This type of heart disease involves one or more of the four heart valves (the aortic and mitral valves on the left side of the heart, and the pulmonary and tricuspid valves on the right). Valve disease causes problems in blood flow to and from the heart. There are two basic categories of heart valve disease: valvular stenosis (stenosis means an abnormal narrowing) occurs when a valve opening is smaller than normal; and valvular regurgitation, or a “leaky” valve, occurs when a valve doesn’t close tightly, allowing some blood to leak backwards (regurgitate).
At MMC, we treat all types of valve disease, including:
- Congenital (present from birth) conditions including bicuspid aortic valve disease
- Mitral valve prolapse
- Mitral valve stenosis
- Mitral valve regurgitation
- Aortic valve stenosis
- Aortic valve regurgitation
- Tricuspid valve disease
- Pulmonary valve disease
- Fibro-calcific degeneration
- Dilation of the valve annulus
Treating Heart Valve Disease
Some valve problems are minor and do not require treatment. Others, depending on how severe they are, may involve treatment with medication, or surgery to repair or replace the valve.
At MMC, a team of medical cardiologists, cardiac surgeons, interventional cardiologists, electrophysiologists, echocardiographers and other experts provides comprehensive care for all types of heart valve disease. They perform some of the most complex and advanced surgical and non-surgical procedures currently available. MMC has always been on the forefront of heart valve disease treatment, performing Maine’s first valve replacement in 1962 – just three years after the world’s first successful valve replacement at the National Institute of Health in 1959.
Advanced treatment capabilities The purpose of treating heart valve disease is to protect the valves from further damage, to prevent or relieve the symptoms of other related heart conditions and, when symptoms become severe or life-threatening, to repair or replace faulty valves. No other hospital in northern New England offers all the advanced treatment options for valve disease that are available at MMC:
- Surgical treatment options – Surgical options include heart valve repair or replacement with traditional open-heart surgery.
- When valve replacement is necessary, there are two kinds of prosthetic (artificial or substitute) heart valves available today: mechanical valves that are created from man-made materials, and biological valves taken from animal or human donors. MMC’s cardiac surgeons have unparalleled experience in heart valve surgery, performing more of these surgical procedures than any other hospital in Maine.
- For appropriate patients, valve repair is the optimal treatment, and MMC’s cardiac surgeons are some of New England’s most experienced and respected in this procedure.
- Minimally invasive treatment options – Minimally invasive approaches offer appropriate patients an alternative to traditional open surgery, and the benefits of smaller incisions, less blood loss and faster recovery:
- A procedure called percutaneous valvuloplasty (or transcatheter valve repair) is an option for carefully selected patients who have stenosis (narrowing) of the mitral, pulmonary or aortic valve. Performed in the cardiac catheterization lab, this procedure involves inserting a balloon catheter through a blood vessel in the groin and guiding it to the heart where it is positioned inside the narrowed valve. By inflating and deflating the balloon, the valve opening can be widened. MMC was the first hospital in Maine to perform this cutting-edge procedure in 2009, and is among an elite group of U.S. hospitals offering this technique.
- MMC also is participating in a national clinical trial to test a minimally invasive approach for treating mitral valve regurgitation. Also performed in the cath lab, during this procedure a special metal clip (MitraClip®) is delivered via catheter and attached to the flaps (leaflets) of the mitral valve. The doctor adjusts the clip placement to achieve optimal blood flow and pressures through the valve, then releases the clip and withdraws the catheter. The clip holds the valve leaflets in place, limiting leakage. This procedure is complex and challenging, and involves echocardiographers, interventional cardiologists, anesthesiologists and other team members – a collaborative approach that is the hallmark of cardiac care at MMC. Patients who are candidates for traditional open mitral valve surgery at MMC are carefully evaluated to see if this non-surgical approach is appropriate for them.
- Medical management – Patients with heart valve disease may be prescribed medications to treat symptoms and reduce the chance of further valve damage. Some medications may be stopped after heart valve surgery to correct the problem; others may need to be taken indefinitely. MMC cardiologists provide careful, ongoing medical management to ensure the best possible outcomes.