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Heart Valve Disease Diagnosis and Treatment at University Hospitals
University Hospitals Harrington Heart & Vascular Institute experts are recognized for excellence in heart valve disease treatment and diagnosis. We bring together an entire multidisciplinary team through our Valve and Structural Heart Disease Center, working collaboratively to identify heart valve disease earlier for improved quality of life. With convenient locations available across the region, we provide innovative care for any heart valve disease.
We have a strong commitment to improving heart health across northeast Ohio. As a leader in key clinical trials, our experts are able to offer the latest treatment options to a larger number of patients. With clinical expertise and strong patient education, our goal is to prevent heart valve issues from causing other serious heart conditions such as stroke, arrhythmias, hypertension and heart failure.
In many cases, medication or lifestyle changes will reduce the effects of heart valve disease. But when surgical repair or replacement is necessary, our team has the expertise for even the most complex conditions. As one of the first in the U.S. to use transcatheter aortic valve replacement, or TAVR, we bring our patients the most innovative procedures for aortic stenosis and other heart valve concerns. Because of our significant experience and strong outcomes with TAVR, University Hospitals is recognized as a high-volume TAVR Center of Excellence.
What is Valve and Structural Heart Disease?
Heart valve disease occurs when one or more of the valves in your heart cannot function properly. The heart’s valves normally assist in controlling the flow of blood through the chambers of the heart. When heart valve disease is present, a valve may be unable to close properly or open completely. This can force your heart to work harder every time it beats. Our team treats any type of heart or vascular condition, including a wide range of heart valve diseases such as:
- Bicuspid aortic valve
- Mitral valve prolapse
- Aortic valve stenosis
- Mitral valve stenosis
- Tricuspid valve stenosis
- Pulmonary valve stenosis
- Mitral valve regurgitation
- Aortic valve regurgitation
- Pulmonary or pulmonic valve regurgitation
- Tricuspid valve regurgitation
Often times, heart valve disease does not cause any symptoms and is diagnosed after a heart murmur is detected through a routine physical exam. However, if heart valve disease symptoms are present, they can include shortness of breath, chest pain or pressure, dizziness or fainting, weakness, a racing heartbeat and swelling of the feet, ankles or abdomen.
Identifying Heart Valve Disease with Comprehensive Diagnostic Tests
The symptoms of heart valve disease are often confused with conditions such as stress or the effects of physical inactivity or aging. Therefore, if you experience any symptoms or have a heart murmur, our heart specialists may use one or a few of the following diagnostic tests to determine whether heart valve disease is present:
- Cardiac Computed tomography (CT) scans: Using x-ray imaging technology, our team creates cross-sectional images of the heart.
- Cardiovascular magnetic resonance imaging (CMRI): Cardiac MRIs take detailed images of the chambers and blood vessels of the heart.
- Chest X-rays: The purpose of chest x-rays is to gain insight into the size and shape of the heart.
- Coronary catheterization: Coronary catheterization pinpoints blocked or restricted blood vessels.
- Echocardiogram (Echo): Echocardiograms evaluate anatomy, valve function and blood flow through the heart.
- Electrocardiogram (ECG): An ECG can uncover issues with heart rhythm through recording the electrical activity generated by the heart muscle.
- Exercise stress tests: Exercise stress tests measure how the heart functions when it must work harder than usual.
- Fractional flow reserve computed tomography (FFR-CT): Through advanced research, our team has significantly improved the cardiac computed tomography image quality with the development of the FFR-CT.
- Nuclear ventriculography: Using tracers, this non-invasive imaging test makes heart chambers and blood vessels visible. Used in conjunction with stress tests, our team can assess heart muscle function and viability.
- Optical coherence tomography (OCT): As the world leader in OCT imaging, this intravascular imaging technology allows our team to see and measure blood vessel characteristics.
- Positron emission tomography (PET) scan: Including specialized PET scans such as PET F-18, our team can determine the flow of blood through the coronary arteries to the heart muscle and determine any damage.
- Transesophageal echocardiogram (TEE): Using a small probe, this imaging test allows a closer look at the heart’s structure and function.
Treatments to Protect Valves and Reduce Symptoms
The main goals of treating heart valve disease include protecting the valves from further damage, reducing symptoms and repairing or replacing valves for long-term heart health. Our heart specialists often recommend one or a combination of the following treatments:
- Lifestyle changes: Lifestyle changes such as a low-sodium diet, regular exercise and quitting smoking can all improve heart valve disease symptoms.
- Medications: There are a variety of medications available to reduce the symptoms of heart valve disease. These medications can reduce blood pressure, normalize heart rhythm, open blood vessels, prevent blood clots and remove excess fluid in the body.
- Heart valve surgery: Heart valve surgery may be necessary to repair or replace any defective valve to improve heart function. We will determine the best option between repair or replacement based on your unique heart function issue.
- MitraClip: A non-surgical procedure, MitraClip places a clip on the mitral valve to correct the lack of closure in the mitral valve which allows blood to flow backward in your heart.
- TAVR: Transcatheter aortic valve replacement, or TAVR, is a minimally invasive procedure that eliminates the need for open heart surgery valve replacement. It involves inserting a replacement valve through a catheter and implanting it inside the existing aortic valve. We are one of the first facilities in the country to utilize this cutting-edge treatment.
- TMVR: Transcatheter mitral valve replacement, or TMVR, is a minimally invasive procedure currently in clinical trials at University Hospitals which allows valve replacement using a catheter-based approach.
- Watchman device: Particularly for patients at high risk for stroke, the Watchman® device is an alternative for stroke prevention in patients with non-valvular atrial fibrillation (AFib) to reduce the risk of a clot forming in a blood vessel from the left atrial appendage (LAA) of the heart.
- Balloon aortic valvuloplasty: This is a nonsurgical procedure during which a severely stenotic aortic valve is dilated with a balloon. It is usually reserved for very sick patients who cannot undergo TAVR or as a “bridge” treatment before a mandatory surgical intervention in another organ.
- Balloon mitral valvuloplasty: This is a nonsurgical procedure that dilates severely stenotic mitral valves with a balloon. It is the gold standard procedure for patients with severe mitral stenosis who fulfill certain criteria. A patient’s eligibility for this procedure is determined by the heart team.
- Transcatheter repair of congenital defects: Through catheterization, a “plug” can be fed through a thin tube and inserted in the heart to block any leaks or close holes for patients with atrial septal defects, patent foramen ovale and ventricular septal defects.
What Causes Valve and Structural Heart Disease?
Valve and structural heart disease can develop before birth, (congenital), be acquired during your lifetime or result from an infection. Causes include:
- Changes or damage in the heart valve structure or weakening of the valve tissue due to aging, coronary artery disease, heart attack, high blood pressure, untreated infection or injury
- Calcification accumulating on the valves
- Congenital birth defects
- Radiation received as treatment for childhood cancer
- Related illnesses and conditions including infective endocarditis, syphilis and rheumatic fever
- Myxomatous degeneration, an inherited connective tissue disorder that weakens the heart valve tissue
Can Valve and Structural Heart Disease Be Prevented?
Valvular disease has become an increasing problem in recent years. It is more common among older people because as we age, our heart valves can become lined with calcium deposits that cause the valve flaps to thicken and become stiffer.
You’re also at higher risk for valve or structural heart disease if you have risk factors for coronary heart disease, including high cholesterol, high blood pressure, smoking, insulin resistance, diabetes, being overweight or obese, lack of physical activity, and a family history of early heart disease.
Heart-healthy eating, physical activity and other heart-healthy lifestyle changes can make a significant impact on your heart health.
For More Information about Heart Valve Disease
If you have questions about heart valve disease or have concerns about symptoms affecting your heart function, contact one of our team members at a convenient location near you.