University of Minnesota Physicians Heart surgeons offer a full range of heart valve repairs and replacements.
A problem valve may not open wide enough, not close tightly enough, or both. In any case, not enough blood gets sent out to the body. Symptoms of valve problems may include breathing problems; angina—pain, pressure or tightness in your chest; feeling dizzy, faint or lightheaded; tiredness, especially with activity; or waking up at night coughing or short of breath.
Men and women of any age can have heart valve trouble. You may have been born with a problem valve—that’s a congenital defect. Or, a valve may have worn out as you aged.
Stenosis and Regurgitation
When a valve doesn’t open all the way, the condition is called stenosis. Blood has to flow through a narrower opening, and the heart muscle has to work harder to push the blood through the valve. Aortic valve stenosis is a narrowing of the aorta, the big blood vessel that carries blood to all the tissues of the body.
When a valve doesn’t close tightly enough, the problem is called regurgitation. The valve itself may be considered leaky. When a valve leaks, the heart has to move the blood twice.
Mitral valve repair is performed by cardiothoracic surgeons to treat stenosis or regurgitation. The mitral valve is the inflow valve for the left side of the heart.
Treating valve problems
Different problems require different treatments. When your surgeon opens your chest, he or she cuts through your breastbone to reach the heart. A heart-lung machine, used during the surgery, supplies the blood with oxygen and pumps it back through your body. Then depending on your specific issue, the surgeon will either repair or replace the problem valve. You have a series of valves.
- Valve repair—is a surgeon’s first preference. This means you keep your own heart valve and your surgeon sews a ring around the entrance to the valve to improve its size or shape. Cutting tissue to let the valve open or close better is another form or repair. When repair is not possible, the valve is replaced.
- Mechanical valves—are made of metal or hard carbon and are designed to mimic the natural valve. Mechanical valves can last for decades, but blood sticks to them. To prevent any blood clots from developing on these hard, artificial valves, you will be required to take Coumadin, a blood thinner, for life.
- Biological (or “tissue”) valves—are natural valves taken from an animal, typically a pig or a cow. A very thin polyester mesh cuff is sewn around the outside of the valve to ease the implantation. Blood does not clot as readily on biological valves, so Coumadin may be required for only a short time. Biological valves, however, wear out faster than mechanical valves and may have to be replaced.
- Homografts or allografts—are human valves obtained from a donor. This type of valve is especially beneficial for pregnant women and children because it does not require longtime use of anti-coagulation therapy. Since the availability of these valves depends on donors, supply is limited.
Surgery to any valve at the right time can improve both the quality and length of your life.