Valve Surgery

Depending on a patient’s individual circumstances, heart-valve disease can be treated in a variety of ways – including heart-valve surgery. Over the past few years, great advances have been made in the surgical treatment of diseased heart valves. The diagnostic tests available at the Swedish Heart & Vascular Institute help to identify the location, type and extent of valve disease. The results of these tests, the structure of the heart, and the patient’s age and lifestyle will help determine the best possible procedure. If surgery is indicated, a surgeon may decide to repair the valve. Or, the heart valve may need to be replaced instead of repaired. There are a number of different types of valve surgery, including surgery of the aortic valve, the mitral valve and the tricuspid valve.

Aortic valve surgery

During aortic valve surgery, the aortic valve may be either repaired or replaced – with that decision based on the results of diagnostic tests, the structure of the heart, the patient’s age and medical condition, and other factors. In addition, aortic valve surgery can be performed using traditional heart valve surgery or a minimally invasive approach.

Though the aortic valve is usually replaced, repair may be an option for some patients. Types of repair include:

• Bicuspid aortic valve repair (the valve between the left atrium and left ventricle)
• Repair of an enlarged aorta (the main artery of the heart)
• Repair of valve tears or holes

If circumstances dictate that the aortic valve needs to be replaced, a Swedish cardiac surgeon may select from a variety replacement valves, both mechanical (man-made) and biological (from a living creature).

Specific patient characteristics and medical history determine the type, which include:

• Biological valve replacement
• Homograft (obtained from a human donor) aortic valve replacement
• Mechanical valve replacement
• Aortic stentless valve replacement

Mitral valve repair

The mitral valve, which is one of four valves within the heart, lies between the left atrium and the left ventricle. Mitral valve repair is an optional surgical procedure of choice for patients with a leaky valve (mitral regurgitation). When the leak is caused by a degenerative valve disease such as mitral valve prolapse, the valve can be repaired – rather than replaced. Also, valves affected by mitral annual calcification (MAC) or endocarditis may be repaired.

Tricuspid valve surgery

The role of the tricuspid valve is to make sure blood flows in a forward direction through the heart, from the right atrium to the left ventricle. People with tricuspid valve disease will generally have one of two problems: tricuspid regurgitation, when the valve is leaky or doesn’t close tight enough, causing blood to leak backward across the valve, or tricuspid stenosis, when the valve leaflets are stiff and do not open widely enough, causing a restriction in the forward flow of blood. Tricuspid valve disease may be tolerated for a long time without any symptoms – but when the disease is severe, it may be necessary to repair or replace the valve. Surgeons at Swedish specialize in this procedure.