More than five million Americans are diagnosed with valvular disease each year. Valvular disease occurs if one or more of your heart valves does not work correctly.

What is valvular disease?

The heart has four valves: the tricuspid, pulmonary, mitral, and aortic valves. These valves have tissue flaps, called leaflets, that open and close with each heartbeat. The leaflets make sure blood flows in the right direction through your heart's four chambers and to the rest of your body. Valvular disease causes the heart muscles to work harder to circulate the correct amount of blood through the body.

There are two main forms of the condition: valvular stenosis and valvular insufficiency.

  • Valvular stenosis is when the tissues forming the leaflets become stiffer and narrow the valve opening, which reduces the amount of blood that can flow through the heart. This reduces heart function and the rest of the body will not receive adequate blood flow.
  • Valvular insufficiency, also known as “leaky valve,” occurs when the leaflets do not close completely, letting blood leak backwards through the valve.

The causes of heart valve disease

Disease of the heart valves can be caused by any number of factors, the most common of which are:

  • birth defects
  • age-related changes
  • rheumatic fever
  • cardiomyopathy
  • aortic aneurysms
  • infections

What are the signs and symptoms of heart valve disease?

The effects of valvular disease vary, and may include:

  • shortness of breath
  • fatigue
  • weakness
  • dizziness
  • chest discomfort
  • palpitations
  • swelling of the ankles, feet, or abdomen
  • weight gain
  • fainting

If you are experiencing any of these symptoms, discuss it with your physician.

Treating valvular disease

Valve repair or replacement is the way to correct valve disorders. These surgical procedures are completed with open-chest heart valve surgery, using either a mechanical valve or valves made from tissue (cow, pig, or human).

For aortic valve disease, replacement is the most common approach. Over the last two decades, valve repair has emerged as the preferred procedure for treating leaking mitral or tricuspid valves. A vast array of valve repair techniques exists.

Valve replacement or repair may be performed through minimally invasive approaches. This type of procedure is performed through a small incision and leads to a quicker recovery and a better cosmetic result.

Transcatheter aortic valve replacement (TAVR) is a less invasive procedure used to replace the aortic valve. This approach replaces the narrowed or diseased valve using a catheter and does not require opening the chest. It can often be done without general anesthesia. The mitral valve can also be repaired using a catheter, allowing a surgeon to place a clip on the valve in order to reduce or eliminate a leak.

Each patient is different

What treatment option is right for you depends on many factors. Your cardiac surgeon, in collaboration with your cardiologist, will review your medical record and diagnostic imaging results to determine the best option for you.

Our Structural Heart Program consists of a multidisciplinary team that includes interventional cardiologists, cardiac surgeons, echocardiography specialists and nurse practitioners who will provide individualized recommendations for either surgical versus transcatheter therapies.

For more information, visit our website.

Afshin Ehsan, MD

Afshin Ehsan, MD

Dr. Afshin Ehsan is a cardiothoracic surgeon, director of minimally invasive cardiac surgery and director of quality at the Lifespan Cardiovascular Institute.