Heart Valve Diseases Treatment

---

Heart valve disease is a lifelong condition. However, many people have heart valve defects or disease but don’t have symptoms. The condition may stay the same throughout your life and not cause any problems. Or, the condition may slowly get worse until you start to notice symptoms. If not treated, heart valve disease can cause heart failure or other life-threatening conditions.

Your healthcare provider may recommend healthy lifestyle changes or medicine first to treat symptoms, which may delay problems. Eventually, you may need to have your faulty heart valve repaired or replaced. After repair or replacement, you’ll still need certain medicines and regular checkups with your doctor.

Healthy lifestyle changes include:

• Choosing heart-healthy foods
• Aiming for a healthy weight
• Managing stress
• Getting regular physical activity
• Quitting smoking

Before starting any exercise program, ask your doctor about what level of physical activity is right for you.

Your doctor may prescribe medicines to relieve the symptoms of your heart valve disease, prevent it from getting worse, or treat other heart problems that can affect your heart valves. These may include:

• Medicines to control high blood pressure, such as diuretics and vasodilators, to ease pressure on the heart and reduce the amount of work the heart must do to pump blood
• Medicines to control the heart rate
• Blood thinners to treat or prevent blood clots
• Antibiotics to treat infections that cause heart inflammation or prevent rheumatic fever
• Prostaglandin for newborns to keep certain pathways of the heart open and maintain blood flow to the body

Your doctor may recommend heart valve repair if you have new symptoms of heart valve disease or your current symptoms get worse.

The various ways that heart surgeons repair heart valves are listed below. While most require surgery, some minimally invasive options are becoming available.

• Fixing valve flaps: Surgeons may sew flaps together, reshape flaps, patch tears, reattach loose flaps, or split apart flaps that have fused. These procedures are called valvuloplasty.
• Inflating a balloon: This allows blood to pump blood through a valve or stretch a valve opening. Valvuloplasty may also involve a balloon.
• Placing a stent: This allows blood to flow or plugs a leaking valve.
• Implanting a device to treat mitral valve regurgitation: This can be used for people who should not have open-heart surgery.
• Removing calcium deposits: Obstructions such as clumps of bacteria or tumors can also be removed.
• Repairing supporting structures: Replacing or shortening the cords that give the valves support allow the valve to close properly.
• Tightening or strengthening the valve base: This prevents the tissue from sagging or leaking. Surgeons may attach a plastic ring. These procedures are called annuloplasty.

Heart valve repair can improve symptoms, but sometimes problems return.

Possible complications of heart valve repairs include valve damage or leakage, blood vessel injury, cardiac compression, and stroke.

Sometimes faulty or diseased heart valves cannot be repaired and must be replaced.

Your surgeon will replace the faulty or diseased valve with either a mechanical or a biological heart valve. Your team of doctors will work with you to determine whether a mechanical or a biological valve is best for you, depending on your age, risk factors, and other medical conditions.

• Biological valves, also called tissue valves, are made from animal tissue and may have man-made parts as well. Although tissue valves do not require blood thinners, they do not last as long and may have to be replaced.
• Mechanical valves are made from carbon or other sturdy material, so they last longer than biological valves and usually do not have to be replaced. However, mechanical valves require you to take blood-thinning medicines for the rest of your life. These valves may also carry additional risks during pregnancy.

Valves can be replaced during open-heart surgery or with a minimally invasive procedure using a catheter — a thin tube threaded through a blood vessel to the heart. A common example of the procedure using a catheter is transcatheter aortic valve replacement (TAVR). TAVR, which is sometimes called transcatheter aortic valve implantation (TAVI), replaces the aortic valve to treat aortic stenosis.

Your doctor will discuss which heart treatment is best for your circumstances.

The risks of heart valve replacement include stroke, blood clots, damage and bleeding where the catheters were inserted, and injury to the kidneys or the heart. Sometimes the new valve leaks because it does not fit well.

If a heart valve disease is left untreated, it can lead to serious or life-threatening complications. Learn more about the following conditions and the symptoms to watch for:

• Acute respiratory distress syndrome (ARDS)
• Arrhythmias (irregular heartbeats) or other conduction disorders
• Blood clots
• Bloodstream infections, including septic shock
• Expanding, bulging, or tearing of the aorta
• Heart failure
• Infective endocarditis, a type of heart inflammation
• Liver damage
• Pulmonary hypertension (high blood pressure in the lungs)
• Stroke
• Cardiac arrest

Talk to your doctor about your risk.