Valve Disease

The Valve Center of Excellence at the Florida Hospital Cardiovascular Institute

The Florida Hospital Cardiovascular Institute excels at the repair and replacement of heart valves. Recognized around the world for the volume of procedures performed, expertise and success, valve surgery has become a routine practice at our Institute. We treat more cardiac patients than any other hospital in the nation. Between 2004 and 2006, our surgeons repaired or replaced more than 1,500 valves. Our award-winning cardiac care program has also earned its solid reputation as a comprehensive training facility for visiting surgeons across the country and all over the globe.

What is heart valve disease?
Whether present at birth or developing later in life, any deterioration in the function of the heart’s four valves is called valve disease.  When the opening of a heart valve is narrowed and restricts blood flow, the condition is known as stenosis. When valves stiffen, weaken or deform, causing leakage between the heart’s chambers, the condition is called insufficiency (or regurgitation). When present individually or in combination, these conditions can seriously affect blood flow to all parts of the body.

Your heart contains four valves that work in coordination to control the flow of blood in your heart. There is a single valve in each half of the heart – the tricuspid valve and the mitral valve – as well as the aortic and pulmonic valves that receive and send blood through your blood vessels. Each of these heart valves plays a key role in maintaining the one-way directional flow of blood and as the pressure changes behind and in front of the valve, its flap-like door (or leaflet) opens at precisely the right time and then closes tightly to prevent a backflow of blood. If left untreated, valve disease can affect your quality of life or even become life threatening.

Most people with heart valve disease experience a number of warning signs including:

Shortness of breath - Usually when active, but often when lying down

Dizziness - Fainting, light-headedness, disorientation

Weakness - Excessive fatigue, even with normal activity

Chest pressure - A feeling of weight or pressure in the chest when active

Palpitations - Racing heart, odd “flip-flop” sensations

Swelling - Ankles, feet or abdomen

Rapid weight gain - Up to several pounds in one day

The severity of symptoms may not be an accurate barometer of your condition. Some patients with serious valve disease show few symptoms. It’s extremely important to follow up with your doctor if you experience any of the issues listed above and an echocardiogram should be done to access valve function.

What treatment options are available?

The three main goals of effective treatment of heart valve disease: 

  • Protect valves from further damage
  • Lessen the severity of symptoms
  • Repair or replace valves

Medications
Various medications can be effective in treating pain, slowing the rate of progression or resolving other symptoms, but none have been shown to actually cure heart valve disease or repair its damage as it is a “mechanical” process.

You may be prescribed a number of medications designed to make it easier for your heart to do its job.  Medications can help remove excess fluid from the body, control heart rhythm, treat high blood pressure and reduce the possibility of blood clots forming on the valve’s surface.

Surgery
Not all cases of heart valve disease require surgery.  If your condition is stable or only minimally affects your day to day life, medication and monitoring is often the preferred course of action. Depending on the nature and severity of your condition though, your physician may recommend some form of surgery that involves either repair or replacement of the affected valve.  It’s now a safe and effective procedure in institutions that specialize in valve surgery with large volumes.

All four heart valves are different and each has specific requirements for repair or replacement.  Wherever possible, repair is the preferred option, providing a normal functioning long term valve.  If necessary, valves may be replaced with bioprosthetic valves (tissue valves) or prosthetic valves (mechanical valves).  Valve options should be discussed at length with your surgeon to determine what is right for each individual patient.

Edwards SAPIEN Transcatheter Aortic Valve Replacement (TAVR)

The Florida Hospital Cardiovascular Institute has been selected as one of the first sites to offer the recently FDA-approved Edwards SAPIEN Transcatheter Aortic Valve Replacement (TAVR) as a treatment option for patients with inoperable, severe, symptomatic aortic valve stenosis.

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Aortic valve disease is characterized by a damaged and dysfunctional aortic valve. The aortic valve is one of four valves that control the flow of blood into and out of the heart.
The mitral valve is positioned on the left side of the heart between the upper and lower chambers. This valve prevents blood from going into the left ventricle as blood is pumped into the aorta.  When the valve doesn’t close tightly, leaks, or doesn’t open adequately (stenosis), the condition is known as mitral valve disease. Left untreated, mitral valve disease can lead to heart failure.Symptoms can include: Shortness of breath, palpitations in the chest, chest pain, severe swelling, fainting or light headedness, abdominal pain, increased wet coughing, decreased endurance, lethargy and the onset of irregular heart rhythms.
Located between the upper and lower chambers of the right side of the heart, the tricuspid valve can either become narrower or not close fully, causing the valve to either allow blood to leak back into the atrium or not pump sufficient amounts of blood. Left unchecked, this can lead to heart failure. Tricuspid disorders can also increase the risk of endocarditis, a condition in which the tissues lining the inside of the heart and valves become infected and destroyed.Symptoms can include (and often they are not present) a fluttering sensation in the neck or chest due to irregularities in the rhythm of your heart, pressure in the upper abdomen because of an enlarged liver, fatigue and swelling.
Relatively rare, pulmonic valve disease is usually present at birth. The valve that regulates the flow of blood between the heart’s lower right chamber and the pulmonary artery is too narrow. As such, the flow of blood is reduced from the heart to the lungs, where the blood picks up oxygen.Symptoms can include: If symptoms are present (and most times they are not), they include shortness of breath, fatigue, chest pains, fainting, a bluish tint to the skin and a heart murmur.