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.
The goals of treating heart valve disease might include:
- Repairing or replacing faulty valves
- Lifestyle changes to treat other related heart conditions
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.
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
Heart surgeons can repair heart valves by:
- Adding tissue to patch holes or tears or to increase the support at the base of the valve
- Removing or reshaping tissue so the valve can close tighter
- Separating fused valve flaps
Sometimes cardiologists repair heart valves using cardiac catheterization. Although catheter procedures are less invasive than surgery, they may not work as well for some patients. Work with your doctor to decide whether repair is appropriate. If so, your doctor can advise you on the best procedure.
Heart valves that cannot open fully (stenosis) can be repaired with surgery or with a less invasive catheter procedure called balloon valvuloplasty. This procedure also is called balloon valvotomy.
During the procedure, a catheter (thin tube) with a balloon at its tip is threaded through a blood vessel to the faulty valve in your heart. The balloon is inflated to help widen the opening of the valve. Your doctor then deflates the balloon and removes both it and the tube. You’re awake during the procedure, which usually requires an overnight stay in a hospital.
Balloon valvuloplasty relieves many symptoms of heart valve disease, but may not cure it. The condition can worsen over time. You still may need medicines to treat symptoms or surgery to repair or replace the faulty valve. Balloon valvuloplasty has a shorter recovery time than surgery. The procedure may work as well as surgery for some patients who have mitral valve stenosis. For these people, balloon valvuloplasty often is preferred over surgical repair or replacement.
Balloon valvuloplasty doesn’t work as well as surgery for adults who have aortic valve stenosis. Doctors often use balloon valvuloplasty to repair valve stenosis in infants and children.
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 10 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.
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.
Other Approaches for Repairing and Replacing Heart Valves
Some forms of heart valve repair and replacement surgery are less invasive than traditional surgery. These procedures use smaller incisions (cuts) to reach the heart valves. Hospital stays for these newer types of surgery usually are 3 to 5 days, compared with a 5-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—2 to 4 weeks versus 6 to 8 weeks for traditional surgery.
Transcatheter Valve Therapy
Interventional cardiologists perform procedures that involve threading clips or other devices to repair faulty heart valves using a catheter (tube) inserted through a large blood vessel. The clips or devices are used to reshape the valves and stop the backflow of blood. People who receive these clips recover more easily than people who have surgery. However, the clips may not treat backflow as well as surgery.
Doctors also may use a catheter to replace faulty aortic valves. This procedure is called transcatheter aortic valve replacement (TAVR). For this procedure, the catheter usually is inserted into an artery in the groin (upper thigh) and threaded to the heart. A deflated balloon with a folded replacement valve around it is at the end of the catheter.
Once the replacement valve is placed properly, the balloon is used to expand the new valve so it fits securely within the old valve. The balloon is then deflated, and the balloon and catheter are removed.
A replacement valve also can be inserted in an existing replacement valve that is failing. This is called a valve-in-valve procedure.
To help treat heart conditions related to heart valve disease, your doctor may advise you to make heart-healthy lifestyle changes, such as:
- Heart-healthy eating
- Maintaining a healthy weight
- Managing stress
- Physical activity
- Quitting smoking
Your doctor may recommend heart-healthy eating, which should include:
- Fat-free or low-fat dairy products, such as skim milk
- Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
- Fruits, such as apples, bananas, oranges, pears, and prunes
- Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
- Vegetables, such as broccoli, cabbage, and carrots
- Whole grains, such as oatmeal, brown rice, and corn tortillas
When following a heart-healthy diet, you should avoid eating:
- A lot of red meat
- Palm and coconut oils
- Sugary foods and beverages
Two nutrients in your diet make blood cholesterol levels rise:
- Saturated fat—found mostly in foods that come from animals
- Trans fat (trans fatty acids)—found in foods made with hydrogenated oils and fats, such as stick margarine; baked goods, such as cookies, cakes, and pies; crackers; frostings; and coffee creamers. Some trans fats also occur naturally in animal fats and meats.
Saturated fat raises your blood cholesterol more than anything else in your diet. When you follow a heart-healthy eating plan, only 5 percent to 6 percent of your daily calories should come from saturated fat. Food labels list the amounts of saturated fat. To help you stay on track, here are some examples:
|If you eat:||Try to eat no more than:|
|1,200 calories a day||8 grams of saturated fat a day|
|1,500 calories a day||10 grams of saturated fat a day|
|1,800 calories a day||12 grams of saturated fat a day|
|2,000 calories a day||13 grams of saturated fat a day|
|2,500 calories a day||17 grams of saturated fat a day|
AvocadosNot all fats are bad. Monounsaturated and polyunsaturated fats actually help lower blood cholesterol levels. Some sources of monounsaturated and polyunsaturated fats are:
- Corn, sunflower, and soybean oils
- Nuts and seeds, such as walnuts
- Olive, canola, peanut, safflower, and sesame oils
- Peanut butter
- Salmon and trout
You should try to limit the amount of sodium that you eat. This means choosing and preparing foods that are lower in salt and sodium. Try to use low-sodium and “no added salt” foods and seasonings at the table or while cooking. Food labels tell you what you need to know about choosing foods that are lower in sodium. Try to eat no more than 2,300 milligrams of sodium a day. If you have high blood pressure, you may need to restrict your sodium intake even more.
Dietary Approaches to Stop Hypertension
Your doctor may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan if you have high blood pressure. The DASH eating plan focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and low in fat, cholesterol, and sodium and salt.
The DASH eating plan is a good heart-healthy eating plan, even for those who don’t have high blood pressure. Read more about DASH.
Try to limit alcohol intake. Too much alcohol can raise your blood pressure and triglyceride levels, a type of fat found in the blood. Alcohol also adds extra calories, which may cause weight gain.
Men should have no more than two drinks containing alcohol a day. Women should have no more than one drink containing alcohol a day. One drink is:
- 12 ounces of beer
- 5 ounces of wine
- 1½ ounces of liquor
Maintaining a healthy weight is important for overall health and can lower your risk for heart valve disease. Aim for a Healthy Weight by following a heart-healthy eating plan and keeping physically active.
Knowing your body mass index (BMI) helps you find out if you’re a healthy weight in relation to your height and gives an estimate of your total body fat. To figure out your BMI, check out the National Heart, Lung, and Blood Institute’s online BMI calculator or talk to your doctor. A BMI:
- Below 18.5 is a sign that you are underweight.
- Between 18.5 and 24.9 is in the normal range.
- Between 25.0 and 29.9 is considered overweight.
- Of 30.0 or higher is considered obese.
A general goal to aim for is a BMI of less than 25. Your doctor or health care provider can help you set an appropriate BMI goal.
Measuring waist circumference helps screen for possible health risks. If most of your fat is around your waist rather than at your hips, you’re at a higher risk for heart disease and type 2 diabetes. This risk may be higher with a waist size that is greater than 35 inches for women or greater than 40 inches for men. To learn how to measure your waist, visit Assessing Your Weight and Health Risk.
If you’re overweight or obese, try to lose weight. A loss of just 3 percent to 5 percent of your current weight can lower your triglycerides, blood glucose, and the risk of developing type 2 diabetes. Greater amounts of weight loss can improve blood pressure readings, lower LDL cholesterol, and increase HDL cholesterol.
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Consider healthy stress-reducing activities, such as:
- A stress management program
- Physical activity
- Relaxation therapy
- Talking things out with friends or family
Regular physical activity can lower many heart valve disease risk factors.
Everyone should try to participate in moderate-intensity aerobic exercise at least 2 hours and 30 minutes per week or vigorous aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats faster and you use more oxygen than usual. The more active you are, the more you will benefit. Participate in aerobic exercise for at least 10 minutes at a time spread throughout the week.
Talk with your doctor before you start a new exercise plan. Ask your doctor how much and what kinds of physical activity are safe for you.
Read more about physical activity at:
- Physical Activity and Your Heart
- U.S. Department of Health and Human Services, 2008 Physical Activity Guidelines for Americans
If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk for atherosclerosis and other health problems. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.
For more information about how to quit smoking, visit the Smoking and Your Heart Health Topic.