AORTIC VALVE SURGERY

In adult cardiac surgery, the aortic valve is the most common valve that we perform surgery upon. There are two reasons why a valve fails.  It either gets blocked (stenosis), or it leaks (insufficiency).

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BICUSPID AORTIC VALVE SURGERY

A normal aortic valve has three leaflets.  In 1-2% of the population, the aortic valve is “bicuspid,” meaning it has two leaflets instead of three.  This is a congenital form of heart disease, so if you are told you have a bicuspid valve, that means that you had it since birth.

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MITRAL VALVE SURGERY

Like any valve, the mitral valve can become either blocked (“stenosis”) or it can leak (“insufficiency”). But, by far, the most common mitral valve problem today is mitral insufficiency – a leaking mitral valve.

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MITRAL VALVE REPAIR

Here I present a case study of a mitral valve repair to treat a mitral valve murmur secondary to mitral regurgitation.

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MITRACLIP

Mitral regurgitation is one of the most common valve diseases in the US, but for some patients, traditional surgical approaches are not an option.  In these cases, a minimally invasive technique involving a MitraClip is sometimes used in patients with significant symptomatic MR.

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PULMONARY VALVE SURGERY

There are a number of congenital defects involving the pulmonary valve.  Tetralogy of Fallot, Transposition of the Great Vessels, and Pulmonary Atresia are some of the more common of these congenital anomalies.

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TRICUSPID VALVE SURGERY

The two most common reasons to operate on an adult’s tricuspid valve are: “functional” tricuspid regurgitation and infection of the tricuspid valve

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TRANS-CATHETER AORTIC VALVE REPLACEMENT (tavr)

This technology allows doctors to place a new valve in your heart without your having to undergo open heart surgery.

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TRANS-CATHETER MITRAL VALVE REPLACEMENT (tmvr)

Trans-Catheter Mitral Valve Replacement (TMVR) is not FDA approved yet in the United States. However, research studies are currently underway and hopefully, we will have this technology available in the next few years.

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Case Study – Multiple Valve Procedures

With permission from our patient to post, Thomas is sitting in a chair doing crossword puzzles, just two days after major reconstructive heart surgery, replacing his mitral valve and repairing his tricuspid valve, radio-frequency bi-atrial maze procedure for atrial fibrillation, clip occlusion of his left atrial appendage to reduce his lifelong risk of stroke from afib, and replacement of his ascending aorta for a large aortic aneurysm that was found incidentally during his workup for his valvular heart disease! Now that’s a large puzzle!

Thomas is doing great on postoperative day 2 and reports no pain! We have restored his heart valve function and he is no longer in atrial fibrillation, and we prevented the possibility of an aortic rupture that most certainly put his life at great risk. He will remain on blood thinners for only a few months, so long as his heart rhythm stays normal.

Congratulations to Thomas, and to our collaborative heart teams at Einstein and Jefferson!

Below you can hear the testimony of another patient with multiple valve surgeries.