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Heart Valve Disease Treatment Without Surgery

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What Are The Risk Factors & Complications Of Aortic Valve Stenosis

Minds of Medicine: Solving Heart Valve Problems without Surgery – TAVR

Some of the major risk factors for heart valve disease are the age of the person, unhealthy blood cholesterol levels, high blood pressure, smoking, insulin resistance, intravenous drug use, diabetes, overweight or obesity, lack of physical activity, and a family history of early heart disease. Do not ignore infections such as rheumatic fever, endocarditis, infected gums so as to prevent or reduce worsening of any type of heart valve disease.

On a long run, aortic valve stenosis may cause heart failure, stroke, blood clots, bleeding, erratic heart rhythm , infections in the heart and death.

Benefits And Risks Of Tavr

The initial clinical trials of TAVR, begun in 2007, evaluated TAVR in patients who were too ill to be considered for SAVR. These trials showed benefit at extending quality and length of life in patients with severe AS. Since that time, trials have been performed comparing TAVR to SAVR in patients who are considered high risk and intermediate risk for traditional SAVR. In each of these studies, TAVR was shown to be no worse or even better than SAVR. Because of the quick recovery with TAVR, it soon became the standard of care for intermediate and high surgical risk patients with AS.

The recent news about TAVR concerns clinical trials conducted on the healthiest patients that is, patients who are considered low-risk surgical candidates. The PARTNER 3 Trial and the CoreValve Low-Risk Trial were presented at the recent American College of Cardiology Meetings in March 2019. Both trials showed significant benefits of TAVR compared to SAVR, including reduced rates of death, stroke, and repeat hospitalizations. It is expected that TAVR in low-risk patients will gain FDA approval in the near future. When this occurs, TAVR will be the standard of care or all patients with AS.

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William P Clements Jr University Hospital

All heart surgeries take place in UT Southwesterns William P. Clements Jr. University Hospital, ranked the #1 hospital in Dallas-Fort Worth by U.S. News & World Report.

Clements University Hospital brings together the knowledge, expertise, research, and innovation of a world-class medical institution into one remarkable facility with the patient at the center of it all.

  • 24 Surgical Suites

Mild Valve Lesions Linked To Long

Yoga After Heart Valve Surgery

Heart diseases are the main cause of mortality worldwide.

Dr. Antonio Orraca, Member of the Board of Directors of the Puerto Rican Society of Cardiology. Photo: Medicine and Public Health Magazine. Fabiola Plaza.

According to Dr. Antonio Orraca, Member of the Board of Directors of the Puerto Rican Society of Cardiologyare most common in heart disease patients and their time with the main reason Mortality in Puerto Rico and around the world, among them valvular problems, is the most common aortic stenosis, which occurs when the hearts aortic valve narrows.

According to the Mayo Clinic Portal, in aortic stenosis, the valve does not open fully and this reduces or blocks the flow of blood from the heart to the aorta and the rest of the body, leading to heart failure, stroke, blood clots, bleeding, heart rhythm problem , infections that affect the heart, such as endocarditis, and even death.

To the specialist, as the population ages, the valve becomes narrower and narrower, showing poor opening. In turn, they explain that another valvular condition is mitral regurgitation, which occurs in the mitral valve, a problem also known as mitral regurgitation.

As we get older, structural changes appear throughout the body and the heart is not spared, the valves change, he said.

View the full program here.

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Treatment Options For Heart Valve Disease

Jun 11, 2021Cedars-Sinai Staff

Every year, more than 5 million people in the U.S. are diagnosed with heart valve disease. The human heart contains four separate valves: mitral, tricuspid, pulmonary and aortic. If one of these valves is not functioning properly, the heart has to work harder to pump blood and keep it flowing in the right direction, leading to heart valve disease.

Dr. Joanna Chikwe, chair of the Department of Cardiac Surgery at Cedars-Sinai, says that while some people might be hesitant to undergo surgery to replace or repair a heart valve, it’s far riskier to let severe heart disease go untreated.

“If you have a mitral valve that leaks, you want a mitral valve surgeon. If you have an aortic valve that needs replacing, you should consult an aortic valve surgeon.”

“Surgery is actually the safest option you have,” Dr. Chikwe says. “The things that you’re scared of when you think about heart surgery, like dying or having a stroke, are actually more likely to happen if you do nothing.”

Heart Valve Disease Diagnosis And Treatment

The many specialists in our Complex Heart Valve Program combine their expertise to care for each patient. We also offer the widest array of treatment options in Oregon, including some that are available only at OHSU.

Youll find:

  • Providers with deep experience treating patients with high-risk and complex conditions.
  • Advanced imaging for precise diagnosis and treatment.
  • The latest treatment options, including some that we helped pioneer.
  • Access to next-generation therapies through clinical trials.

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When Compressed And Being Inserted The Valve Is Less Than 10 Mm But At Full Expansion Parts Of The Device Measure Over 50 Mm

The procedure, which usually takes one to two hours, involves inserting the Harmony valve within a thin, hollow tube into a vein in the groin or neck, which is then guided to the heart. The collapsed valve is then released in the region where the pulmonary valve typically is and begins to function immediately.

These valves are expected to last as long as surgical valves, with patients likely to spend one night at the hospital compared to a week with traditional open heart surgery, Zampi said. This approach requires less anesthesia, helps us reduce surgery risks like bleeding complications and infections and gets patients back to resuming regular activities much more quickly.

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Among people who benefit from the procedure are those born with tetralogy of fallot, a rare condition caused by a combination of four heart defects including a hole in the heart that leads to inadequate blood flow to the lungs.

These patients often undergo at least one surgery as a baby, but eventually need more interventions to address a leaky pulmonary valve.

That was the case for Lauren Boyce, 28, who was the first patient to receive the Harmony valve in the state of Michigan at Mott in June.

Boyce, of Canton, underwent open heart surgery for tetralogy of fallot as a newborn. She routinely sees a cardiologist but hasnt needed any interventions since then, she said.

What Are The Risks Associated With Valve Disease Treatment

Transcatheter Treatments of Valvular Heart Disease

As with all surgeries, there are risks. Because every patient is different, your doctor and your health care team will discuss your treatment options and recommend the best option for you.

People who have damaged, repaired or replaced heart valves are at increased risk for developing an infection of the valve .

Is it true that dental work can increase risks for people with heart valve problems?

It depends. The American Heart Association does not recommend antibiotics before dental procedures, except for patients at the highest risk of endocarditis. If a person has had heart valve surgery, but has not had a heart valve replaced, the cardiologist or surgeon will decide if antibiotics are needed. Read more about the antibiotic prophylaxis guidelines for infective endocarditis.

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How Is A Bicuspid Aortic Valve Diagnosed

Your doctor will review your symptoms and medical history. A physical exam that includes using a stethoscope to listen carefully to the heart should also be part of the appointment.

If your doctor detects a heart murmur, it may be an indication that more tests are needed. This is often how a bicuspid aortic valve is first diagnosed, especially in people without symptoms.

The main test to diagnose a bicuspid aortic valve is an echocardiogram. Echocardiography uses sound waves to produce moving images of the heart on a computer screen.

This type of screening shows how blood flows through the heart and can often reveal problems with the hearts valves or blood vessels.

For a more detailed view, medical staff may use a transesophageal echocardiogram. Theyll numb your throat before guiding a transducer down your esophagus. They can then see some chambers of the heart that dont usually show up on a regular echocardiogram.

Other tests your doctor may perform include:

What Are Your Options

If your surgeon needs to repair your mitral valve through tiny incisions , here are minimally invasive surgical options:

  • Right mini-thoracotomy. The surgeon inserts special instruments and repairs the valve through a 2- to 3-inch incision in a skin fold on the right side of the chest.
  • Partial upper sternotomy. This also involves a 2- to 3-inch incision, this time in the upper portion of the sternum. This gives the surgeon easier access to repair the valve.
  • Robotically assisted mitral valve repair. In this case, your surgeon works through a few incisions of about 1 inch or less. With a computer console, the surgeon can control instruments on thin robotic arms. This allows him or her to open the thin sac around your heart to perform the repair.
  • However, as these require your surgeon to stop the heart, you may not be a candidate for surgical minimally invasive repairs. In this case, percutaneous repair or replacement may be feasible, such as the following options:

  • MitraClip. This is a clip inserted through the groin vein to repair deformed mitral leaflets. It is FDA- approved for patients with severely leaking valves who are at high risk for conventional surgery.
  • Percutaneous rings. There are ways to repair mitral valves using rings that can be inserted through the groin or neck veins to help the valve close better. They are available under clinical trials at this time.
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    What Is Heart Valve Replacement

    During a heart valve replacement procedure, the surgeon removes your diseased heart valve and replaces it with a prosthetic or artificial heart valve. This artificial valve works much like a normal heart valve.

    An artificial heart valve is either a mechanical or a tissue valve. Mechanical heart valves are made of a strong material such as titanium or carbon. Tissue heart valves are obtained either from human donors or from animal tissue.

    After receiving your new heart valve, you will likely begin noticing improvement in how you feel. Complete recovery from surgery may take approximately 6 to 12 weeks. Most heart valve patients are able to resume a normal lifestyle.

    Early Detection Of Heart Valve Disease Is Key

    Treating Aortic Valve Disease

    Heart valve diseases are relatively easy to diagnose. Theyre often first detected by primary care doctors during a routine physical exam by listening with a stethoscope. If your doctor hears a certain kind of heart murmur that indicates a type of heart valve disease, theyll likely refer you to a cardiologist for a transthoracic echocardiogram. This test uses ultrasound to create an image of the heart and let your cardiologist see how your valves are working.

    If we find evidence of heart valve disease, you need to be seen by a heart valve specialist. We have a dedicated team of specialists who care for patients with mild, moderate, or severe heart valve disease.

    Related reading: The heart care team: Dedicated experts for every patient

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    What Happens During Balloon Valvuloplasty

    During a balloon valvuloplasty, a specially designed catheter is inserted into a blood vessel in the groin and guided to the heart. The tip is directed inside the narrowed heart valve. Once there, a tiny balloon is inflated and deflated several times to widen the valve opening. Once the cardiologist is satisfied the valve has been widened enough, the balloon is removed.

    During the procedure, the cardiologist may perform an echocardiogram to get a better picture of the valve.

    Non-surgical procedures to treat valvular disease, such as transcatheter aortic valve replacement , provide additional treatment options using a catheter for valve disease. With a TAVR, you get a thin tube that runs through a small opening in your leg and up to your heart. Your doctor uses that tube to put in the new valve.

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    Goal : Lengthen And Improve The Quality Of Life

    The odds are very good that valve repair or replacement will lengthen life and improve health and quality of life. Most valve patients can expect to return to their full activity level. Although not all valve conditions are life-threatening, it could be a mistake to assume the condition is insignificant. Some valve disease problems can lead to an increased risk of death if treatment recommendations are not followed. Some valve disease problems can lead to a significantly increased risk of death. If youve been told that you require valve treatment, it shouldnt be ignored or postponed indefinitely. If finances are keeping you from receiving surgical treatment that you need, there are studies and government initiatives to help make the procedure affordable. Learn more about health care laws and government programs seeking to provide affordable coverage at the HealthCare.gov website.

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    Goal : Give You The Best Possible Option For Returning To A Healthy And Active Life

    Your providers will weigh your risks for surgery with the possibility of your return to a healthy and active lifestyle. Depending on your heart health, your overall health, your age and your ability to heal after surgery, they will help you choose a plan that provides as full a recovery as possible.

    Heart Valve Repair Or Replacement Surgery

    Heart valve repair without surgery at Michigan â the Harmony valve

    The heart is a pump made of muscle tissue. It has 4 pumping chambers: 2 upper chambers, called atria, and 2 lower chambers, called ventricles. Valves between each of the heart’s pumping chambers keep blood flowing forward through the heart.

    • Tricuspid valve. Located between the right atrium and the right ventricle
    • Pulmonary valve. Located between the right ventricle and the pulmonary artery
    • Mitral valve. Located between the left atrium and the left ventricle
    • Aortic valve. Located between the left ventricle and the aorta

    When valves are damaged or diseased and do not work the way they should they may need to be repaired or replaced. Conditions that may cause heart valve dysfunction are valve stenosis and valve regurgitation .

    When one valve becomes stenotic , the heart has to work harder to pump the blood through the valve. Valves can become narrow and stiff from infection and aging. If one or more valves become leaky, blood leaks backwards, which means less blood is pumped in the right direction. Based on your symptoms and the overall condition of your heart, your healthcare provider may decide that the diseased valve needs to be surgically repaired or replaced.

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    Leaky Heart Valve And Pulmonary Regurgitation

    Like the tricuspid valve, a small amount of pulmonic regurgitation may be present in healthy people. There are rare cases when a leaky pulmonary valve causes problems. These may be due to:

    • Elevated blood pressure in the pulmonary artery
    • Previous surgery as a child to repair a severe heart defect

    Usually, no treatment is required for pulmonary regurgitation. Treating the underlying medical condition is the best approach.

    Goal : Achieve Recovery Milestones

    Your health care team can also help you determine your return to health by helping to identify milestones such as sitting up alone, walking short distances, self-care and bathing, incision healing, walking longer distances, driving, and within a few weeks, returning to work and engaging in all activities.

    Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.

    Last Reviewed: May 12, 2020

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    Myth: Not All Atrial Fibrillation Is Important To Treat

    The truth: Atrial fibrillation, or AFib, is caused by a misfiring of the electrical pathways in the heart muscle, interrupting the hearts ability to pump blood effectively. Individuals with heart disease often have AFib as well.

    Sometimes, patients have symptoms such as dizziness or shortness of breath, but not necessarily. In either case, untreated, AFib can worsen valve disease and increase a patients risk of stroke and death.

    That is why AFib should be addressed when valve disease is present.

    Today, we have a vast range of therapy options for AFib, said Shivang Shah, MD, cardiologist at Franciscan Physician Network Indiana Heart Physicians in Indianapolis. These options include managing stroke risk and the symptoms associated with Afib. These options can be tailored to the individual patient using the shared decision-making principle at our office visits.

    As far as Im concerned, there is no such thing as a little atrial fibrillation, said Dr. Gerdisch. When a patient is first admitted to a hospital with AFib, their five-year life expectancy drops 50 percent lower than their predicted lifespan. Thats why every major medical society recommends that AFib be addressed, when possible, during heart surgery.

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