Enjoy Life on Your Terms After Heart Valve Treatment

Heart valves can develop problems with age or due to injury, such as from a heart attack. Some people are born with a congenital condition which may affect the heart valves.

Valve conditions increase your risk of developing heart failure or arrhythmia (irregular heart beat). Without treatment, heart valve problems can cause:

• Fatigue
• Breathlessness
• Blood clotting problems

The two most common problems we treat with heart valve replacement or repair are:

• Stenosis: The valve hardens and becomes stiff. As a result, it narrows and doesn’t close all the way, and blood can’t flow as it should.
• Regurgitation: Valve leaflets don’t close tightly. Blood flows backward through the leaky heart valve, disrupting and slowing blood flow.

Our heart team has a high level of expertise in valve surgeries. Research has shown that people have better outcomes at more experienced programs. Valve replacement and repair procedures we offer include:

• Aortic valve repair or aortic valve replacement: This valve controls blood flow from the left ventricle (one of the heart’s lower chambers) into the aorta. Surgery can re-establish efficient, one-way blood flow through the aortic valve. The aorta is the body’s largest blood vessel that supplies blood to your whole body.
• Transcatheter aortic valve replacement (TAVR): The TAVR procedure is a minimally invasive option to treat aortic stenosis, a stiffened aortic valve. A team of interventional cardiologists (doctors specializing in minimally invasive procedures) and cardiac surgeons insert a new aortic valve inside the diseased valve. We guide an expandable replacement valve to your heart through a catheter (a thin, flexible tube inserted through an artery). MoBap doctors were among the first in the nation to perform TAVR.
• Mitral valve repair or mitral valve replacement: The mitral valve controls blood flow from the left atrium (one of the heart’s upper chambers) to the left ventricle. A weak mitral valve makes it harder for oxygenated blood from your lungs to reach your body. Restoring the mitral valve lets your heart deliver this blood to your body.
• Transcatheter mitral valve repair: This minimally invasive procedure treats some patients with a leaky mitral valve. Using a catheter-based approach through the groin, our heart experts feed a small, cliplike device (MitraClip™) through an artery to your mitral valve. The clip corrects how your mitral valve closes to restore healthy blood flow.
• Tricuspid valve repair or triscuspid valve replacment: Located on the right side of the heart, the triscuspid valve separates the upper and lower chambers of your heart. If the tricuspid valve isn't working correctly, blood flow to the heart can be impacted. This procedure helps restore normal blood flow.
• Pulmonic valve repair or pulmonic valve replacement: The pulmonic valve is located on the right side of the heart and is one of four valves that regulate blood flow in the heart. If the valve isn't working properly, blood flow from your heart to your lungs can be interrupted. This procedure helps restore normal blood flow.
• Ross procedure: A surgeon replaces a diseased aortic valve with your pulmonary valve. We use an artificial valve to replace the pulmonary valve, which controls blood flow to the lungs. This procedure enables the strong pulmonary valve to serve for the aortic valve, which must withstand a lot of pressure.

If you have heart valve surgery, the procedure may be an open or minimally invasive surgery. What doesn’t change is our team’s caring approach throughout your valve treatment.

Before you have heart surgery at MoBap, your surgical team reviews your case in a collaborative environment. Our highly specialized surgeons and cardiologists consider each case individually to develop personalized treatment plans for each patient.

After heart valve surgery, your heart can pump blood the way it should. Whenever possible, our heart experts repair damaged heart valves. Valve repair lets you keep your natural tissue, potentially avoiding infections and the need for future surgeries. When repair isn’t an option, we can replace the valves with artificial or tissue valves.

Some people are eligible for minimally invasive heart valve repair or replacement. Many of these procedures use a catheter-based approach without any incisions. Minimally invasive procedures can offer less risk of infection, a shorter hospital stay and a faster recovery.

Minimally invasive: Some heart valve repair and replacement procedures are performed using minimally invasive techniques. These procedures use smaller incisions or a catheter-based approach.

Open-chest: Our cardiac surgeons also perform open-heart surgery to replace or repair valves. During the procedure, our surgical team:

1. Makes an incision down the middle of your chest and opens your breastbone (sternum)
2. Either repairs your natural heart valve to correct the underlying issue or replaces the faulty valve or removes it and replaces it with a mechanical valve (made of plastic or metal) or a tissue valve (using tissue from a pig, cow or human donor)
3. Wires your sternum bone back together and closes your incision

Before a valve procedure, your cardiologist may have requested these tests to assess your heart health:

• CT Scan: CT imaging provides pictures of your heart valves. For TAVR or minimally invasive mitral valve repair, your doctor will also check the size and condition of your valve and blood vessels.
• Echocardiography (echo): Using ultrasound (imaging with sound waves), we review your heart valves and heart function.
• Heart catheterization: Before valve repair, we will perform a cardiac catheterization to study blood flow to your heart. This test helps us understand your heart’s health.

After your valve replacement or repair procedure, we carefully monitor you as you recover from surgery. We have a specialized heart recovery unit (Cardiac ICU) where our dedicated cardiac nurses take care of you. Depending on your procedure, you may stay in the cardiac ICU before being transferred to a heart floor, or you may go directly to the heart floor.

Many people leave the hospital within a day or two after a TAVR procedure or minimally invasive mitral valve surgery. After an open-chest surgery, you may stay up to 3-5 days in the hospital.

When you return home, you will need to avoid lifting heavy objects until your doctor tells you it is safe, especially if you had a chest incision. After open-heart surgery, you should limit activity for about six weeks, or until your breastbone heals. If you had TAVR or another minimally invasive surgery, your heart team will talk with you about any precautions you need to take as you recover. Discharge instructions will be discussed before leaving the hospital.

We’ll check in with you after surgery, and your surgical team will see you several times to make sure you are progressing as expected. Your team will explain how to take medications. We’ll also talk with you about how to care for your new valve to help it last as long as possible.

After valve repair or replacement, your heart team will refer you to a cardiac rehabilitation program. The cardiac rehab program includes exercises to rebuild your strength as your heart heals. Our specially trained exercise physiologists and nurses will oversee your cardiac rehab and help customize your care plan.

Our heart surgeons and interventional cardiologists (heart doctors who perform minimally invasive procedures) have extensive expertise in open and minimally invasive heart valve procedures. U.S. News & World Report ranks our program as “high performing” for aortic valve replacements. We are one of only three hospitals to receive this ranking in St. Louis.

Our cardiac surgery program outcomes exceed several national quality benchmarks, according to the Society of Thoracic Surgery (STS) data registry. Developed to improve safety and patient outcomes for cardiothoracic surgeries, the STS data registry is the largest cardiac surgery registry in the world.

- Performs hundreds of aortic valve replacements each year
- Among a select group of heart programs in the U.S. to consistently receive the STS’ highest 3-star rating
- Highly specialized team of surgeons and cardiologists meet weekly to develop individualized treatment plans for each patient
- Centrally located in St. Louis

To schedule an appointment with a MoBap heart specialist, call 314-860-5506 or fill out a contact form.

Meet our team of cardiologists and surgeons.