Is Heart Valve Repair Surgery Right for You?
There are several ways to treat a problem heart valve. One of them is through surgery to repair it.
While heart valve repair is generally the preferred method for treating a diseased heart valve, some patients are not candidates for heart valve repair surgery. This is because their valves are too badly damaged. Every patient's condition is unique, and each doctor has a unique approach to treatment. Your doctor will determine if heart valve repair surgery is the best treatment for your particular condition.
Your doctor will get information about your heart valve condition by performing tests that may include any or all of these:
- Listening to your heart to hear the valves opening and closing and the rush of blood through them.
- Conducting an echocardiogram, which uses sound waves to produce detailed images of your heart. This is the most common test used to find out if a heart valve can be repaired. But often, direct inspection during surgery is the only way to find out.
- Performing a magnetic resonance imaging (MRI) study, which uses a magnetic field and radio waves to get detailed images of the inside of your heart.
- Taking an x-ray image of your chest to check your heart, its major vessels, and your lungs for abnormalities.
- Ordering an echocardiogram (ECG) to measure the electrical impulses given off by your heart. An ECG gives your doctor important information about your heart's rhythm and its size.
The procedure used to repair your heart valve depends on which valve is damaged. Tricuspid and mitral valves are the most likely to be repaired. A large percentage of patients with mitral valve damage have successful repair procedures.
Aortic valve repair is only done at a few large centers in the United States. If damaged, the aortic valve is usually replaced. These are some of the procedures used to repair damaged heart valves:
- Balloon valvotomy – If possible, your surgeon may recommend this procedure as it does not require open heart surgery. A thin, flexible tube (catheter) with a small deflated balloon at its tip is inserted into an artery in your arm or groin and guided into your narrowed valve. The balloon is quickly inflated, which stretches the valve opening and allows more blood to flow through it.
- Commissurotomy – If the valve is narrowed because of thickened leaflets or leaflets that are stuck together, your surgeon opens the valve by cutting the places where the leaflets join.
- Ring annuloplasty – When a valve loses its shape and strength, it's unable to close tightly. An annuloplasty gives the leaflets support through ring-like devices that your surgeon attaches around the outside of the valve opening.
- Reshaping – If a valve has lost its shape and cannot close completely, your surgeon may cut out a piece of a leaflet so the valve can close properly again.
- Decalcification – Over time, calcium deposits keep heart valves from closing properly. If this happens, your surgeon will remove the calcium buildup from the leaflets so that they can function normally.
- Repair – Heart valves are supported by chords (chordae tendineae and the papillary muscles). These can weaken and stretch so the valve cannot function properly. Repair shortens or replaces these chords so that the valve can close normally.
- Patching – If one of your valve leaflets has a hole or tear, your surgeon may repair it with a tissue patch.
Besides heart valve repair, other treatment options include medication and heart valve replacement.
Make sure you get answers to all your questions and that you understand completely why a particular method of treatment was chosen for you.
Information on this site should not be used as a substitute for talking with your doctor.
Always talk with your doctor about diagnosis and treatment information.
Last updated: 22 Sep 2010