Monday, October 3, 2022

Leaky Heart Valve Surgery

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Issues With The Heart Valve

Cardiologists repair leaky heart valves without open-heart surgery

The function of the heart is to move the blood through the heart in a single direction. If there is found valve leakage, then the valve leaflets are bound to fail in closing properly. Some blood is also regurgitated backwards in wrong direction.

In case of severe regurgitation or heart valve leakage, the heart needs to work harder for re-pumping blood through the heart and within the body. The heart is enlarged due to this overwork. If the person finds himself to get tired with his regular day to day activities, then he is probably experiencing one or even more such symptoms that are already mentioned. Then it is high time to consult the cardiologist. For instance, the person may find walking up the drive can be exhausting. Again, bending over for taking clothes from dryer could possibly cause pain in the chest. He might experience breathlessness due to the heat when outdoors. They all could be possible signs of disease in the heart valve.

Using a stethoscope, the general physician could listen to the patients heart. By listening to the heart, it is possible to know if it is a heart murmur. It is depending upon the murmur intensity that the general physician might refer the person to a qualified cardiologist for further investigation and treatment.

Patients Felt Noticeably Better For Two Years After Procedure To Fix Leaking Heart Valve

Contact: Nicole Napoli, nnapoli@acc.org, 202-669-1465

New Orleans, LA –

Patients with heart failure and a leaking heart valve reported feeling better and experiencing fewer heart failure symptoms if they underwent a procedure to repair their valve than patients who received standard treatment alone, according to research presented at the American College of Cardiologys 68th Annual Scientific Session.

The findings are the latest to come from the COAPT trial, which investigated the use of a procedure called transcatheter mitral valve repair in patients with secondary mitral regurgitation, a condition where the mitral valve does not close properly due to problems with the hearts chambers. In 2018, COAPT researchers reported that patients undergoing TMVR had significantly better rates of survival at two years compared with those receiving standard medical therapy. For the new study, researchers further analyzed data from the trial to determine whether the valve repair also improved patients quality of life.

At the start of the trial, participants scored 52 out of 100 on the KCCQ summary score, on average, which reflects a relatively poor quality of life. Patients heart failure symptoms significantly limited their daily activities, causing shortness of breath or fatigue when walking on level ground or doing light housework, Arnold said.

The study was funded by Abbott.

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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.

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Whats The Best Way To Fix Leaky Heart Valves

By Jonathan Springston, Editor, Relias Media

For patients with tricuspid or mitral regurgitation, or leaky heart valves, investigators discovered those who underwent mitral valve surgery plus tricuspid annuloplasty fared better than those who underwent only mitral valve repair. Specifically, the researchers observed that over a two-year period, the former group was less likely to die, less likely to need a reoperation, and less likely to experience severe stage regurgitation vs. the mitral valve surgery alone group.

Millions of patients are diagnosed with leaky heart valves annually, which can necessitate surgical repair. The mitral valve procedure is more minor, a repair of tissue that could lead to additional adjustments or even valve replacement. Another option is tricuspid annuloplasty, whereby surgeons resize or reshape the suspect valve. Although both procedures can be performed concurrently, many patients pick one procedure or the other.

After two years, among patients who underwent both procedures, 3.9% died, developed severe regurgitation, or needed a reoperation vs. 10.2% in the mitral valve surgery alone group. The authors observed no significant differences between patient groups in quality of life or changes in functional status. However, 14.1% of patients who underwent both procedures required a permanent pacemaker vs. 2.5% in the mitral valve surgery alone group.

Traditional Surgery Vs Dr Doolabhs Approach

How Serious Is a Leaky Heart Valve?

Dr. Doolabh offers an approach to heart valve repair that is dramatically different from what is typically performed: He doesnt cut through the breastbone.

Traditional heart valve surgery requires cutting through the breastbone while Dr. Doolabhs approach avoids the breastbone altogether with a small incision between the ribs.

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The Ticker Tapes Podcast

Alex Martins hope of joining the army was dashed after a shock diagnosis. Alex talks about the physical challenges and emotional strain as he recovers from a major operation, and adjusts to a new life with a mechanical heart valve. Hear his story and other real experiences from people living with heart and circulatory diseases.

Positive Outcome Quick Recovery

How did things turn out for the worlds first catheter-based mitral valve repair patient? It was a complete win and a clinical success acutely, explained Dr. Rinaldi. The care team was able to take the patients mitral valve leak from severe down to mild. The patient did really well during the procedure and went home the next day.

Ultimately, durability for this technique still poses challenges and the research work and innovation continue. While this procedure is investigative and not yet a standard modality of care, the acute outcomes are promising. Ongoing studies will indicate whether these results are repeatable.

When were caring for patients, we dont want to just offer good care we want to offer the best science-based medicine available, Dr. Rinaldi said. Our goal is to provide the latest techniques and technology to our patients. Thats why were continuing to pioneer these technologies through clinical trials.

To learn more about heart care at Sanger Heart & Vascular Institute, visit online.

Caution: CardioMech MVRS is an investigational device in the United States. CardioMech MVRS is limited by federal law to investigational use. It is not available for sale in the United States. The CardioMech MVRS is not available for sale in any region and has not received any regulatory approvals.

1 Leon, Martin B., . What is Structural Heart Intervention Today London: PCR London Valves 2017.

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What Are The Symptoms Of Leaking Heart Valves

Leaking of heart valves means that the heart is not able to pump out enough blood to reach the peripheral organs and tissues. In this situation, the heart tends to beat faster in order to pump out more blood rapidly.Therefore, symptoms of leaky heart valves can be seen as the following:

  • Palpitations
  • Chest discomfort or chest pain in severe conditions
  • Swelling over ankles or feet
  • Tiredness or fatigue
  • Dizziness or fainting
  • Weakness

Signs and symptoms may appear rapidly if the cause for valvular insufficiency is of a sudden onset whereas in some patients the signs and symptoms may develop gradually and are often unnoticeable.

Recovering From An Aortic Valve Replacement

Leaky Heart Valve After Surgery to Repair Tetralogy of Fallot (TOF) – CHOP

You’ll usually need to stay in hospital for about a week after an aortic valve replacement, although it may be 2 to 3 months before you fully recover.

You should take things easy when you first get home, but you can start to gradually return to your normal activities over the next few weeks.

You’ll be given specific advice about any side effects you can expect while you recover and any activities you should avoid.

You won’t usually be able to drive for around 6 weeks and you’ll probably need 6 to 12 weeks off work, depending on your job.

Read more about recovering from an aortic valve replacement.

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Leaking Heart Valves Life Expectancy

  • Although a leaky heart valve can have fatal effects, it is usually diagnosed accidentally as it does not have specific signs and symptoms.
  • Nearly every person has a small amount of valvular regurgitation which can be effectively managed with the help of suitable diet and exercise
  • In some patients, a leaky heart valve remains in the same condition lifelong, not causing any trouble while in some it may develop rapidly leading to heart failure.

Therefore, it can be said that life expectancy with leaking heart valves is quite relative and can vary from person to person.If you are diagnosed with a leaky valve, irrespective of how minor the leak is, it is advisable to keep a regular follow-up with your doctor to be updated about your leaky valve.

Treatment For Leaky Heart Valves

You doctor may prescribe medications to maintain adequate pumping action of the heart.Since major valvular leakage is a mechanical problem, it is eventually required to be replaced by surgery. Valvular surgeries may be of the following types:

Valve repair surgery a damaged valve is fixed without use of prosthetic. Valve replacement surgery this is performed when valve repair is not possible. The damaged valve is replaced by a prosthetic or artificial one. Minimally invasive heart valve surgery

Patients are required to be on blood-thinning agents even after surgery. This helps to prevent formation of blood clots on the repaired/ replaced heart valve post-surgery.The patients need to be serially tested for PT/INR once put on medications to assess and adjust dosages if required.Whether you are diagnosed with a valve condition or not, there are certain measures which you can take to manage and also avoid development of valvular/ cardiac conditions in future:

  • Curb smoking and alcohol intake
  • Maintain an optimal weight and BMI
  • Eat a well balanced diet
  • Those at high risk should consume a salt-restricted and fat-free diet.
  • Follow a suitable exercise program. High-intensity exercises are to be avoided for patients with leaky valve

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How Is A Leaky Heart Valve Diagnosed

A doctor usually diagnoses a leaky heart valve by:

  • Listening to the heart with a stethoscope for abnormal sounds such as a heart murmur
  • Looking at the results of a heart ultrasound, also called an echocardiogram

A person√Ęs description of symptoms along with the physical exam and echocardiogram can determine how serious a leaky heart valve is.

Repair Procedure: Balloon Valvuloplasty

Can a Heart Valve Be Replaced Without Open Heart Surgery?

View an animation of valvuloplasty.

For many people, valve tightness can be relieved during a procedure called balloon valvuloplasty. It’s done as part of a cardiac catheterization, which is less invasive than general surgery or open heart surgery. Balloon valvuloplasty is more often performed for mitral stenosis and aortic stenosis.

In a balloon valvuloplasty, a small catheter holding an expandable balloon is threaded into the heart and placed into the tightened valve. Next, the balloon is expanded to stretch open the valve and separate the leaflets.

In some cases the valve cannot be successfully treated by balloon valvuloplasty, and a different surgical treatment is needed to open the valve and allow better blood flow.

Treatment results can vary depending on the experience and training of your medical care teams. Hospitals can become very proficient at managing care around certain conditions. When a valve problem is complex, it is very important to choose anexperienced team to do the repair.

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What Is A Leaky Heart Valve

The heart has four valves. They include:

  • tricuspid valve
  • mitral valve
  • aortic valve

The valves consist of flaps that open to let blood flow in one direction as it moves through the chambers of the heart. Then the valves close to keep blood from flowing backwards into the chamber it just left. Each valve typically has three flaps, except for the mitral valve, which has two.

Any of the four valves can become leaky. This means that just after the heart squeezes and pumps blood forward, some blood will leak backward through the valve. Leaking through the valve is also called valve regurgitation.

What Are Heart Valves

The heart consists of 4 chambers2 atria and 2 ventricles . Blood passes through a valve as it leaves each chamber of the heart. The valves prevent the backward flow of blood. They act as one-way inlets of blood on one side of a ventricle and one-way outlets of blood on the other side of a ventricle. The 4 heart valves include the following:

  • 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.

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Keyhole Heart Surgery That Closes Leaky Valves Available In England

Surgery which seals leaky heart valves using a tiny clip will now be available across the NHS, after the rollout of the life-saving procedure was suspended due to the pandemic.

Mitral valve disease results in the narrowing or leaking of the valve which keeps blood flowing in the right direction in the heart.

Symptoms include breathlessness, heart palpitations and swollen ankles, but if left untreated the condition can lead to blood clots, stroke and heart failure.

MVD affects thousands of people in the UK and standard treatment involves invasive open heart surgery, which some patients are considered too weak to undergo.

But an alternative, less-invasive, form of keyhole surgery, Trans-catheter Edge to Edge Repair , will now be available to patients across the NHS.

The two-hour procedure involves attaching a tiny clip, guided through a vein in the groin, to the heart valve to seal the leak.

Around 70 per cent of patients who undergo TEER find their symptoms improve and are able to return to normal daily activities.

In 2019 just three sites in England were offering the surgery, Bristol Royal Infirmary, Royal Brompton and Wythenshawe Hospital, Manchester.

Minimally Invasive Heart Valve Surgery

Cardiologist Q& A: Do Leaking Heart Valves Require Surgery?

Valve disease treatment has improved dramatically over the past 15 years. Today, UT Southwestern is one of a handful of centers in the US where a surgical replacement or repair of a heart valve is possible without cracking the chest.

Using a mini-thoracotomy approach, Dr. Doolabh is able to repair or replace a valve through a small 2-inch incision between the ribs without cutting through the breastbone . As a result, recovery time is reduced to 10 days versus six weeks for traditional open surgery. Dr. Doolabh has performed more of these surgeries than any other surgeon in Texas and in a new -state-of-the-art hospital, UT Southwestern continues to lead the field in cardiology and heart surgery as the 14th-ranked program nationally, according to U.S. News & World Report.

Through minimally invasive surgery, we need to make only a 2-inch incision to repair or replace a valve, and the recovery time is reduced to 10 days versus six weeks for traditional open surgery. Weve performed more of these procedures than others in North Texas, and UT Southwestern is leading the advancement of additional new treatments.

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How Is Heart Valve Disease Diagnosed

If you are having symptoms, your doctor will suggest doing some tests to see how your heart is working.

The most common test is an echocardiogram. Your doctor might also suggest a chest x-ray or an ECG .

If you arent having symptoms, your doctor can still pick up signs of possible problems with your heart if they listen to the rhythm of your heart. If your doctor hears a murmur , they may refer you for further tests to see how your heart is working.

Risks Of An Aortic Valve Replacement

An aortic valve replacement is a big operation and, like any type of surgery, carries a risk of complications.

Some of the main risks of an aortic valve replacement include:

  • wound, lung, bladder or heart valve infections
  • a temporarily irregular heartbeat
  • reduced kidney function for a few days

The risk of dying from an aortic valve replacement is around 2%, although this risk is much smaller than that of leaving severe aortic valve problems untreated.

Most people who survive surgery have a life expectancy close to normal.

Read more about the risks of aortic valve replacement.

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What To Expect Afterward

Once your heart valve has been repaired or replaced, your doctor will want you to walk, eat, and drink again as soon as possible. But it’ll be a few weeks before you get your energy back.

You may need to follow a special diet. If not, just make sure to eat plenty of “heart healthy” foods like fruits, vegetables, and whole grains.

Exercise is important to get your heart strong again, but you’ll need to slowly build up your activity level and pace.

Most people recover from heart valve surgery over several months. If you don’t need open heart surgery, the time frame could be shorter.

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What Else Should I Ask My Healthcare Provider

Cardiologists repair leaky heart valves without open

To learn more about how a leaky heart valve is affecting you, consider asking your healthcare provider:

  • Which valve is affected?
  • What is causing the leaky valve?
  • What lifestyle changes might help?
  • Should I have a procedure to repair or replace the heart valve?
  • Can I still do all of my normal activities?
  • What is my prognosis?

A note from Cleveland Clinic

A leaky heart valve doesn’t close properly when the heart beats. Heart valve leakage can place extra strain on the heart and cause symptoms or even heart failure. If you have symptoms of a leaking heart valve, talk to your healthcare provider. There are many ways to repair or replace a valve, and lifestyle changes may help.

Last reviewed by a Cleveland Clinic medical professional on 03/09/2021.

References

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