Diseased heart valves can be treated both surgically (traditional heart valve surgery) and non-surgically (balloon valvuloplasty).
During traditional heart valve surgery, a surgeon will make an incision down the center of the sternum (breastbone) to get direct access to the heart. The surgeon then repairs or replaces an abnormal heart valve or valves.
During minimally invasive heart valve surgery, the surgeon performs the procedure through smaller incisions which reduces blood loss, trauma, and length of hospital stay.
The most commonly repaired heart valve is the mitral valve, but the aortic, pulmonic, and tricuspid valves may also undergo some of these repair techniques:
- Commissurotomy (fused valve leaflets or flaps are separated to widen the valve opening)
- Decalcification (calcium deposits are removed to allow the leaflets to be more flexible and close properly)
- Reshape leaflets (a segment may be cut out and the leaflet sewn back together, allowing the valve to close more tightly if one of the leaflets is floppy – quadrangular resection)
- Chordal transfer (the chordae are transferred from one leaflet to the other and the leaflet where the chordae was removed is repaired by quadrangular resection if a leaflet of the mitral valve has prolapsed)
- Annulus support (valve annulus (the ring of tissue supporting the valve) it may be reshaped or tightened by sewing a ring structure (made of tissue or synthetic material) around the annulus if it’s too wide)
- Patched leaflets (the surgeon may use tissue patches to repair any leaflets with tears or holes)
- The advantages of heart valve repair surgery include decreased the need for life-long blood thinner (anticoagulant) medication and preserved heart muscle strength
A non-surgical option for valve disease is balloon valvotomy which is used to increase the opening of a narrowed (stenotic) heart valve.
It is used for select older people who have aortic stenosis (narrowing of the aortic valve) but are not able to undergo surgery, patients who have mitral valve stenosis (narrowing of the mitral valve) with symptoms, and some patients with pulmonic stenosis (narrowing of the pulmonic valve).
During the procedure, a specially designed catheter is inserted into a blood vessel in the groin and guided to the heart. Once inside the narrowed heart valve, a tiny balloon is inflated and deflated several times to widen the valve opening.