Heart Valve Disease

The normal heart valve performs an amazing mechanical function, opening and closing with each beat of the heart, about 40 million times per year for an entire lifetime. In a lifetime, that is over 2.5 billion times, generally without failure. There are times when heart valves may not work properly. In children there may be congenital defects at birth that sooner or later result in valve malfunction. Certain diseases, such as rheumatic fever, can damage the valves enough that they will eventually need to be repaired or replaced.

Age can also result in stiffening or deposition of calcium on the valve, which may also require repair or replacement. Today valve surgery can correct these problems and restore the function of diseased valves, thus restoring health in many patients.

When a valve malfunctions, three things may happen:

  1. The valve does not open all the way, restricting the forward flow of blood (called stenosis).
  2. The valve does not close properly, allowing blood to flow backwards (called regurgitation or insufficiency).
  3. The valve neither opens nor closes properly, causing a combination of numbers 1 and 2 above.

Often patients with early or mild forms of valve disease live a fairly normal life without treatment. In some cases, treatment with various types of drugs may be all that is required. When symptoms such as dizziness, fatigue, shortness of breath or chest pain become significant enough to affect daily life, surgical treatment must be considered.

Treatment of Valve Disease

For some patients, the existing natural valve will need to be replaced by a prosthetic valve (manufactured heart valve). In other cases, surgical repair of the natural valve can be successfully performed. Your physician will explain your case and the options you have in your upcoming surgery.

If your physician recommends a prosthetic heart valve, there are two possibilities. They are mechanical prostheses (valves) and tissue prostheses (valves) as described below and featured in Figure 3.

Figure 3. Mechanical and tissue valve prosthesis examples

Mechanical Valves

On-X Prosthetic Heart Valve

Stented Tissue Heart Valve

Stentless Tissue Heart Valve

There are many good options for heart valve replacement. Each patient will need to review the options with their surgeon and cardiologist to decide which is best for them. Your heart condition, general health, size, age, sex and activity level will all contribute to your decision. These factors are discussed following a review of all replacement options.