Valvular Heart Disease

Valvular heart disease is the leading cause of heart failure and occurs when any valve in the heart has damage or is diseased.

About Valvular Heart Disease

The heart has four chambers, with two collecting chambers (atria) and two pumping chambers (ventricles). A normal heart had four chambers and four valves. The valves open and close to control the flow of blood into and away from the heart. Valvular heart disease occurs when any of these values are damaged or diseased, causing them to not function properly.

Healthy heart valves are able to fully open and close during the heartbeat, but diseased valves can become “leaky,” allowing blood to leak back into the heart chamber where they do not fully open and close. This reduces forward blood flow and may prevent your heart from efficiently pumping blood to the rest of your body. Damaged heart valves can become narrow and stiff, restricting the flow of blood. This forces the heart to work harder to pump blood through the narrowed or stiff valve and out to the rest of the body.

The two main types of valvular heart disease include:

• Aortic Stenosis: Occurs when there is a narrowing of the aortic valve opening
• Mitral Regurgitation: Occurs when the mitral valve does not close completely, allowing blood to flow backward into the left atrium

Symptoms of Valvular Heart Disease

Symptoms vary depending on the severity of the damage or disease.

Symptoms of valvular heart disease may include:

• A bluish color at the lips or fingers
• Chest pain
• Dizziness with exertion
• Fatigue
• Irregular heartbeats or palpitations
• Low blood pressure
• Passing out
• Shortness of breath
• Tiring easily during exercise (for babies, this includes during feeding)

Diagnosing Valvular Heart Disease

During physical examinations, the doctor listens to the patient’s heart and lungs and may detect a heart murmur, which are extra sounds heard throughout the cardiac cycle due to increased blood flow. If your doctor suspects obstructed blood flow, a recommendation to see a cardiologist may be made.

Tests performed when diagnosing valvular heart disease may include:

• Cardiac Catheterization: During cardiac catheterization, a small catheter (thin tube) is inserted into a larger blood vessel, typically in the groin, and guided to the heart where blood pressure and oxygen measurements can be taken in the aorta and pulmonary artery as well as the four chambers of the heart. A dye can also be injected through the tube to make the heart’s structure more visible on an X-ray.
• Cardiac MRI or CT Scan: A cardiac MRI or CT scan is used to take more detailed images of the heart to help define the anatomy and detect anomalies.
• Chest X-Ray: A chest X-ray produces an image of the tissue and bones in the heart and lungs and helps your provider assess the shape, size, and structure of the heart and lungs as well as the aeration of or any congestion in the lungs.
• Echocardiogram: An echocardiogram uses ultrasound technology to create a moving image of the heart and its valves, allowing your provider to assess the structure and function of the heart. An echocardiogram also helps provide information about blood flow and how well the heart is pumping blood.
• Electrocardiogram (ECG or EKG): An electrocardiogram uses electrodes that are placed on the body to record the electrical activity taking place in the heart. An ECG/EKG test helps detect abnormal rhythms, such as cardiac arrhythmias, stress on the heart, and damage to the heart muscles.

Treating Valvular Heart Disease

Treatment options vary based on age, health, medical history, and the severity of the heart’s damage or disease. As the condition becomes more severe, your doctor may recommend valve replacement or repair. This procedure can be performed using either open-heart surgery or minimally invasive surgery, which involves accessing the valve via an artery in the groin under monitored anesthesia.

Treatment options for valvular heart disease may include:

• Balloon Valvuloplasty: Using the cardiac catheterization method, a small tube can be inserted through a blood vessel in the groin and guided to the heart. A balloon can be pushed through the tube and inflated in the aortic valve to stretch the narrow portion. A stent may be added after the balloon is removed to ensure the aorta stays open.
• Valve Replacement: The aortic valve can be surgically replaced with a biological valve made from animal tissue or a mechanical valve. The pulmonary valve and a portion of the pulmonary artery from the patient (Ross procedure) or an aortic valve from a donor can also be used to replace the valve and part of the aorta.
• Valvotomy: The aortic valve can be opened directly by incising into it.

After treatment, the patient will need time to rest and recuperate at home, and activities may be limited. Patients will be guided through a personalized rehabilitation program to help safely and effectively build strength and endurance and regain physical abilities. Once the patient's cardiologist approves, they should be able to resume normal activities.

Care Team Approach

Patients are cared for by a dedicated multidisciplinary care team, meaning the patient will benefit from the expertise of multiple specialists across a variety of disciplines. Our board-certified and fellowship-trained heart surgeons have extensive experience treating patients with heart disease and vascular disorders and work alongside a team of cardiac experts, including cardiologists, interventional cardiologists, electrophysiologists, critical care specialists, hospitalists, anesthesiologists, perfusionists, nurses, advanced practice providers, social workers, psychologists, child life specialists, dietitians, physical and occupational therapists, pharmacists, and more, providing unparalleled care for patients every step of the way. We collaborate with our colleagues at the Dell Medical School and The University of Texas at Austin to utilize the latest research, diagnostic, and treatment techniques, allowing us to identify new therapies to improve treatment outcomes. We are committed to communicating and coordinating the patient’s care with referring physicians and other partners in the community to ensure that we are providing comprehensive, whole-person care.

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