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    Barbara Walters' Heart Surgery

    Heart Specialists Say Procedure Is Common, Outlook Good

    Heart Valve Problems: How They're Detected

    Walters told her viewers that her heart valve problem had been detected during an echocardiogram, the use of sound waves to create a moving picture of the heart.

    Why would a doctor order an echo? "If the doctor heard a murmur during a physical exam, an echo would be the next logical step," Makkar says.

    When the narrowing of an aortic valve progresses, symptoms such as shortness of breath with exertion can occur. Chest pain, fainting, or lightheadedness are other possible symptoms.

    Heart Valve Surgery: The Options

    Heart valve replacement surgery can be done in the conventional way, in which the physician makes an incision, divides the breastbone to get to the heart, and puts the patient on a bypass machine while the heart is stopped and the valve replaced, DeRose tells WebMD.

    ''In general, most isolated valve operations [involving one valve and no other procedure] lasts four to six hours," DeRose says. Makkar says it could be less, perhaps two to four hours.

    ''The operation can also be done minimally invasive,'' DeRose says. This approach does not include dividing the breastbone, but making tiny incisions and inserting a telescope-like device between the ribs to insert the new valve.

    ''Both [approaches] require stopping the heart," DeRose says.

    Another minimally invasive approach, still under investigation, involves inserting a stent with a valve inside, eliminating the need to stop the heart, says Makkar, who is studying this approach. The stent, once in place, pushes aside the native valve and the new valve starts to function.

    The replacement valves can be mechanical (also called synthetic), or tissue, obtained from pigs or cows. With tissue valves, Makkar says, the patient does not need to be on blood thinners long-term.

    "But if you put in a completely artificial, or mechanical, valve, you have to be on Coumadin for a lifetime," Makkar says.

    The plus of mechanical valves, however, is that they last a lifetime, while tissue valves generally have a life expectancy of up to about 15 years, Makkar tells WebMD.

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