve surgery, the surgeons on our medical staff also specialize in minimally invasive repair of mitral valves. These procedures feature smaller incisions that are made between the ribs without cutting the breastbone. Smaller incisions tend to be less traumatic, and decrease the risk of bleeding, resulting in less pain, shorter hospital stays, and quicker recovery times.

Some of the ways in which your surgeon can repair your mitral valve include:

  • Commissurotomy, in which valve leaflets (the flaps that open and close to keep blood moving in the right direction) that have become fused together are separated to allow the valve to open and close properly;
  • Decalcification, in which the surgeon removes calcium deposits from valve leaflets, allowing them to open and close properly;
  • Quadrangular or triangular resection, in which the surgeon removes a portion of a floppy valve leaflet and sews it back together, allowing the valve to close properly;
  • Annulus support, in which the surgeon sews a ring around the base of your mitral valve (annulus) that has become too wide to reshape and tighten it;
  • Patched leaflets, in which the surgeon patches tears or holes in valve leaflets to prevent leaking;
  • Valvuloplasty, a procedure similar to angioplasty, in which your physician uses a balloon-tipped catheter to widen a narrowed (stenotic) mitral valve. The catheter is inserted into a blood vessel through a small incision in the groin, advanced to the heart, positioned inside the narrowed portion of the valve, and inflated. As the balloon inflates, it pushes the walls of the mitral valve out, widening it and allowing more blood to flow through it after the balloon is removed.
  • MitraClip® insertion, which is a newer type of mitral valve repair. A physician inserts a catheter through a small needle puncture in the vein in the groin to deliver a small clip that is then attached to the leaflets of the mitral valve. The clip helps the valve by improving closure and reducing blood flow back through the valve (called regurgitation).

Replacing Heart Valves

Sometimes heart valves can't be repaired and must be replaced. This surgery involves removing the faulty valve and replacing it with a man-made or biological valve.

Biological valves are made from pig, cow, or human heart tissue and may have man-made parts as well. These valves are specially treated, so you won't need medicines to stop your body from rejecting the valve.

Man-made valves last longer than biological valves and usually don't have to be replaced. Biological valves usually have to be replaced after about ten years, although newer ones may last 15 years or longer. Unlike biological valves; however, man-made valves require you to take blood-thinning medicines for the rest of your life. These medicines prevent blood clots from forming on the valve. Blood clots can cause a heart attack or stroke. Man-made valves also raise your risk of infective endocarditis.

You and your doctor will decide together whether you should have a man-made or biological replacement valve.

If you're a woman of childbearing age or if you're athletic, you may prefer a biological valve so you don't have to take blood-thinning medicines. If you're elderly, you also may prefer a biological valve, as it will likely last for the rest of your life.

Transcatheter Aortic Valve Replacement (TAVR)

The Heart Valve Center of Texas also specializes in the transcatheter aortic valve replacement (TAVR). TAVR is a procedure for select patients with severe symptomatic aortic stenosis (narrowing of the aortic valve opening) who are not candidates for traditional open chest surgery or are high-risk operable candidates. TAVR is performed on a beating heart and does not require cardiopulmonary bypass. Approximately 300,000 people worldwide suffer from severe aortic stenosis, which occurs when the heart's aortic valve is narrowed, restricting blood flow from the heart to the body. The TAVR valve is made of bovine (cow) pericardium and is supported with a metal stent. Read more about TAVR surgery »

Transfemoral Approach

A catheter is placed in the femoral artery (in the groin) similar to angioplasty and guided into the chambers of the heart. A compressed tissue heart valve is placed on the balloon catheter and is positioned directly inside the diseased aortic valve. Once in position, the balloon is inflated to secure the valve in place. This procedure is performed with general anesthesia in a hybrid suite (which has both catheterization and surgical capabilities). A team of interventional cardiologists and imaging specialists, heart surgeons, and cardiac anesthesiologists work together, utilizing fluoroscopy and echocardiography, to guide the valve to the site of the patient's diseased heart valve.

Patients who are candidates for TAVR include those with:

  • Critical aortic stenosis
  • Advanced age
  • Frailty or debility
  • Cerebral and peripheral vascular disease, lung disease, and other co-morbidities

Also, patients who have been turned down for conventional aortic valve surgery may be candidates for TAVR.

Ross Procedure

Doctors also can treat faulty aortic valves with the Ross procedure. During this surgery, your doctor removes your faulty aortic valve and replaces it with your pulmonary valve. Your pulmonary valve is then replaced with a pulmonary valve from a deceased human donor.

This is more involved surgery than typical valve replacement, and it has a greater risk of complications. The Ross procedure may be especially useful for children because the surgically replaced valves continue to grow with the child. Also, lifelong treatment with blood-thinning medicines isn't required. But in some patients, one or both valves fail to work well within a few years of the surgery. Researchers continue to study the use of this procedure.

Less Invasive Procedures

Some forms of heart valve repair and replacement surgery are less invasive than traditional surgery. These procedures use smaller incisions to reach the heart valves. Hospital stays for these newer types of surgery usually are three to five days, compared with a five-day stay for traditional heart valve surgery.

New surgeries tend to cause less pain and have a lower risk of infection. Recovery time also tends to be shorter – two to four weeks versus six to eight weeks for traditional surgery.

The highly trained cardiac surgeons and interventionalists on our medical staff offer a complete range of traditional surgical heart valve procedures, as well as minimally invasive surgical and catheter-based management of aortic and mitral valve disease. With comfort and care a top priority, we try to take a minimally invasive approach to treating heart valve disorders first. This interventional approach means that one can often avoid a traditional surgical procedure. Interventional procedures usually result in less scarring, a shorter hospital stay, and a quicker recovery for most patients. In addition to traditional (open heart) heart valve procedures, The Heart Valve Center of Texas offers evaluations and expertise for highly specialized procedures such as:

  • Transcatheter Aortic Valve Replacement (TAVR)
  • Transcatheter mitral valve repair with MitraClip®​
  • ​Robotic-assisted surgery for repair of a mitral valve that does not close properly.
  • Minimally invasive valve repair and replacement through small incisions called port access. This procedure avoids the traditional sternotomy, which is surgery through your breastbone.
  • Comprehensive evaluation for mitral valve repair.

In addition, via a process that begins with evaluation at The Heart Valve Center of Texas, these heart valve specialists also perform:

  • Ventricular Septal Defect (VSD) Closure (post-surgical or post-infarction)
  • Atrial Septal Defect (ASD) Closure
  • Patent Formen Ovale (PFO) Closure
  • Valvuloplasty (Aortic, Mitral, Pulmonic and Tricuspid)
  • Paravalvular Leak (PVL) Closure
  • Left Ventricular Pseudoaneurysm Closure
  • Valve-in-valve procedures for degenerated bioprosthetic​ valves in inoperable/high-risk surgical patients
  • Transcatheter Left Atrial Appendage Exclusion
  • Clinical Research Study Opportunities


Currently, no medicines can cure heart valve disease. However, lifestyle changes and medicines often can treat symptoms successfully and delay problems for many years. Eventually, though, you may need surgery to repair or replace a faulty heart valve.

In addition to heart-healthy lifestyle changes, your doctor may prescribe medicines to:

  • Lower high blood pressure or high blood cholesterol.
  • Prevent arrhythmias (irregular heartbeats).
  • Thin the blood and prevent clots (if you have a man-made replacement valve). Doctors also prescribe these medicines for mitral stenosis or other valve defects that raise the risk of blood clots.
  • Treat coronary heart disease. Medicines for coronary heart disease can reduce your heart's workload and relieve symptoms.
  • Treat heart failure. Heart failure medicines widen blood vessels and rid the body of excess fluid.

Lifestyle Changes to Treat Other Related Heart Conditions

To help treat heart conditions related to heart valve disease, your doctor may advise you to make heart-healthy lifestyle changes, such as:

Source: National Heart, Lunt, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services.

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