Heart valves separate the upper and lower chambers of the heart and keep blood flowing in one direction by preventing blood from traveling backward with each heartbeat. Heart valve disease occurs is the valve is too tight (stenosis) or leaky (regurgitation). Both stenotic and regurgitant valves cause the heart to fail. The damage can only be undone by fixing the problem with the valve. Many times, when multiple problems exist or when the patient is older, these disorders are complex and require an individualized treatment plan carried out by a highly skilled valve team.
Treatment depends upon which valve is affected. Surgery – either valve repair or replacement – is often the preferred treatment option for patients suffering from complex valve disease.
Valve repair preserves a patient's original valve without the need for a prosthetic (artificial or biological valves taken from human or animal valve tissue), offering the best long-term outcome for restoring proper valve function. When surgery is performed by an experienced team, regurgitant (leaky) valves that allow blood to travel into the heart (tricuspid on the right and mitral on the left) can usually be fixed. The American Heart Association/American College of Cardiology (AHA/ACC) Guidelines for the Management of Patients with Valvular Heart Disease recommend that repair if performed on these valves whenever possible.
Stenotic (tight valves), on the other hand, usually need replacement. This is often the case with the valves where blood exits and prevents return into the heart (aortic valve on the left side).
There are also catheter-based treatments for valve disorder that can be highly effective in particular patients. Balloon valvuloplasty (where a balloon is put across the valve through a vein from the leg and inflated) often times is the treatment of choice for patients with mitral stenosis. Valvuloplasty of the pulmonary valve (the "out" valve on the right side) is also first line therapy and both of these procedures produce long-lasting good outcomes in the appropriate patients. These procedures require significant skill and expertise by the valve team, as well as strong collaboration between the cardiology and surgery teams to achieve the expected results.
Experience matters when it comes to complex valve surgery, and no one knows that better than the Heart Team at SLU Hospital. Led by Dr. Richard Lee and Dr. Michael Lim, our team specializes in the individual evaluation of patients with complex valve disease to offer the best possible treatment recommendations by experienced physicians.
At SLU Hospital, we specialize in both valve repair and replacement surgeries for mitral, tricuspid and aortic valves. We are particularly dedicated to repairing malfunctioning valves versus opting for total valve replacement. We also have significant experience in catheter-based balloon valvuloplasty, and offer this therapy to appropriate patients. We routinely handle the most challenging cases, including those that involve repairing or replacing more than one heart valve or correcting previously unsuccessful valve surgeries.
