Heart Valve Repair

What is a heart valve repair?

A heart valve repair is a surgical procedure to fix a diseased or damaged heart valve. Heart valves keep blood flowing in one direction through the four chambers of your heart. They have tissue flaps that open to allow blood to flow forward to the body. The flaps then close tightly so blood does not leak backwards into the heart. Diseased or damaged heart valves can cause a backflow of blood or not allow blood to flow forward normally. If possible, heart valve repair is preferred over heart valve replacement because it preserves the strength and function of your heart muscle.

Heart valve repair is a major surgery with significant risks and potential complications. You may have less invasive treatment options available depending on your circumstances. You should consider getting a second opinion about all your treatment choices before having a heart valve repair.

Types of heart valve repair

The types of heart valve repair procedures include:

• Balloon valvuloplasty is a catheter procedure to open a stenosed (narrowed) heart valve. Your doctor inserts the catheter through a vessel in your groin or arm and threads it to your heart valve. Your doctor inflates a balloon in the tip of the catheter to widen or open your heart valve.
• Commissurotomy is a surgical procedure that opens or separates valve flaps that are fused together. This widens the valve opening.
• Decalcification. When calcium deposits collect on your heart valves, the tissue flaps become stiff. Decalcification removes these deposits. This improves the flexibility of the tissue flaps and allows the heart valve to work better.
• Patched leaflets. In this procedure, your doctor will fix holes or tears in the heart valve flaps, or leaflets. Your doctor will repair the damage with a tissue patch.
• Ring annuloplasty. Your doctor will repair the ring-like base of your heart valve with metal, tissue, or a special cloth material. This helps tighten a valve that is too loose or too wide.
• Triangular resection. This procedure fixes a floppy mitral valve flap (leaflet) that does not close properly. Your doctor will remove a section of the floppy leaflet and sew the remaining parts back together. This allows the valve to close more tightly.

Other surgical procedures that may be performed

In addition to a heart valve repair, your doctor may also recommend one or more other procedures. These include:

• Coronary artery bypass graft (CABG) is commonly called heart bypass surgery. CABG bypasses or provides a new route around diseased coronary arteries with healthy vessels taken from other places in your body.
• Percutaneous coronary intervention, or angioplasty, is the widening or opening of a blocked or narrowed artery.  After widening the coronary artery, a stent is typically placed in the artery to keep it open longer.

Why is a heart valve repair performed?

A heart valve repair is a major surgical procedure that your doctor may recommend when one or more of your heart valves does not open or close correctly. A heart valve that does not close all the way leads to regurgitation. Regurgitation lets blood flow backward instead of forward. A heart valve that does not open all the way is called stenosis, which is a narrowing of the valve opening. Stenosis prevents blood from flowing forward effectively.

Your doctor may consider a heart valve repair for you if your heart valve disease causes serious symptoms. These include fatigue, dizziness, passing out, shortness of breath, and swelling of the ankles. Talk with your doctor about all of your treatment options and consider getting a second opinion.

Reasons for heart valve repair include:

• Aortic regurgitation or stenosis. The aortic valve opens to allow blood to leave the heart and closes to prevent blood from flowing back into the heart.
• Congenital heart valve disease, a condition that is present at birth
• Mitral valve regurgitation or stenosis. The mitral valve opens to allow blood to leave the left atrium and enter the left ventricle. It closes to prevent blood from flowing back into the left atrium.
• Pulmonary valve regurgitation or stenosis. The pulmonary valve opens to allow blood to leave the heart and go to the lungs to pick up oxygen. It closes to prevent blood from flowing back into the heart.
• Tricuspid valve regurgitation or stenosis. The tricuspid valve opens to allow blood to leave the right atrium and enter the right ventricle. It closes to prevent blood from flowing back into the right atrium.