Valve Repair and Replacement

If your heart valve disease is severe or your symptoms are getting worse, surgery may be the best treatment option. Surgery can restore healthy blood flow to your heart and protect it from damage. 

At Banner Health, our heart specialists offer advanced cutting-edge options that can repair or replace heart valves. We are skilled in both open-heart valve surgery and minimally invasive procedures. We’re here to help you understand your surgical options, so you can feel confident about your treatment and recovery.

Why might you need heart valve surgery?

Your health care provider or cardiologist may recommend heart valve surgery if:

• Your valve is severely narrowed (stenosis) or leaking (regurgitation)
• Medications or other treatments haven’t helped
• You have symptoms of heart valve disease like shortness of breath, chest pain or fatigue
• Your heart function is starting to get worse

Surgery can help your valves work better, so your symptoms improve and you’re not as likely to have complications from your valve problem.

Valve repair versus valve replacement

Depending on your valve condition and your overall health, your care team may recommend either valve repair or valve replacement.

What is valve repair?

Valve repair fixes your existing heart valve. It’s an option if you have a mitral or tricuspid valve condition. Valve repair may involve:

• Reshaping or tightening the valve
• Removing extra tissue 
• Reinforcing the valve with a ring, called annuloplasty
• Placing transcatheter devices, like MitraClip or PASCAL, which put the leaflets back together where they are leaking

Your heart specialist will examine your echocardiograms to determine if you’re a candidate for valve repair. With valve repair, you keep your own tissue. You may have less need for lifelong medication.

What is valve replacement?

If a valve is too damaged to repair, a surgeon can replace it with an artificial valve. There are two types of artificial valves:

• Mechanical valves: These are strong and they last a long time. For them to remain open, you need to take blood thinners every day for life. These valves require open surgery for placement.
• Biological valves: These are made from cow, pig or human tissue. You may not need blood thinners with biological valves, but they may need to be replaced after 10 to 20 years. Biological valves can be placed with catheters or open surgery.

Your specialists will explain more about the differences between these options so you can choose the one that fits your needs, lifestyle and goals.  They will review your imaging studies, such as your cardiac CT scan, to help determine the best option for replacing your valve.

Types of heart valve procedures

At Banner Health, we offer a full range of heart valve procedures. Your care team will help you decide which one is right for you.

Open-heart valve surgery

In this traditional type of heart valve surgery, a surgeon opens the chest to directly access and repair or replace the valve.

You may need open-heart valve surgery if:

• Your valve is too damaged to be repaired or replaced with less-invasive options
• More than one valve is diseased or damaged
• You have other heart problems that also need to be treated with surgery

You will usually need general anesthesia for these procedures, and you may need to use a heart-lung bypass machine to circulate your blood during surgery.

Modern surgical treatments are safer than ever, often with extremely low risks. 

Catheter-based procedures and surgery

With a catheter-based approach, your care team uses smaller incisions and specialized tools. They don’t need to fully open your chest. Your heart beats normally throughout the procedures, so no heart lung machine is not needed.

Depending on which valve is diseased, certain minimally invasive (catheter-based) procedures could be options for you.

Transcatheter aortic valve replacement (TAVR)

TAVR is used to treat aortic stenosis. Using a catheter (thin tube), the new valve is threaded through your blood vessels, starting at your groin. When it reaches the old valve, it expands and takes over for it. You’ll probably be awake or lightly sedated for the procedure. 

In the past, TAVR was only used as an option for people who were at high risk for complications from open-heart surgery. However, it is now more widely used and an option for more people, depending on their overall health and heart structure.

With TAVR, most people go home from the hospital in one to two days and are able to return to their normal routine quickly.

Transcatheter mitral valve repair (MitraClip or PASCAL) 

MitraClip and PASCAL are catheter-based procedures that treat mitral regurgitation. These procedures clip the two sides of the valve leaflets (flaps) together, so they close more tightly and don’t leak as much. In the procedure, a small clip is inserted into a blood vessel in the groin and travels to the valve through a catheter. 

Patients typically go home the next day. It is a safe therapy and may be an option if you can’t have open-heart surgery because of your age or other health conditions.

Transcatheter tricuspid valve repair (TriClip) 

TriClip is similar to MitraClip or PASCAL, but it treats tricuspid regurgitation.  It may be an option if you have severe tricuspid regurgitation and need relief of symptoms. 

Like MitraClip or PASCAL, TriClip is a safe procedure, and patients typically go home the next day.   

Transcatheter tricuspid valve replacement (TTVR or Evoque)

This procedure involves replacing your tricuspid valve with a biological prosthesis, using a blood vessel in your groin. TTVR is often done in patients who are not candidates for tricuspid repair and offers complete relief of tricuspid regurgitation. 

Transcatheter mitral valve replacement (TMVR)

This procedure replaces the mitral valve through a catheter rather than with surgery. It could be an option if you can’t have open-heart surgery or you’ve had valve repair in the past that didn’t work. 

What to expect after heart valve surgery

Recovery depends on how your procedure is performed.

After open-heart valve surgery you can expect:

• A hospital stay of about five to seven days
• Full recovery in six to eight weeks or more
• Cardiac rehab to help with your recovery

Compared to open-heart valve surgery, after minimally invasive heart surgery, you’re likely to have:

• A one-to-two-day hospital stay
• Less pain
• Smaller scars
• Faster return to daily activities

Your care team will give you more information about what you can expect as you recover.

There are always risks with surgery. General risks include bleeding, infection, stroke, irregular heartbeat and kidney damage. Risks of heart valve surgery include blood clots with mechanical valves, valve deterioration with tissue valves, residual leakage and stenosis. Your providers can explain more about the risks and benefits of surgery.

Whether you choose a minimally invasive (catheter-based) approach or open-heart surgery, recovery doesn’t end when the procedure is over. Learn what to expect next.

How long does a repaired or replaced heart valve last?

The lifespan of a heart valve depends on the type of valve:

• Mechanical valves: Can last a lifetime, but you need to take blood thinners to lower the risk of blood clotting every day
• Biological valves: Typically last about 10 to 20 years
• Repaired valves: May last many years, but they need to be monitored regularly as leaks can come back in a small number of patients

Regular checkups and imaging help make sure your valve continues to work the way it should.

Why choose Banner Health?

When you choose Banner Health for heart valve surgery, you’re choosing top-notch care with:

• Experienced cardiac surgeons and interventional heart teams
• Advanced treatment options like TAVR, TMVR, TTVR and TriClip
• Cutting edge and investigational therapies 
• Personal plans based on your unique needs
• Full support from diagnosis through recovery, including cardiac rehab

Ready to take the next step?

We’re here to guide you through your treatment choices so you feel confident in your care plan.

Schedule a consultation with a heart specialist at Banner Health and learn about the options that can help treat your heart valve disease.