Your heart has four valves that keep blood flowing in the correct direction. In some cases, one or more of the valves don't open or close properly. This can disrupt blood flow from your heart to your body and cause symptoms.
If you are experiencing the symptoms of heart valve disease – tiredness, shortness of breath, heart palpitations, dizziness or lightheadedness, fainting and chest pain – your cardiologist may recommend that you undergo an evaluation by a team of multidisciplinary experts from the Summa Health Heart and Vascular Institute Heart Valve Program.
This patient-centered heart valve program allows patients to meet with a geriatrician, cardiologist, cardiothoracic surgeon, and team of specialized nurses all in the same visit. The program is specifically designed to deliver the best possible patient care and convenience while ensuring that multiple specialists can easily work together simultaneously.
Upon being referred into the program, you will undergo a complete physical evaluation and several tests. The Summa Health heart valve team will then discuss your test results and – taking into account your surgical risk – determine the best treatment option to get you back to enjoying life.
The most common heart valve disease treatment options include open-heart valve surgery, non-invasive valve surgery and medical management. The choice of treatment will depend on a variety of factors including the severity of your condition and any other medical problems you may have, your level of function and mobility, and you and your family's wishes.
If you wish to be first evaluated by a Summa Health cardiologist for possible referral into the program, talk to your doctor. A physician referral is needed to be seen in the Summa Health Heart Valve Program.
Open-Heart Valve Surgery
Some patients may be candidates for traditional open-heart valve surgery, whether it be surgical aortic valve replacement (SAVR) or a mitral valve replacement.
Surgical aortic valve replacement (SAVR) is a treatment option for patients diagnosed with severe aortic stenosis, a tightening of the aortic valve in the heart. During the procedure, a cardiothoracic surgeon makes an incision in your chest to access the heart. The length and location of the incision may vary depending on the type of surgical approach selected by your physician. Your damaged or diseased aortic valve will be removed and a new valve will be sewn into place.
There are two main types of new valves:
- Mechanical: Made of man-made materials, such as titanium or carbon, these valves last the longest. Blood-thinning prescription medication or aspirin may be needed for the lifetime of the patient.
- Biological: Made of human or animal tissue, these valves may last 10 to 20 years. Lifetime blood-thinning medication may NOT be needed.
SAVR has risks and potential complications, just as any other major surgery. These include blood clots, bleeding, infection, irregular heartbeats, and stroke. If you are not an ideal candidate for open-heart surgery, you may be considered for transcatheter aortic valve replacement (TAVR), a minimally invasive treatment option. TAVR may be a better and safer treatment option for patients who are elderly, frail, deconditioned or have other health problems.
After valve replacement surgery, your doctor may recommend that you participate in cardiac rehabilitation, a program of education and exercise designed to help you improve your health and help you recover after open heart surgery.
If you wish to be first evaluated by a Summa Health cardiologist for possible referral into the program, talk to your doctor. A physician referral is needed to be seen in the Summa Health Heart Valve Program.
Non-Invasive Valve Surgery
The majority of Summa Health patients with aortic stenosis are candidates for transcatheter aortic valve replacement (TAVR), which offers a faster recovery than SAVR. Mitral clip, another minimally invasive surgical approach, also may be a preferred strategy over surgical mitral valve replacement for some patients.
Transcatheter Aortic Valve Replacement (TAVR)
Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that replaces narrowing heart valves (aortic stenosis) without open heart surgery. It’s often a better and safer treatment option for patients who are elderly, frail, deconditioned or have other health problems. Although, recent research is beginning to show promise for this procedure in younger patient populations.
Summa Health System – Akron Campus was the first hospital between Cleveland and Columbus to offer this minimally invasive approach and has completed more than 500 procedures to date.
Much like a heart stent, TAVR uses a catheter to guide a new aortic valve within a person’s heart. The catheter – a small flexible and hollow tube – is used to implant a new aortic valve in the heart. Most commonly, a small opening is made in the large artery at the top of the leg and the catheter is then used to deploy, or expand, the new valve inside the old non- functioning valve. If the large artery at the top of the leg cannot be used, a small incision can be made through the chest wall to implant the new valve.
If it is determined a TAVR is the best treatment, members of the heart valve procedural team will work shoulder-to-shoulder sharing various parts of this highly technical procedure. The heart valve team is comprised of specially trained and certified cardiothoracic surgeons, interventional cardiologists, imaging specialists, cardiovascular anesthesiologists, and other highly skilled cardiac professionals.
The procedure is performed in The Richard M. and Yvonne Hamlin Hybrid Operating Room Suite located at the Summa Health System Akron Campus by a cardiothoracic surgeon. The hybrid OR suite combines the functionality of a traditional operating room, a cardiac catheterization lab and an electrophysiology lab in a single spacious surgical suite, and is specifically designed for performing TAVR and other procedures which require multiple specialists to work together simultaneously
Since it is unnecessary to open the patient’s chest to perform the TAVR procedure, patients often return home after one day of hospital-based observation and care.
Mitral Clip
Transcatheter mitral valve repair, or mitral clip, is a minimally invasive procedure that can be an option for patients with mitral regurgitation. Mitral regurgitation occurs when the mitral leaflets or flaps inside the valve do not close properly and blood flows from the main pumping chamber of the heart (left ventricle), back through the mitral valve, and back into the top left chamber of the heart (left atrium). This extra strain can enlarge and weaken the heart leading to a condition called congestive heart failure in which the heart cannot pump enough blood to keep up with the demands of the body. Symptoms may include shortness of breath, swelling, abnormal weight gain, fatigue, irregular heartbeats, and cough.
Unlike surgery, the mitral clip procedure does not require opening the chest and temporarily stopping the heart. It is best suited for patients that are too high risk or too deconditioned for an open heart surgery.
A thin tube or catheter is passed through a large vein in the upper leg to reach the heart. A clip is placed in the center of the mitral valve to reduce the mitral regurgitation. The valve continues to open and close allowing blood to flow on either side of the clip. The hospital stay for this procedure ranges from 1-3 days depending on your recovery and overall health. Benefits of this type of surgery include a shorter hospital stay, fewer complications, decreased post-operative pain and quicker recovery.
Medical Management
There are currently no medications that can cure or delay the progression of heart valve disease. Typically, medical management of patients who are unable to undergo surgery focuses on making them feel more comfortable, as well as on reducing cardiovascular risk factors such as hypertension, diabetes, smoking, high cholesterol and obesity. These medications may include statins, beta blockers or anti-hypertensive treatments.