Valve Procedures

The heart has four valves that keep blood from flowing in the wrong direction as it travels through the heart. Problems arise when one of the valves in the heart does not work properly.

Valves are like doors between the chambers of the heart. If a valve doesn't open all the way (a condition called stenosis), less blood moves through the "doorway." If the valve doesn't close tightly, blood may leak backwards (called regurgitation). Either problem means that the heart must work harder to pump enough blood. Also, blood might back up in the lungs or in the body because it can't move forward.

Causes of Heart Valve Trouble

• Genetic (inborn) structure problems with the valves
• Infection or rheumatic fever (which can damage valves)
• Degenerative conditions (anything that causes the heart to lose its ability to perform well.)
• Aging

Symptoms of Heart Valve Trouble

When heart valve trouble is present, a physician will probably notice a murmur when listening to the heartbeat. In addition, the patient may notice symptoms such as these:

• Problems breathing when lying down.
• Wheezing, coughing, shortness of breath during exercise
• Walking up at night coughing or short of breath
• Weakness, tiredness
• Dizzy spells, fainting
• Swollen ankles or feet
• Chest pain or pressure

Tests that can help a cardiologist to diagnose valve conditions include echocardiogram, electrocardiogram (ECG), chest x-ray, and cardiac catheterization.

Open-heart valve surgery can repair or replace damaged heart valves. During an open-heart procedure on a valve, the heart is stopped and the blood is circulated through a heart-lung machine. An incision is made in the heart. If the valve is to be repaired, parts of it may be cut and separated to make them open wider, or parts of it may be strengthened or shortened to help the valve close more tightly.

If the valve is to be replaced, the damaged valve is removed, and a new valve is sewn into place. The new valve may be man-made from metals and plastics, it may be a natural valve taken from an organ donor's heart, or it may be a replacement valve from a cow or a pig.

Mechanical valves are more durable, lasting up to 20 years or longer. However, if a mechanical valve is used, the patient must take anticoagulant drugs for the rest of his or her life. If human or animal valves are used, anticoagulants may not be necessary.

At Bridgeport Hospital, valve surgery includes:

• aortic valve replacement with human donor valves
• aortic and mitral valve replacement with mechanical or animal valves
• minimally invasive replacement of mitral and aortic valves
• mitral valve repair
• tricuspid valve repair and replacement