Heart Valve Disease Program

Aortic valve stenosis is the most common valve condition and occurs with aging. It is more common in men than in women and is most frequently seen in people over age 75. In some cases, people are born with aortic valves that contain only 2 flaps, known as a bicuspid valve, and this population often experiences aortic stenosis at a younger age. The thickening of the aortic valve occurs with a build-up of calcium in the valve itself. This thickening makes a smaller opening for the blood to leave the heart, forcing the heart to work harder to pump the blood through the body.

Aortic Valve Regurgitation, or aortic valve insufficiency, is when the three flaps of the valve do not close correctly. This allows blood to flow back into the heart instead of out to the body. This can cause the heart to stretch and enlarge to accommodate the extra volume of blood, which can eventually lead to heart failure. There are chronic and acute versions of aortic regurgitation. With chronic aortic regurgitation, the symptoms usually build over time. But acute aortic regurgitation occurs suddenly and can be caused by a heart infection or a ruptured heart or aorta from a trauma, such as a car accident.

Aortic stenosis cannot be cured or improved with medication. But your physician may prescribe medications to manage symptoms and limit the risks of other cardiac events.

For patients with mild or moderate aortic stenosis and/or minimal symptoms, your doctor may recommend waiting for any interventions and continue monitoring the disease progression with regular testing, such as annual echocardiograms.

Transcatheter Aortic Valve Replacement (TAVR), sometimes called Transcatheter Aortic Valve Implant (TAVI) is a minimally invasive procedure to replace the aortic valve without surgery. The physician accesses an artery, usually the femoral artery near the groin, and threads a catheter up to your heart. The valve replacement is fed through the catheter and deployed inside the existing aortic valve. Patients usually remain in the hospital overnight and go home the following day.

This procedure is done in the Cardiac Cath lab and is done to help open a stiff aortic valve and provide short term symptom relief. A small catheter is threaded through the arteries, often starting in the femoral artery near the groin. The catheter has a balloon at the end of it which is inflated inside the valve. This widens the valve, and then the balloon is deflated and removed through the catheter.

In this heart surgery, performed by a cardiac (heart) surgeon, the heart is accessed minimally invasively utilizing robotics or through an open incision down the center of the chest, depending on the individual situation. The cardiac surgeon then replaces the aortic valve. The minimally invasive recovery time is longer than the TAVR recovery. The open-heart surgical procedure recovery is longer than both the minimally invasive and TAVR approaches. However, for some patients with severe aortic stenosis, open-heart surgery may be the most appropriate procedure. It is also an important option for people not eligible for TAVR due to their individual cardiovascular anatomy or other existing health conditions.

 With mitral valve regurgitation, the two flaps don’t come together to seal properly, causing blood to flow backwards from the left ventricle to the left atrium. To make up for the backwards blood flow, the heart has to work harder to do its job, which eventually results in fatigue, shortness of breath and even heart failure. Mitral valve regurgitation can happen slowly over time or as a result of an enlarged heart from another heart condition, such as heart failure or a heart attack.

Aortic stenosis cannot be cured or improved with medication. But your physician may prescribe medications to manage symptoms and limit the risks of other cardiac events.

For patients with mild or moderate aortic stenosis and/or minimal symptoms, your doctor may recommend waiting for any interventions and continue monitoring the disease progression with regular testing, such as annual echocardiograms.

This procedure is done in the Cardiac Cath lab. A small catheter is threaded through the femoral vein near the groin and up to the heart. The physician then attaches the MitraClip® to both flaps to decrease the size of the opening and limit the amount of blood that flows backwards through the mitral valve.

In this heart surgery, performed by a cardiac surgeon, the mitral valve is repaired or replaced by accessing it from outside the heart. This can be done as an open procedure, where the chest it cut open down the sternum, or as a minimally-invasive, robotically-assisted approach which does not require the sternum to be cracked. The cardiac surgeon works with each patient to identify the most appropriate procedure for their situation.

During the robotic-assisted surgery, the procedure is done in the main operating room utilizing the da Vinic robotic system. The heart surgeon makes 5 small incisions in the chest through which the small camera and robotic arms are inserted. This allows the surgeon to see the heart clearly to perform the operation in a minimally invasive way. The robotic arms do not move on their own, but they are completely controlled by the surgeon through the. Learn more about Riverside’s robotically assisted cardiac surgery program.

This procedure is done in the Cardiac Cath lab and is done to help open a stiff mitral valve. A catheter is threaded through the arteries, often starting in the femoral artery near the groin. The catheter has a balloon at the end of it which is inflated inside the valve. This widens the valve, and then the balloon is deflated and removed through the catheter.