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Valvular heart disease occurs when heart valves don't work as well as they should because of problems caused by disease, aging or a birth defect. Problems can include valves that do not open properly caused by a narrowing (stenosis), or weak valves that do not close properly, which result in the blood flowing back from where it just came (regurgitation).
Diseases of the heart valves are classified according to the specific valve involved and the type of valve defect. The most common abnormalities are: mitral stenosis, mitral regurgitation, aortic stenosis, and aortic regurgitation. Any problem with a valve makes the heart work harder, and to make up for this extra workload the heart may get larger. When the heart can no longer pump adequately, heart failure may occur and unmanaged heart failure may lead to needing a VAD or heart transplant.
How is it diagnosed?
The diagnosis of valvular heart disease is usually performed by one of the following tests:
- Physical examination - may reveal a murmur, evidence of heart enlargement and fluids within the lungs.
- Electrocardiogram (EKG) - a test that records the electrical activity of the heart and detects heart muscle damage may also reveal arrhythmias and/or chamber enlargement.
- Echocardiography - creates a two-dimensional picture of the cardiovascular system and can also produce accurate assessment of the velocity of blood and cardiac tissue at any arbitrary point using pulsed or continuous wave Doppler ultrasound.
- MRI - can provide clear three-dimensional images of the heart and its valves.
How is it treated?
Treatment for valvular heart disease depends on the type and severity of the diagnosis. People with minor valve problems may not require treatment. Those with more serious disorders can often be treated successfully with medications.
If medications are not successful or a valve condition worsens, interventional procedures and/or surgery may be necessary. These may include heart valve repair or replacement.
A heart valve repair may be done by one of the following procedures:
- Percutaneous balloon valvuloplasty - a non-surgical, catheter-based procedure to treat valvular stenosis.
- Valvulotomy - a type of open-heart surgery in which a surgeon cuts into a valve to repair valvular damage.
- Minimally invasive heart valve surgery - a surgical repair of a defective heart valve is performed through a small incision (3.5 inches) which involves less risk, fewer complications, less bleeding and faster recovery by the patient.
- Heart valve surgery - if heart valve repair is not an option, an open-heart surgery in which biological or mechanical valve is used to replace a defective heart valve may be performed.
How does Advocate Christ Medical Center make a difference?
Advocate Christ Medical Center is at the forefront when it comes to researching and treating the growing problem of valvular heart disease. We participate in numerous clinical trials related to ventricular assist devices and we are a leading center nationally for implanting new experimental heart pumps. We also pioneered robotic mitral valve repair and have expertise in valve-sparing procedures and complex aortic repair in people with aortic disease.
Christ Medical Center performs the most surgeries to correct valvular heart disease of any hospital in the state, and our outcomes consistently top national benchmarks. We are on the leading edge of innovation, as well:
- Christ Medical Center is one of the top five medical centers nationally for ventricular assist device (VAD) surgeries.
- We are the first program in Illinois (second program nationally) to receive Joint Commission disease specific VAD certification.
- We are a leader in the implantation of mechanical assist devices to improve long-term quality of life in patients with end-stage heart failure.
- Surgeons at Advocate Christ Medical Center were the first in Illinois to perform robotically assisted mitral-valve repair surgery.
- Our heart transplantation and mechanical assist devices program features nationally renowned cardiologists and cardiac surgeons.
Because our cardiac surgeons perform more valve surgeries than any hospital in the state, they have a high skill level. This results in excellent clinical outcomes and mortality rates that are consistently below the national average. Our cardiac surgeons perform valve-sparing procedures whenever possible rather than valve replacement. Repair is more surgically complex than replacement, but it allows patients to avoid blood thinners and the complications of prosthetic valves. Also, the need for follow-up surgeries is lower after valve repair, even after several years.
We take a multi-disciplinary approach to treatment and our physician teams meet weekly to discuss patient cases and lay out the best treatment plan. Cardiologists and cardiac surgeons work closely together and communicate openly with each other as well as with referring physicians. The services at Christ Medical Center are ideal for patients with more complicated valvular heart disease as well as for those patients seeking a second opinion. Patients with diseases of the aortic valve, tricuspid valve, and mitral valve are all candidates for care at Advocate Christ Medical Center.
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