Balloon Valvuloplasty.
Heart valves that don't open fully can be repaired with surgery or with a less invasive catheter procedure called balloon valvuloplasty. This procedure also is called balloon valvotomy.
During the procedure, a balloon-tipped tube is threaded through your blood vessels and into the faulty valve in your heart. The balloon is inflated to help widen the opening of the valve. Your doctor then deflates the balloon and removes both it and the tube.
You're awake during the procedure, which usually requires an overnight stay in the hospital. Balloon valvuloplasty relieves many of the symptoms of heart valve disease, but it may not cure it. The condition can still worsen over time. You may need medicines to help with symptoms or surgery to repair or replace the faulty valve.
Balloon valvuloplasty has a shorter recovery time than surgery. For some patients who have mitral valve stenosis, it may work as well as surgical repair or replacement. For these reasons, balloon valvuloplasty usually is preferred over surgical repair or replacement for these people. Balloon valvuloplasty doesn't work as well as surgical treatment for adults who have aortic valve stenosis.
Balloon valvuloplasty often is used in infants and children. In these patients, valve stenosis is caused by a congenital defect that can be repaired by a one-time procedure.
Replacing Heart Valves
Sometimes heart valves can't be repaired and must be replaced. This surgery involves removing the faulty valve and replacing it with a man-made valve or a biologic valve.
Biologic valves are made from pig, cow, or human heart tissue and may have man-made parts as well. These valves are specially treated, so no medicines are needed to stop the body from rejecting the valve.
Man-made valves are more durable than biologic valves and usually don't have to be replaced. Biologic valves usually have to be replaced after about 10 years, although newer biologic valves may last 15 years or longer.
Unlike biologic valves, however, man-made valves require you to take blood-thinning medicines for the rest of your life. These medicines prevent blood clots from forming on the valve. Blood clots can cause a heart attack or stroke. Man-made valves also raise your risk for endocarditis.
You and your doctor will decide together whether you should have a man-made or biologic replacement valve. If you're a woman of childbearing age or if you're athletic, you may prefer a biologic valve so you don't have to take blood-thinning medicines. If you're elderly, you also may prefer a biologic valve, as it will likely last for the rest of your life.
Other Approaches for Repairing and Replacing Heart Valves
Some newer forms of heart valve repair or replacement surgery are less invasive than traditional surgery. These procedures use smaller incisions to reach the heart valves. Hospital stays for these newer types of surgery are usually 3 to 5 days, compared to 5 day stays for traditional heart valve surgery.
New surgeries tend to cause less pain and have a lower risk of infection. Recovery time also tends to be shorter—2 to 4 weeks versus 6 to 8 weeks for traditional surgery.
Some cardiologists and surgeons are exploring procedures that use cardiac catheterization to thread clips or other devices in a tube through your blood vessels and into the faulty valve in your heart. The clips or devices are used to reshape the valve and stop the backflow of blood. It's not yet known how effective these procedures are.
The Ross operation is a surgical procedure to treat faulty aortic valves. During this operation, your doctor removes your faulty aortic valve and replaces it with your pulmonary valve. The pulmonary valve is then replaced with a pulmonary valve from a deceased human donor.
This is more involved surgery than typical valve replacement, and it has a greater risk of complications.
The Ross operation may be especially useful for children because the surgically replaced valves continue to grow with the child. Also, lifelong treatment with blood-thinning medicines isn't required. But in some patients, one or both valves fail to work properly within a few years of the surgery. Experts continue to debate the usefulness of this procedure.
Serious risks from all types of heart valve surgery vary according to your age, health, the type of valve defect(s) you have, and the surgical procedure(s) performed.