Heart Valve Diseases Research

• TAVR and transcaval TAVR: To improve treatments for heart valve disease, researchers led by a team at the NHLBI developed new ways to make surgical procedures called transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve replacement (TMVR) safer for high-risk patients. Doctors use TAVR and TMVR to replace faulty heart valves. However, during these procedures, the damaged valve can block blood flow, causing life-threatening complications. Using the new methods, called BASILICA and LAMPOON, doctors are able to split the damaged heart valve during surgery, helping prevent the heart valves from blocking blood flow. NHLBI researchers also developed a modified TAVR procedure, called transcaval TAVR, that has helped make TAVR a treatment option for a wider range of patients.

• Comparisons of heart valve repair approaches: Research from the Cardiothoracic Surgical Trials Network (CTSN) aims to improving outcomes for patients with heart problems, including heart valve disease. For example, with funding from the NHLBI, CTSN researchers compared two surgical procedures — valve repair and valve replacement — in patients whose mitral regurgitation resulted from ischemia. In this study, patients did equally well and had good heart function with either procedure, even though replacement was more effective at correcting the leakage. Another study found that people with mitral and tricuspid valve regurgitation, a condition sometimes called “leaky heart valves,” appeared to do better after 2 years if they had a tricuspid valve repair at the time of mitral valve surgery. However, despite better short-term outcomes, the researchers found that repairing both valves simultaneously raised the risk of needing a pacemaker. Research from CTSN researchers is still ongoing, and scientists remain committed to discovering new treatment options for patients with heart valve diseases.

Our Division of Cardiovascular Sciences oversees much of the research on heart valve diseases that we fund.

Current research on the causes of heart valve disease

• Genetics and heart valve disease: NHLBI-funded researchers are identifying and validating new target genes as potential contributors to heart valve diseases and other cardiovascular diseases. Genetic mutations contribute to congenital heart defects, such as bicuspid aortic valve.
• Causes of heart valve thickening: An NHLBI-funded study aims to provide a better understanding of a condition called myxomatous degeneration, which happens when otherwise healthy valves thicken. This thickening prevents complete closure and can lead to mitral valve prolapse or regurgitation, which are most often issues with the mitral valve between the left atrium and the left ventricle. Myxomatous degeneration affects up to 3% of the population, but the cause is unknown.

Find more NHLBI-funded studies on causes of heart valve diseases at the NIH RePORTER.

Current research on diagnosing heart valve diseases

• Early detection tools: NHLBI-funded researchers are using digital stethoscopes and deep learning algorithms to reduce the number of patients whose valve problems are not diagnosed early enough. This research aims to promote early and accurate diagnoses, especially in areas that have limited access to specialized cardiac care.
• Better understanding repair outcomes: NHLBI-funded research studies are ongoing to optimize the use of cardiac magnetic resonance and echocardiography-based artificial intelligence to identify patients who could benefit most from treatment for mitral valve prolapse. A small percentage of patients will develop life-threatening cardiac arrest. Currently, clinicians have a difficult time predicting these devastating outcomes.

Find more NHLBI-funded studies on diagnosing heart valve diseases at the NIH RePORTER.

Current research on treatments for heart valve diseases

• Improved treatments for mitral valves: NHLBI-funded scientists are investigating new treatments that can help prevent heart failure in people with a specific type of mitral regurgitation. Mitral valve regurgitation occurs when the mitral valve does not close all the way and blood flows backward. Valve replacement and repair are high-risk procedures that are not suitable for many patients.
• More catheter-based repair options: Other research teams are creating innovative valve repair systems that make catheter repair easier for clinicians to perform.
• Less-invasive treatments for children with heart valve defects: NHLBI-supported research is examining minimally invasive heart valve repair treatment options specifically for young children with congenital heart valve defect, who often need open-heart surgery to repair the damage.
• Dedicated funding for heart valve disease research: In December 2022, Congress created the Cardiovascular Advances in Research and Opportunities Legacy (CAROL) Act which provides an additional $100 million over five years to NIH for more research on valvular heart diseases.

Find more NHLBI-funded studies on the treatments for heart valve disease at the NIH RePORTER.

Our Division of Intramural Research, which includes investigators from the Cardiovascular Branch and the Laboratory of Cardiovascular Intervention, is actively engaged in studying heart valve diseases.

Researchers from the Laboratory of Cardiovascular Intervention collaborate with medical centers across the United States to teach techniques developed at the NIH. For example, intramural scientists established the NHLBI collaborative research program to teach cardiac intervention strategies using techniques such as TAVR, LAMPOON, and BASILICA.

Read more about these projects and ongoing clinical trials.

• The Pediatric Heart Network (PHN) involves hospitals in the United States and Canada that conduct studies to improve the quality of life for children with congenital or acquired heart conditions, including heart valve diseases. The PHN is part of the Bench to Bassinet Program, which covers basic to complex clinical research.
• The National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) includes medical data, clinical images, and biological samples from more than 3,600 patients, including those with heart valve diseases.
• Through NHLBI’s Trans-Omics for Precision Medicine (TOPMed) program, researchers can use data from studies focused on heart disorders, including heart valve diseases, to predict, prevent, diagnose, and treat numerous medical conditions based on a patient’s unique genes, environment, and molecular signatures.
• NHLBI population and epidemiology studies in different groups of people, including the Atherosclerosis Risk in Communities (ARIC) Study, the Multi-Ethnic Study of Atherosclerosis (MESA), and the Cardiovascular Health Study (CHS), have made major contributions to understanding the causes and prevention of heart valve diseases and other heart and vascular diseases.
• In 2009, the NHLBI convened a working group to discuss new research directions to improve understanding and, ultimately, treatment of calcium buildup that narrows the aortic valve, called calcific aortic valve stenosis. Over the last decade, several groups have talked about the future of heart valve research. In 2020, action items from an NHLBI working group were published in a paper on patient-centered research of heart valve disease. Those action items identified gaps, barriers, and priorities for future research.