Heart Valve Problems

Care & Treatment

Heart valve disease cannot be cured with medications. However, lifestyle changes and medicines can often treat symptoms and delay problems for many years.

Eventually, a person may need a procedure or surgery to repair or replace a damaged heart valve.

Medications

In addition to heart-healthy lifestyle changes (for example, improvements to your diet and level of exercise), the healthcare professional may prescribe medicines to:

  • Lower high blood pressure and make it easier for your heart to pump blood
  • Thin the blood to prevent blood clots from forming around your heart valve
  • Treat coronary heart disease with medicines that can reduce the hearts workload and relieve symptoms
  • Treat heart failure with medicines that can reduce fluid build-up and swelling

A person with heart valve problems needs frequent check-ups and periodic echocardiograms to find out if the heart valve becomes worse or needs surgery. 

Heart Valve Surgery

A healthcare professional may recommend repairing or replacing a damaged heart valve, even if there are no symptoms. The decision depends on:

  • Severity of heart valve disease.
  • Whether a person needs heart surgery for other reasons. For example, coronary artery bypass surgery and valve surgery can happen at the same time.
  • A person’s general health, age, and level of mobility and independence.

The cardiology specialist might recommend repair of the valve instead of replacing it, based on the degree of valve disease and other factors.

Heart Valve Repair

There are several ways that heart surgeons can repair valves. These include:

  • Patching holes or tears.
  • Removing or reshaping the valve.
  • Separating valve flaps so the valve can open and close properly.

Sometimes heart valves can be repaired with less serious procedures. For example, valves that can’t open fully may benefit from a cardiology specialist inserting a thin catheter with a balloon at the tip through a blood vessel to the narrowed valve. The balloon is then inflated to widen the valve opening. 

This procedure, called balloon valvuloplasty, may not cure the heart valve disease, but can help treat the symptoms.  Within a year, the valve closes again in about three-quarters of the people who have had the procedure. This procedure may help when a person needs to build up their strength before the main surgery. 

Heart Valve Replacement

If a valve cannot be repaired, it must be replaced with a mechanical (human-made) valve OR a biological valve (made from human or animal tissue).

  • Mechanical valves are made of durable human-made materials. They last longer than biological valves but require people to take blood thinners. The blood thinners help prevent clots from forming around the new valve. Clots can cause a stroke or heart attack.  
  • Biological valves are made from human, pig, or cow heart tissue. They may have some human-made parts. Although biological valves do not require a person to take blood thinners, they usually have to be replaced after 10-15 years.

Until recently, surgical aortic valve replacement (SAVR) was the only effective treatment for severe aortic stenosis. This is a major surgery that requires opening a person’s chest and is not appropriate for everyone.

An alternative is transcatheter aortic valve replacement (TAVR). This procedure involves using a catheter to enter an artery that leads to the heart, without needing to cut open a person’s chest. The catheter is used to replace the damaged valve.

Transcatheter Mitral Valve Repair

Until 2018, people with severe mitral valve regurgitation had no safe procedures available. They had to be treated medically.

Now there is transcatheter mitral valve repair available using the MitraClip™ device. This involves using a catheter to implant a small device called the MitraClip in the valve to help it close more fully and restore normal blood flow. The Clip is inserted through an artery using a catheter.

Other Approaches for Repairing and Replacing Heart Valves

New ways of repairing or replacing heart valves can help some people. These methods use smaller incisions (cuts), tend to cause less pain, and have a lower risk of infection. These procedures also tend to have shorter hospital stays and recovery times compared to traditional surgery.

 

Last Updated February 2023

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