Heart valve issues such as regurgitation (where the valve doesn’t close tightly and leaks) or stenosis (narrowing) stemming from a congenital condition or damage due to age or a serious illness can require surgical repair or valve replacement.
CTVS has spent more than 60 years treating heart valves and other cardiothoracic issues, and our board-certified experts can help guide you in deciphering the many valve repair and replacement options that are available today.
In most cases, patients can be treated with surgical valve repair. Repairing the valve is often the preferred method if someone’s native valve is strong enough.
If a valve is severely defective or damaged then a replacement valve will be needed to improve or restore heart functionality.
Surgical Valve Repair
Valve repair can be performed via open heart surgery or more minimally invasive techniques. Some of the procedures that CTVS provides for valve repair include:
Our skilled cardiothoracic surgeons use both mechanical and bioprosthetic (tissue) valves in valve replacement surgery.
Mechanical valves tend to be more durable than bioprosthetic valves, but they do require a lifelong regimen of blood-thinning medication after replacement surgery to prevent blood from sticking to the synthetic valve and clotting.
Biological valves are made out of animal tissue or human tissue from a donated heart. While blood thinners are not needed with this form of replacement valve, there is a more slight risk of failure with them and the need for additional surgeries in the future.
Surgical procedures that CTVS performs in relation to valve replacements include:
- TAVR and TMVR (Transcatheter aortic valve replacement and transcatheter mitral valve replacement)
TAVR is a minimally-invasive procedure performed by inserting a new aortic valve via catheter to replace the patient’s damaged valve. It can be a better option over traditional open-heart surgery for some patients due to faster recovery times.
According to CTVS board-certified cardiothoracic surgeon Dr. Robert Neely, “more and more people are candidates for TAVR as a first line for therapy.”
TMVR is a similar, minimally-invasive procedure done by catheter for those needing a mitral valve replacement but who may not be able to sustain the risks of open heart surgery. Anyone with severe mitral valve regurgitation or a mix of mitral valve regurgitation and stenosis is a candidate for TMVR. The technology surrounding TMVR is still developing, but research shows it to be a promising and effective alternative for the treatment of mitral valve regurgitation when surgery is not a viable option.
- SAVR (Surgical Aortic Valve Replacement)
The TAVR procedure may not be appropriate for some patients due to their anatomical structure, in which case traditional open heart surgery/SAVR is needed to accomplish their valve replacement.
CTVS board-certified cardiothoracic surgeon Dr. Brendan Dewan says that although there is sometimes slightly more risk involved with an open-heart surgical procedure, the “surgical aortic valve replacement (SAVR) with a tissue prosthesis is a very safe procedure. Both SAVR and TAVR valves are durable but many degrade over 10-15 years.” It is preferred to treat younger patients initially with SAVR. “This allows them to be better candidates for TAVR down the line, should they require another valve,” says Dr. Dewan. “With SAVR or TAVR, we not only see a reduction in mortality, but patients also report improved energy, exercise capacity, and quality of life.”
The Ross Procedure uses a patient’s own pulmonary valve to replace the damaged aortic valve. That pulmonary valve is then replaced with a cryopreserved cadaver pulmonary valve. This procedure is highly effective resulting in excellent valve longevity, and is suitable for a wide range of patients. CTVS has been performing the Ross Procedure on Central Texans for more than 20 years.
MICS is another approach used in valve repair and replacement that allows for a smaller incision. Patients who undergo MICS will either have a smaller incision on their breastbone or a small incision between the ribs.
“All patients needing mitral valve surgery are candidates for a minimally invasive approach, including both valve repair and valve replacement,” says CTVS board-certified cardiothoracic surgeon Dr. Faraz Kerendi. “In most cases, additional procedures such as tricuspid valve repair and treatment of atrial fibrillation may also be performed via a minimally invasive approach.”
Dr. Kerendi says that some patients may not be eligible for a MICS procedure such as those who have had previous open heart surgeries or those requiring an accompanying procedure at the same time.
For questions or guidance on heart valve repair and replacement, or any other cardiothoracic conditions, please visit ctvstexas.com or call us at (512) 459-8753 to schedule an appointment with one of our board-certified specialists.