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.
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:
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.
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:
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.
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 »
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:
Also, patients who have been turned down for conventional aortic valve surgery may be candidates for TAVR.
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.
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:
In addition, via a process that begins with evaluation at The Heart Valve Center of Texas, these heart valve specialists also perform:
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:
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.
Physicians are members of the medical staff at one of Baylor Scott & White Health's subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor Scott & White The Heart Hospital – Plano or Baylor Scott & White Health.