Heart Valve Disease Treatment
What Are the Pros and Cons of Each Type of Heart Valve?
- Mechanical heart valves. The advantage to mechanical heart valves is their sturdiness. They are designed to last for many years. There are also drawbacks. Due to the artificial material involved, people who receive these valves will need to take life-long blood-thinner medication (anticoagulants) to prevent clots from forming in the mechanical valve. These clots can increase the risk for a stroke. Also, some people report a valve ticking sound that is usually not bothersome. It is the sound of the valve leaflets opening and closing.
- Biological heart valves. The advantage of biological heart valves is that most people do not need to take life-long blood thinners, unless they have other conditions (such as atrial fibrillation) that warrant it. Biologic valves, traditionally, were not considered as durable as mechanical valves, especially in younger people. Previously available biologic valves usually needed to be replaced after about 10 years. However, some studies show that some biologic valves may last at least 17 years without decline in function. This represents a new milestone in the durability of biologic valves.
- Homograft heart valves. Homografts are ideal heart valves for aortic valve replacement, especially when the aortic root is diseased or there is infection. The heart's natural anatomy is preserved and patients do not need to take life-long blood thinners. However, the limited availability is a drawback in some settings.
Are There Non-Surgical Options for Heart Valve Disease?
Yes. Balloon valvotomy is used to increase the opening of a narrowed (stenotic) heart valve. It is used for select patients who have mitral valve stenosis (narrowing of the mitral valve) with symptoms, select older people who have aortic stenosis (narrowing of the aortic valve) but are not able to undergo surgery, and some patients with pulmonic stenosis (narrowing of the pulmonic valve).
What Happens During Balloon Valvotomy?
During a balloon valvotomy, a specially designed catheter is inserted into a blood vessel in the groin and guided to the heart. The tip is directed inside the narrowed heart valve. Once there, a tiny balloon is inflated and deflated several times to widen the valve opening. Once the cardiologist is satisfied the valve has been widened enough, the balloon is removed.
During the procedure, the cardiologist may perform an echocardiogram (ultrasound of the heart) to get a better picture of the valve.
New non-surgical procedures to treat valvular disease, such as transcatheter aortic valve replacement (TAVR), are being tested and may provide additional treatment options using a catheter for valve disease in the future.