Heart Valve Repair Advancing At A Strong, Steady Beat

2011-05-04 | |
Last updated: 2014-11-25

Diagnosis and Treatment of Heart Valve Failure

For those affected by a defective heart valve, there are few symptoms. The most common symptom, a shortness of breath, is very general and does not readily point to a problem of the heart valves. Sometimes, those affected will experience chest pain. In infants, the symptom may be a blue coloration of the skin indicating low blood oxygen levels. In the event that a heart problem is suspected, however, echo-cardiogram imaging of the beating heart can be used to confirm whether the heart is pumping correctly.

In patients affected by heart valve problems, surgery to correct the heart valve is currently the only option. The recent discovery that chronic inflammation is behind age-related heart valve problems may mean that anti-inflammatory drugs can prevent the condition in some people in the future, but this is not currently the case.

The treatment to correct defective heart valves currently involves open-heart surgery in most cases. In such surgery, the defective valve will be repaired or replaced. Replacing the valve can mean swapping the existing valve with a mechanical valve or more often, with a valve from a deceased human donor. In some cases, as these replacement valves age, they too may need to be replaced during subsequent surgery. Because such surgery is so invasive, it presents risks for patients and is often not suitable for those in poor health.

While open heart surgery is the most common approach, laparoscopic or “keyhole” surgery is an option at a few of the more advanced medical centers. The benefit of laparoscopic surgery is less risk to the patient and a faster recovery time.

Another improvement over the standard surgical treatment is the use of one of a patient’s other heart valves to replace the defective one. In research by the Imperial College London, investigators found that patients whose own valves had been used as replacements had a 17% higher survival rate than patients who had received a heart valve from a donor. One of the contributing factors to the higher survival rate is that immune suppressing medications are not required when the valve is not from a donor.

Yet another enhancement to valve surgery that is new is the delivery of an artificial replacement valve through an artery in the leg. This approach uses advanced imaging techniques to enable a surgeon to navigate a catheter through the incision in the leg to the heart. The catheter pulls the replacement valve with it into the heart where the surgeon places the valve within the opening of the existing defective valve. This enables the valve to begin operating normally while requiring even less invasive surgery than a laparoscopic approach. This treatment is currently being tested in 40 hospitals across the US.

Although these approaches represent the latest treatment options available to patients, ongoing research is also making advancements that patients could see in the near future. Researchers from Rice University are working to grow heart valves using technologies that have been used to grow other tissues. Their work involves placing a patient’s own stem cells into a miniature gel scaffold in the shape of a heart valve. This allows the stem cells to form a structure in the shape of the valve and to then convert from stem cells into the type of cells that normally make up a heart valve. The benefit to patients will be a resilient heart valve that the body won’t try to reject.

The ability of the human heart to pump our blood for a lifetime is astounding. However, even the most resilient parts eventually wear out and require maintenance. The good news is that medical science is making great strides in repairing the worn out and defective heart valves that come with disease and age. In the years to come, we will continue to see medical advancements that will contribute to keeping our hearts working longer and longer.

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Category: Disease Information, Medical Treatment

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