Wednesday, April 17, 2024

Leaking Heart Valve Life Expectancy Without Surgery

Stages Of Aortic Regurgitation

Cardiologists repair leaky heart valves without open-heart surgery

Stage A This is for people who are at risk of developing aortic regurgitation but do not have it yet. This includes patients with bicuspid aortic valve, history of infection on the valve, rheumatic heart disease, and people born with abnormalities of the valve.

Stage B These patients have mild or moderate aortic regurgitation. The heart function is normal and there are no symptoms. The heart is not significantly enlarged.

Stage C These patients still have no symptoms, but the aortic valve is severely leaky. The heart pumps relatively normally, however there is clear evidence of enlargement.

Stage D These patients have both a severely leaky aortic valve and symptoms. The heart is typically significantly enlarged. Symptoms include shortness of breath, particularly on exercise, swelling and fatigue.

An example of severe aortic regurgitation on an echocardiogram.

Why Its Better To Have Your Mitral Valve Repaired Than Replaced

Having your mitral valve repaired before symptoms become severe can increase your longevity. Heres one patients story.

When Thomas Kimble discovered he would need to have his mitral valve repaired, he was happy to get a recommendation from his Florida cardiologist for a surgeon highly skilled in minimally invasive procedures.

This eased the decision for the Florida resident to move forward, even though, like many individuals, he wasnt experiencing symptoms of his mitral valve regurgitation, which may include fatigue, shortness of breath, chest pain and an irregular heartbeat.

In fact, just prior to his November 2020 surgery with Michigan Medicine Frankel Cardiovascular Center surgeon Gorav Ailawadi, M.D., the 68-year-old was hiking at 11,000 feet in Breckinridge, Colorado. I may have felt a little fatigued, but I attributed it to my age, he says.

What Causes Leaking Heart Valves

The condition of leaky heart valves is called valvular insufficiency or valvular regurgitation. In case of a leaky heart valve, the heart valve does not close completely after blood has passed through. This condition can affect one or more heart valves.

Leaking Heart Valves can be of The Following Types:

  • Congenital Valve Disease it is an abnormality which develops before birth. It can be due to irregular size or malformed leaflets. Congenital leaky valves can be of two types:
  • Bicuspid aortic valve disease this condition affects the aortic valve.This condition affects nearly 2% of the entire population.
  • Mitral valve prolapse this condition occurs due to abnormal growth of connective tissues of the mitral valve. MVP causes tissues of leaflets to become stretchy causing the valve to leak.MVP is seen in about 1-2% of population. MVP is frequently seen among athletes.
  • Acquired Valve Disease these are conditions which affect previously normal valves commonly as a result of the following:
  • Infective endocarditis bacterial infection of the heart valves and its lining . It can cause scarring, growths or holes in the heart valves causing them to leak.
  • Rheumatic heart disease occurs as a result of untreated streptococcal infection.
  • Structural changes such as:
  • Degeneration related to advancing age.
  • Calcification seen in people over 6 years of age. Advancing age, high blood pressure and being overweight are some risk factors.
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    What Does Current Guidance Say On This Issue

    2014 NICE guidelines on management of heart failure recommend surgical aortic valve replacement for people with heart failure due to severe aortic stenosis, who are assessed as suitable for surgery.

    NICE recommend transcatheter aortic valve implantation for people who are unsuitable for surgery. This involves accessing the aorta via a catheter inserted into an artery in the groin or chest. However, the risks involved with this procedure mean that it is currently not recommended as an alternative for people otherwise suitable for surgery. This guidance is under review.

    How Is An Aortic Valve Replacement Carried Out

    An aortic valve replacement is carried out under general anaesthetic.

    This means youâll be asleep during the operation and wonât feel any pain while itâs carried out.

    During the procedure:

    • a large cut about 25cm long is made in your chest to access your heart although sometimes a smaller cut may be made
    • your heart is stopped and a heart-lung machine is used to take over the job of your heart during the operation
    • the damaged or faulty valve is removed and replaced with the new one
    • your heart is restarted and the opening in your chest is closed

    The operation usually takes a few hours.

    Youâll have a discussion with your doctor or surgeon before the procedure to decide whether a synthetic or animal tissue replacement valve is most suitable for you.

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    Can A Heart Valve Be Repaired Without Surgery

    If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.

    Heart valve disease, a malfunction of one or more of the valves that allow blood to flow through the heart, affects roughly 2.5 percent of the U.S. population. More than 6 million people live in the Washington area, which means we can expect more than 152,000 people in our community to have some form of heart valve disease. Fifteen percent of people 75 and older have some problem with their heart valves function.

    Symptoms of heart valve disease often build over time and can vary depending on the valve thats affected:

    • Aortic valve: chest pain, shortness of breath and fainting
    • Mitral valve: shortness of breath and swelling of the extremities
    • Tricuspid valve: swollen feet and liver congestion

    Too many people suffer for years with these symptoms, but they shouldnt. We offer advanced treatment options, ranging from medication alone to minimally invasive procedures that dont require opening up the chest at all.

    Repairing Heart Valves Without Surgery

    The Structural Heart and Valve Center at NYP/Columbia has long been a leader in catheter-based treatmentthe least invasive therapyto repair the mitral valve. This valve regulates blood flow between the upper and the lower chambers on the left side of the heart. When it is damaged or defective, blood flows back up into the upper chamber, producing Mitral Regurgitation .

    Patients with MR often have a heart murmur and may suffer from heart palpitations, shortness of breath, fatigue after exertion, and swelling in the feet or ankles. As their valve disease progresses, patients with MR may experience other problems including heart failure, a condition in which the heart cant pump enough blood to meet the bodys needs.

    Because our volume is one of the highest in the country, our Center is one of the first to study and test new devices for heart valve repair and replacement. As a result, our patients benefit from the latest therapies.

    The following clinical trials promise to extend our range of options for patients not fit enough to undergo the rigors of conventional surgery. These catheterbased approaches are also referred to as percutaneous since no surgical incisions are necessary. Another advantage: The patient doesnt have to be placed upon a heart-lung machine during these procedures. Because the following treatments are minimally invasive, they are generally associated with a significantly faster recovery time and a lower overall risk.

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    What Does It Mean To Have A Leaky Heart Valve

    Heart valves are like doors, says Brian ONeill, M.D., an interventional cardiologist at Henry Ford Health. If that door doesnt close completely, blood can leak backward into the heart.

    Leaky heart valves are a relatively common problem, especially in older adults. Over time, they can make your heart work harder, causing serious damage and uncomfortable symptoms.

    Fortunately, leaky valves are treatable. Treatments can help patients get back to living their lives, Dr. ONeill says. Discover the symptoms that could be impacting your life and your treatment options that can have you feeling better, sooner.

    Nyha Class And Quality Of Life

    Leaky heart valve clip video

    A total of 76 of 192 traced patients are in NYHA class 1 and 94 in NYHA class 2 and generally declare an improved quality of life. Nineteen patients are in class 3 with notably restricted activity. One patient has recurrent CHF . Nine patients suffer severe disability and need continuous assistance. Eleven patients experienced 12 embolic events, five of them with permanent damage all had bioprostheses and two were on warfarin. Two patients have angina, one patient had a gastric haemorrhage and five received a pacemaker. There was one acute endocarditis. Warfarin is consumed by one-fourth of the patients.

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    Heart Valve Problem And Pregnancy

    Heart valve problem in moderate or mild form at the time of pregnancy is easily manageable with complete bed rest or proper medicines. A pregnant woman should make sure to take proper care, so that the disease does not pose any heightened risk to the fetus or the mother. Doctors opt to treat a majority of heart valve condition by prescribing a few safe medicines to intake at the time of pregnancy.

    Severe heart valve problems, such as leaky heart valve makes labor or pregnancy and delivery of the baby risky. In case a woman has severe form of heart valve problem, she should consider repair or replacement of heart valves before pregnancy or planning for a baby. If needed, doctors may perform either of heart valve surgery during the pregnancy. However, surgery performed during pregnancy period may pose a big danger to both the fetus and the mother.

    Most of the individuals with heart valve problems do not have any symptom. However, in some people, conditions usually stay in same condition during the entire life and do not cause any other problem. For other individuals, the problem becomes worse slowly until symptoms related to it develop.

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    Symptoms Of A Leaky Heart Valve

    Frequently, a leaky heart valve causes no symptoms. Many healthy people have one or more valves that are slightly leaky.

    If the heart valve leak is severe, it may impair the forward flow of blood. This can cause symptoms of congestive heart failure, which include:

    • Shortness of breath, especially with exertion or when lying flat
    • Leg swelling or fluid retention elsewhere in the body

    Other symptoms of a leaky heart valve may include:

    • Lightheadedness

    Even when there is significant valve regurgitation, there may be no symptoms.

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    What Is It Like To Have Mitral Valve Surgery

    A team of specialistscardiologists, cardiac surgeons, anesthesiologists, and otherswill work together to determine the best approach for your situation. You will be given general anesthesia, so you will be asleep throughout the operation.

    Your operation will vary depending on the surgeons approach:

    Open: This is the most common and gold standard approach, requiring a larger incision and opening the chest bone so the surgeon has direct access to the heart.

    Minimally invasive: The surgeon works through an incision that is a few inches long on the right side of your chest, dividing the muscles underneath to reach the heart, sometimes utilizing cameras to assist with the operation.

    Robotic: The surgeon makes one 2-inch incision and four half-inch incisions in the chest, and inserts robotic arms and tools along with a camera to provide a real-time picture of the progress.

    Transcatheter: The surgeon and cardiologist can use a procedure to repair or replace the valve either through the groin or through a small incision in the chest. This technology is new and evolving, and Yale offers various innovative techniques relevant to the mitral valve.

    Heart valve surgery requires use of a cardiopulmonary bypass, also known as a heart-lung machine, to temporarily take over the function of the heart and lungs, diverting blood from the heart so that the surgeon can operate.

    Mitral valve surgery typically takes one to four hours.

    Track Your Symptom Progression

    Its important to ask yourself about symptoms.. When doing so, don’t simply think in terms of yes or no, but consider the degree to which you experience symptoms.

    What causes you to become short of breath? Is it walking 3 miles? Or has that walk gotten shorter and shorter over time, and do you now feel breathless after going to the mailbox?

    Do you ever feel lightheaded? Do you ever notice a sudden urge to lie down until you feel steady? How often do you have this sensation?

    What about chest pain or unusual swelling in the feet or ankles? Its important to track your symptoms and remind yourself to review them every 6 months or at least annually. Because most valvular heart problems progress slowly, with good notes you’ll probably be able to see evidence of your condition if it begins to worsen.

    What if Im just out of shape?

    It can be hard to separate habits from the mechanics of the heart, which is one important reason you need a health care professional to monitor your progress regularly. Your health care provider will rely on your reportsto help them make treatment decisions. The better you are at noticing what’s going on, the better you can advocate and participate in building a longer and healthier life.

    ) and makean appointment with yourself every six months to review and repeat the exercise. You never know when being attentive may save a life.

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    Treatment Options For Severe Heart Valve Disease

    We are the only provider within 50 miles of the greater Washington area that offers all of these latest treatments for heart valve disease. With all of the latest technologies available to us in the numerous trials, we have the capability to sometimes treat patients who are otherwise untreatable.

    Ten years ago, our main treatment for severe heart valve disease was a procedure called sternotomy, which involves an incision in the sternum, or the breastbone. Today, a lot of patients are candidates for minimally invasive options, which require smaller incisions or none at all. This means we can treat patients who might not be able to withstand regular surgery.

    We can access your affected heart valve without opening up the chest by inserting thin, flexible tubes called catheters into two other areas of the body:

    • Between the ribs: This procedure is called thoracotomy.
    • Through the artery or vein in the groin: This is an even less-invasive procedure than thoracotomy and requires no incision.

    In the transcatheter procedure, we pass a catheter through the artery or veins and into the heart. From there, we can repair or replace the affected heart valve. Youll likely go home a day or two after your procedure with either a tiny incision or, most commonly, no incision at all.

    Do you have more questions about heart valve repair? Call or click below to make an appointment with a cardiac surgeon.

    Leaky Heart Valve And Tricuspid Regurgitation

    Many healthy adults have a slightly leaky tricuspid valve. This may be discovered incidentally, usually causes no problems, and does not require treatment or follow-up.

    Moderate or severe tricuspid regurgitation may result from pulmonary hypertension. Pulmonary hypertension is high blood pressure in the pulmonary artery. This high blood pressure has many possible causes. The main one is congestive heart failure.

    Medicines may not be effective in treating tricuspid regurgitation. Diuretics, or water pills, can help relieve body swelling, or edema, thatâs due to congestive heart failure. The swelling is not always present, however.

    The tricuspid valve may be repaired during surgery to correct other leaky heart valves. Surgical repair of the tricuspid valve generally works better than replacing it. Surgery to replace the tricuspid valve by itself is only recommended in rare cases.

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    What Is Heart Valve Disease

    Heart valve disease is when one or more of your heart valves dont work like they should.

    There are several types of heart valve disease. The main problems are caused by the valve not opening fully or the valve not closing properly:

    If the valve doesnt open fully, it will block or restrict the flow of blood. This is called valve stenosis or valve narrowing.

    If the valve doesnt close fully, the blood will leak back into the heart instead of forwards into the body. This is called valve incompetence, valve regurgitation or a leaky valve.

    These problems can put extra strain on your heart and make your heart work harder. This can cause you to have symptoms like feeling more tired and out of breath. And over time, it can increase your risk of having a heart attack, a stroke and other heart conditions.

    How Is A Leaky Heart Valve Diagnosed

    Minds of Medicine: Solving Heart Valve Problems without Surgery – TAVR

    A doctor usually diagnoses a leaky heart valve by:

    • Listening to the heart with a stethoscope for abnormal sounds such as a heart murmur
    • Looking at the results of a heart ultrasound, also called an echocardiogram

    A personâs description of symptoms along with the physical exam and echocardiogram can determine how serious a leaky heart valve is.

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    Are There Different Kinds Of Leaky Valves

    A leaking heart valve can occur in any one of the four heart valves:

    • Aortic valve between the left ventricle and the aorta .
    • Mitral valve, between the left atrium and the left ventricle.
    • Pulmonary valve, between the right ventricle and the pulmonary artery.
    • Tricuspid valve, between the right atrium and the right ventricle.

    A leaky valve allows blood to leak backward into the chamber it came from.

    Location of the aortic valve, mitral valve, pulmonary valve and tricuspid valve inside your heart.

    Surgical Replacement Of Aortic Valves Offers Good Long

    This is a plain English summary of an original research article

    People undergoing surgery to replace a narrowed aortic heart valve have only slightly lower life expectancy than people without the condition. Surgery was also associated with a low rate of stroke.

    This review gathered data from 93 observational studies that followed long term outcomes for people with severe aortic stenosis who had the valve replaced with a biological or tissue valve.

    Following surgery, survival ranged from 16 years on average for people aged 65 or less, to six or seven years for those over 75. Fewer than one in 100 developed a stroke each year.

    Ten years after surgery most people still had a good functioning valve. By 20 years the rate of valve deterioration had risen to 48%.

    Bioprosthetic valves appear safe and are linked to average lifespan for this population, but there may be a need for monitoring and possible replacement after the first ten years.

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