Each patient has his or her unique medical history. This information cannot replace discussions with your healthcare professional. You should see your healthcare professional whenever you have symptoms or changes in your health and especially if you have questions about heart valve surgery.
The heart is a muscular organ in your chest, which pumps blood through the blood vessels of the body. Blood provides the body with oxygen and nutrients, and also removes waste. The left side of the heart pumps blood throughout the body, while the right side of the heart pumps blood through the lungs.
Blood is pumped with the help of four valves. The valves are made up of tissue and this tissue forms the leaflets, which open and close to help move blood through the heart. The valves work with the heart to continuously pump blood during rest and during exercise.
The heart is designed to pump blood through your body. A cardiac cycle (heart beat) includes two steps that occur at the same time:
In our heart we have four valves, dividing it into four chambers, two atria and two ventricles. The chambers are compartments like small rooms whose function it is to store the blood and then push it outside.
Valves keep the blood flowing through the heart in the correct direction. The valves open and then close in order to prevent the blood from going backwards.
When heart valves are damaged, blood cannot flow through the heart normally. The following two problems can occur in heart valves:
Aortic stenosis is a narrowing of your aortic valve opening that does not allow normal blood flow. It can be caused by a birth defect, rheumatic fever, radiation therapy or can be related to age.
It is sometimes caused by the build-up of calcium (mineral deposits) on the aortic valve leaflets. Over time, the leaflets can become stiff and no longer fully open and close. When the leaflets don’t fully open, the heart must work harder to push blood through the aortic valve to the body. Because of this extra work, the ventricle walls become thicker over time.
Sometimes the valve leaflets become damaged and fail to close completely. When this happens, some of the blood can leak backwards, in the wrong direction, instead of going forward.
This valve problem makes it hard for the heart to pump enough blood to the rest of the body. This problem can be caused by infection, rheumatic fever, coronary artery disease or can be related to age.
Moderate to severe mitral regurgitation (MR) is undertreated despite being a common problem. Only 2% of the estimated 1.7 million patients with moderate to severe MR are treated, and often it is because they are too sick for surgery.1,4 There is a poor prognosis at one-year is MR is not effectively treated:
MR is a common, progressive disease that initiates a cascade of events progressing to heart failure and potentially death, if untreated.2,3
The type and severity of heart valve disease symptoms depend on which of the four valves is affected, and how severely. If the valve disease is mild, there may be no symptoms. If it is more serious, the symptoms can include:
Your healthcare professional considers many factors in selecting the right approach to treat your valve problem. Typically, your healthcare professional will consider:
You are encouraged to discuss specific treatment recommendations with your healthcare professional. If the disease is mild, valves can be treated through medication. However, when medical treatment is not sufficient, your healthcare professional may recommend replacing the diseased valve.
When a patient needs a heart valve replacement, two types of prosthetic (artificial) heart valves are available: mechanical heart valves and tissue heart valves.
Mechanical heart valves are made from materials such as titanium or synthetic carbon. In the device, there are two “leaflets,” which open and close like a natural heart valve to control the flow of blood.
One advantage of mechanical valves is that they may last a patient’s lifetime. One disadvantage of mechanical valves is that they require life-long anticoagulation therapy (medicine).
Tissue valves are made of animal tissue. There are three types of tissue valves available to patients:
One advantage of tissue valves is that they don’t require patients to use anticoagulants (blood thinner medicine).One disadvantage of tissue valves is that they wear out over time and may need replacement.
Standard Surgical Approach
Aortic valve replacement (AVR) through open-heart surgery is the most common treatment for patients with aortic stenosis. In this operation your diseased heart valve is removed and a new heart valve is put in its place.
Surgical AVR is an open-heart procedure. After the chest is opened, you are put on cardiopulmonary bypass, which temporarily takes over providing blood flow and oxygen to your body during surgery.
Surgical AVR has been performed for many years and commonly produces excellent results to lengthen patients’ lives and improve their quality of life.
Minimally Invasive Surgery
A minimally invasive procedure, referred to as minimal incision valve surgery, can also be performed to replace a malfunctioning valve. The surgical incisions are smaller than in open-heart surgery and made either between the ribs or in the chest.
Patients sometimes experience less pain, shorter hospital stay and faster recovery with minimally invasive surgery compared to open-heart surgery. The main types of minimally invasive heart valve replacement procedures are called mini-sternotomy and mini-thoracotomy.
Contact your physician for more information about heart valve disease and treatment options that are best for you.
IC0 870 001 487/C
Heart failure is a condition in which the heart cannot pump enough blood to meet your body’s needs. If you or a loved one have heart failure, you are not alone. Over 25 million people worldwide have this condition with several million new diagnoses per year. During heart failure, the heart attempts to compensate for lost pumping power, and the heart may change its shape and result in an uncoordinated and inefficient heartbeat.
Symptoms of Heart Failure
At first you might not experience any symptoms. However, over time you may experience some, or all, of the following symptoms:
Treatment can help to relieve the symptoms of heart failure and may help you live longer. There are several ways that heart failure can be treated
Certain lifestyle changes such as increasing physical activity, decreasing emotional stress, weight loss, stopping smoking and eating less salt/fat may reduce heart failure symptoms.
Doctors usually treat heart failure with a combination of medications. Depending on your symptoms, you might take one or more medications including beta-blockers, ACE inhibitors, angiotensin receptor blockers (ARBs), blood thinners and diuretics.
Medical Devices or Surgery
In some cases, doctors recommend interventions such as bypass or valve replacement surgery, implantation of a cardioverter-defibrillator or cardiac resynchronization device, or a heart transplantation.
Autonomic Regulation Therapy
A new form of therapy is being evaluated for patients with heart failure. It is called Autonomic Regulation Therapy (ART) delivered through Vagus Nerve Stimulation (VNS). ART is investigational and being studied in a clinical trial called ANTHEM-HFrEF.
Speak with your physician about which treatment options are right for you.
1. Lloyd-Jones D, Adams RJ, Brown TM, et al; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2010 update: a report from the American Heart Association. Circulation. 2010;121(7):e46-e215.
2. Grigioni F, Tribouilloy C, Avierinos JF, et al; MIDA Investigators. Outcomes in mitral regurgitation due to flail leaflets: a multicenter European study. JACC Cardiovasc Imaging. 2008;1(2):133-141.
3. Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med. 2005;352(9):875-883.
4. Mirabel M, Iung B, Baron G, et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery? Eur Heart J. 2007;28(11):1358-1365.
This information is not intended to replace a consultation with your physician. Contact your physician to discuss any changes in your health and symptoms you are experiencing, so you can obtain a diagnosis and comprehensive information on treatment options.