Valve Repair Surgery

About Valve Repair Surgery

Valve repair surgery aims to restore the normal function of the heart valves. The heart has four valves: the mitral valve, aortic valve, tricuspid valve and pulmonary valve. The valves ensure that blood flows in one direction through each of the heart's four chambers, and then out of the heart and into the body. Heart valve disease occurs when one or more of the heart valves doesn’t work properly. The two main types of heart valve disease are:

• Regurgitation, or leakage of the valve
• Stenosis, or hardening and narrowing of the valve

Valve repair surgery treats obstruction to flow, leakage or a combination of both as it occurs in one of the four principal heart valves.

Experts in Valve Repair Surgery

Massachusetts General Hospital Corrigan Minehan Heart Center physicians are experienced in all forms of heart surgery for valve repair, including minimally invasive mitral valve repair. Valve repair restores and surgically reconstructs the mitral valve so that it functions normally. Minimally invasive procedures tend to provide patients with a quicker recovery time, less blood loss and minimal scarring.

Symptoms of Heart Valve Disease

Patients with heart valve disease may experience symptoms differently, depending on which valve of the heart is affected. Mild cases may not show any symptoms with others can experience symptoms that resemble other medical conditions and problems. Always consult a doctor for evaluation and diagnosis.

The following are the most common symptoms of all heart valve disease:

• Fatigue
• Irregular heart sound (heart murmur)
• Irregular heartbeat
• Shortness of breath

Symptoms of aortic valve disease:

• Chest pain and tightness
• Dizziness
• Faintness

Symptoms of pulmonary valve disease:

• Bluish tint to the nails, lips or skin
• Distended abdomen

Symptoms of tricuspid valve disease:

• Fluid build-up
• Swelling of legs, belly and/or neck veins

Diagnosis of Heart Valve Disease

Our multidisciplinary team of experts at the Heart Valve Program at the Mass General Corrigan Minehan Heart Center manages complex and common valve diseases. Specialists in valvular heart disease, cardiac imaging, interventional cardiology, cardiac surgery and cardiac anesthesia work together to diagnose and understand a patient's heart valve condition. From there, personalized and comprehensive care will determine the best treatment approach.

Valve Repair Surgery vs. Valve Replacement Surgery

Valve replacement surgery replaces the heart valve with a natural, animal-tissue or artificial valve. Artificial valves require lifelong use of blood-thinning medications. Natural valves and animal-tissue valves provide greater freedom from lifelong use of blood-thinner medications but are less durable. Though some patients may be better off with a mechanical valve, tissue valves perform very well and may be recommended.

A repair of a diseased heart valve aims to fix the valve without a full replacement. Valve repair surgeries that use minimally invasive techniques have a decreased risk of infection, blood loss and pain.

How Is Mitral Valve Repair Done?

Valve repair to fix leaky mitral valves is one of the most performed heart procedures. Mitral valve repair surgery may include:

• Sculpting abnormal valve tissue to improve the function of the valve
• Patching holes
• Separating fused valve leaflets
• Replacing supportive cords
• Removing excess tissue
• Using clips, plugs and rings to reinforce the valve

A mitral valve repair procedure often comes with a lower level of after-surgery monitoring and medication because the procedures are commonly less invasive with the use of catheters.

When Is Aortic Valve Repair Needed?

The aortic valve is located at the top of the left chamber of the heart and regulates the flow of blood out of the heart to the rest of the body. Like the mitral valve, the aortic valve can become leaky (regurgitation) or narrowed (stenosis), which can result in blood flowing back into the heart. An aortic valve leak can require surgery for repair.

For patients with bicuspid aortic valve disease (BAVD)—a congenital condition where the aortic valve has only two cuspids instead of three—the potential for leaky bicuspid valves increases, leading to the need for aortic valve leak repair.

Physicians at the Mass General Corrigan Minehan Heart Center are experts in aortic valve repair surgery, even though this procedure is generally performed less frequently than mitral valve repair. Two advantages of aortic valve repair surgery include decreased risk of infection and decreased need for lifelong use of blood-thinning medications.

Other Types of Valve Repair

Pulmonic and tricuspid valve repair are less common than mitral and aortic repair. Only a few hundred patients per year undergo tricuspid valve repair, which requires open heart surgery.

An August 2020 clinical trial at Massachusetts General Hospital performed a new type of tricuspid valve repair procedure that accessed the valve through the femoral leg in the vein and resulted in quicker recovery and discharge from the hospital. Clinical trials investigating new valve repair transcatheter procedures are ongoing and hold great promise for new breakthroughs in treating heart valve disease.

How to Prepare for Valve Repair Surgery

Before your surgery, your treatment team will explain what you can expect and answer any questions you may have. Staying healthy and free from infection is important in the days leading up to your surgery.

Heart Valve Repair FAQs