Heart Valve Disease
We offer a range of minimally invasive and open treatments for heart valve disease. Our goal is to relieve symptoms, preserve your heart health, and help you get back to living the life you love.
Why choose us for heart valve disease?
BJC HealthCare works with WashU Medicine physicians, BJC Medical Group, and providers across the region to deliver extraordinary care. Heart valve problems are common, but for many people, they don’t cause symptoms. In some people, valvular heart disease requires treatment. Our expertise with heart valve procedures and excellent outcomes is well known throughout the region.
At our hospitals, you’ll find:
- Dedicated team: The cardiologists and surgeons on our valve team focus primarily on diagnosing and managing valvular heart disease. You can be confident that you are receiving appropriate medical care or surgery recommendations at the right time.
- Collaborative approach: You have access to experts in cardiology, heart surgery, heart imaging, interventional cardiology and other specialties. These providers work together to coordinate your care and update your treatment plan as needed.
- Excellent results: U.S. News & World Report ranks Barnes-Jewish Hospital as High Performing for aortic valve surgery.
- History of innovation: Barnes-Jewish Hospital was one of the first programs in the world to learn and then teach others how to perform transcatheter aortic valve replacement (TAVR). We also partner with WashU Medicine which takes part in clinical trials to develop new techniques, such as mitral valve clip therapy and valve-in-valve procedures. In addition, we can offer procedures that require compassionate use approval from FDA.
What is heart valve disease?
Heart valve disease is when one or more heart valves don’t work right. The valves normally keep blood flow moving forward in one direction. And they prevent the backward flow of blood as it leaves each chamber of the heart. The heart has 4 chambers: 2 upper chambers (atria) and 2 lower chambers (ventricles). The heart also has 4 valves. They are:
- Tricuspid valve. Located between the right atrium and the right ventricle.
- Pulmonary valve. Located between the right ventricle and the pulmonary artery.
- Mitral valve. Located between the left atrium and the left ventricle.
- Aortic valve. Located between the left ventricle and the aorta.
As the heart muscle contracts and relaxes, the valves open and close, letting blood flow into the ventricles and out to the body at alternate times. The following is a step-by-step explanation of blood flow through the heart:
- The left and right atrium contract once they are filled with blood. This pushes open the mitral and tricuspid valves. Blood is then pumped into the ventricles.
- The left and right ventricles contract. This closes the mitral and tricuspid valves, preventing backward blood flow. At the same time, the aortic and pulmonic valves open to let blood be pumped out of the heart.
- The left and right ventricles relax. The aortic and pulmonic valves close, preventing backward blood flow into the heart. The mitral and tricuspid valves then open to allow forward blood flow within the heart to fill the ventricles again.
Heart valve disease can occur from 2 main types of problems:
- Leakage of the valve (regurgitation or insufficiency). When the valve does not close completely, it causes blood to flow backward through the valve. This reduces forward blood flow and can lead to volume overload in the heart.
- Narrowing of the valve (stenosis). When the valve opening becomes narrowed, it limits the blood flow out of the ventricles or atria. The heart is forced to pump blood with more force to move blood through the narrowed or stiff (stenotic) valve.
Heart valves can develop both regurgitation and stenosis at the same time. Also, more than one heart valve can be affected at the same time. Some of the more common heart valve diseases are:
- Bicuspid aortic valve. With this birth defect, the aortic valve has only 2 leaflets instead of 3. It's more likely to narrow over time. If the valve becomes narrowed, it is harder for the blood to flow through. Often the aortic valve may also develop regurgitation in addition to stenosis. Symptoms often don’t appear until the adult years.
- Mitral valve prolapse. With this defect, the mitral valve leaflets bulge and don’t close correctly during the contraction of the heart. This may lead to a lot of regurgitation over time.
- Mitral valve stenosis. With this problem, the mitral valve opening is narrowed. It's often caused by a history of rheumatic fever. It increases resistance to blood flow from the left atrium to the left ventricle.
- Aortic valve stenosis. This valve disease occurs mainly in older adults. It causes the aortic valve opening to narrow. This increases resistance to blood flow from the left ventricle to the aorta.
- Pulmonary stenosis. With this valve disease, the pulmonary valve does not open enough. This forces the right ventricle to pump harder and enlarge. This is often a condition that is present at birth (congenital).
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Our highly trained team of specialists offers advanced treatments as well as compassionate, personalized care.
Heart valve treatments
Valvular heart disease gets worse over time for many people. Your doctor may recommend heart valve surgery to prevent complications, even if you aren’t having symptoms.
In the past, valve repair often required open-heart surgery that left a large scar. Today, we offer many catheter-based options. In these procedures, we repair or replace a valve using a narrow tube inserted through a blood vessel with no incision. Even many traditional valve surgeries no longer require surgeons to split the breastbone. We can go through the ribs instead with a much smaller incision.
Heart valve surgeries we perform include: