Restoring Flow: Heart Valve Repair and Replacement
Your heart beats more than 100,000 times each day. That can put a particular strain on the heart valves, which control blood flow through the heart’s four chambers. “Valves can wear out for several different reasons,” says Cleveland Clinic interventional cardiologist Howard Bush, MD. “It can run in the family, for example, or it can be a symptom of age.”
In the United States, the most common mitral valve abnormality is prolapse, and the most common valve abnormality is aortic stenosis. The mitral valve separates the left atrium (the first stop for blood from the veins) and the left ventricle. If the mitral valve doesn’t close properly, blood can leak backward from the ventricle into the atrium.
The good news is that valve repair and replacement surgery is now highly advanced, says Cleveland Clinic Florida cardiovascular surgeon Edward Savage, MD. Newer minimally invasive options offer patients shorter hospital stays, quicker recovery and less scarring.
Cleveland Clinic Florida is a leading center for repair and replacement of heart valves, Dr. Savage notes. “This is still heart surgery. We still have to stop the heart. That’s one of the great advantages of Cleveland Clinic Florida — we do a lot of these surgeries and our staff is extremely experienced.”
But surgery is not always the answer, Dr. Savage emphasizes. “That’s another advantage of Cleveland Clinic,” he says. “We have patients coming here from all over, and each gets a thorough evaluation. And because all of our physicians are located in one building, we collaborate closely on our treatment plans.”
Late last year, Andrea DiRienzio experienced this approach firsthand. “I knew I had a congenital issue with my aorta valve,” she says. “My grandmother died of that in her late 40s, so I have it checked every year.” But even though DiRienzio stays active and eats right, she was having trouble breathing last fall. She went to her doctor and asked for a full heart workup; he told her the valve was narrow, but she could probably wait another two years.
But the problem only got worse. In early December, DiRienzio came to see Dr. Bush at Cleveland Clinic Florida for a second opinion. “The key to medicine is determining the right treatment for the right patient,” Dr. Bush says. Medications are appropriate for some patients; others benefit from new interventional procedures, he explains. For active patients like Andrea, surgical replacement or repair is often the right choice, he says.
In Andrea’s case, Dr. Bush’s evaluation revealed another worrying issue. “He found a blockage in my left anterior descending artery — what’s known as the ‘widow maker,’” Andrea says. “That could have gone at any time.” She immediately scheduled surgery with Dr. Savage, and a few weeks later, she had a new aortic valve — and two bypasses.
“I really feel like they saved my life,” Andrea says. “These heart issues could have killed me if they hadn’t caught them. My advice to anyone is, if you don’t feel right, get it checked out. And even if you’re told by your doctor that everything is fine, you should listen to your body, and get a second opinion. I’m so glad that I did, and now I feel fabulous. The physicians at Cleveland Clinic Florida really worked as a team and made sure I knew exactly what was going to happen. It was a great experience.”