Valve Program

As a Center of Excellence, Saint Luke’s Valve Program practices a collaborative and team-based approach in the management of heart valve disease. We’re staffed by specially-trained cardiologists and cardiothoracic surgeons who are supported by an expert team of nurses and researchers.

Our team of cardiologists and cardiovascular surgeons evaluate, treat, and manage patients with aortic stenosis who have:

  • Advanced heart valve diseases
  • Coexisting medical conditions
  • Limited or multiple treatment options
  • Been previously diagnosed and need a second opinion

Our team will work with you and your family to determine the most appropriate treatment to address your specific condition and meet your health goals.

You’ll receive prompt evaluation and diagnosis by a multidisciplinary team of specialists at one time and in one place. You may see one physician or more depending on the diagnosis. Other Saint Luke’s Health System experts may be consulted if needed.

You’ll receive most of your care at Saint Luke’s Hospital of Kansas City—near the Country Club Plaza— however, you may be able to undergo some tests at the closest Saint Luke’s location or your local hospital.

Make an Appointment

You don’t need a physician referral.

816-932-VALV (816-932-8258)

heartvalvecenter@saintlukeskc.org

What is heart valve disease?

Heart valve disorders can arise from two main types of problems:

  • Regurgitation (or leakage of the valve)—When the valve(s) do not close completely, it causes blood to flow backward through the valve. This reduces forward blood flow and can lead to volume overload in the heart.
  • Stenosis (or narrowing of the valve)—When the valve(s) opening becomes narrowed, it limits the flow of blood out of the ventricles or atria. The heart is forced to pump blood with increased force to move blood through the narrowed or stiff (stenotic) valve(s).

Heart valves can develop both regurgitation and stenosis at the same time. Also, more than one heart valve can be affected at the same time. When heart valves fail to open and close properly, the effects on the heart can be serious, possibly hampering the heart's ability to pump enough blood through the body. Heart valve problems are one cause of heart failure.

What are the symptoms of heart valve disease?

Mild to moderate heart valve disease may not cause any symptoms. These are the most common symptoms of heart valve disease:

  • Chest pain
  • Palpitations caused by irregular heartbeats
  • Fatigue
  • Dizziness
  • Low or high blood pressure, depending on which valve disease is present
  • Shortness of breath
  • Abdominal pain due to an enlarged liver (if there is tricuspid valve malfunction)
  • Leg swelling

Symptoms of heart valve disease may look like other medical problems. Always see your doctor for a diagnosis.

What causes heart valve damage?

The causes of heart valve damage vary depending on the type of disease present, and may include the following:

  • Changes in the heart valve structure due to aging
  • Coronary artery disease and heart attack
  • Heart valve infection
  • Birth defect
  • Syphilis (a sexually-transmitted infection)
  • Myxomatous degeneration (an inherited connective tissue disorder that weakens the heart valve tissue)

The mitral and aortic valves are most often affected by heart valve disease.

Diagnoses and Treatments

Once you’ve had your initial exam, our team will discuss your case and determine the best treatment option that day. We’ll make sure you and your family fully understand your diagnosis and treatment options so you make an informed decision.

Treatments available are listed below by the different conditions or diseases that affect the heart’s four valves.

Aortic Valve: aortic stenosis or aortic insufficiency

  • Transcatheter Aortic Valve Replacement (TAVR)—Saint Luke’s was one of the first hospitals in the country, and the first in Kansas City, to offer transcatheter aortic valve replacement (TAVR). This is a key option for patients who are too high risk for traditional valve replacement. Saint Luke’s continues to be a regional leader in TAVR.
  • Surgical options—Saint Luke’s is also one of the few centers in the country to offer valve-in-valve surgery, a procedure reserved for patients who already have an artificial aortic valve and need a second placement.

Mitral Valvemitral stenosis or mitral regurgitation

  • Mitraclip®—Saint Luke’s was among the nation’s first hospitals to perform the MitraClip® procedure and one of only nine throughout the Kansas, Missouri, Nebraska, Iowa, Arkansas, and Oklahoma regions.
     
  • Surgical options—Saint Luke’s surgeons perform nearly one-third of all valve surgeries in Kansas City and research has shown that higher volumes will lead to better patient outcomes.
  • Transcatheter Mitral Valve Replacement (TMVR)—Saint Luke’s valve experts are bringing a transcatheter mitral valve replacement as a treatment option in 2018. The procedure will help patients with mitral disease when surgery and MitraClip® aren’t an option.

Tricuspid Valve: tricuspid stenosis or tricuspid regurgitation

  • Surgical options—Saint Luke’s offers a unique surgical treatment for tricuspid valve replacement, where the surgeon will use extracellular matrix paper to rebuild a patient’s original tricuspid valve.
     

Pulmonic Valve—pulmonic valve regurgitation or pulmonic valve stenosis

  • Surgical options—Saint Luke’s offers expert surgical treatment options for pulmonic valve regurgitation and pulmonic valve stenosis.

How is heart valve disease diagnosed?

Your doctor may think you have heart valve disease if your heart sounds abnormal. This is usually the first step in diagnosing a heart valve disease. A characteristic heart murmur (abnormal sounds in the heart due to turbulent blood flow across the valve) can often mean valve regurgitation or stenosis. To further define the type of valve disease and extent of the valve damage, doctors may use any of the following tests:

  • Electrocardiogram (ECG)—A test that records the electrical activity of the heart, shows abnormal rhythms (arrhythmias), and can sometimes detect heart muscle damage.
  • Echocardiogram (echo)—This noninvasive test uses sound waves to evaluate the heart's chambers and valves. The echo sound waves create an image on a monitor as an ultrasound transducer is passed over the heart. This is the best test to evaluate heart valve function.
  • Transesophageal echocardiogram (TEE)—This test involves passing a small ultrasound transducer into the esophagus. The sound waves create an image of the valves and chambers of the heart on a computer monitor without the ribs or lungs getting in the way.
  • Chest X-ray—This test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. An X-ray can show enlargement in any area of the heart.
  • Cardiac catheterization—This test involves the insertion of a tiny, hollow tube (catheter) through a large artery in the leg or arm leading to the heart to provide images of the heart and blood vessels. This procedure is helpful in determining the type and extent of certain valve disorders.
  • Magnetic resonance imaging (MRI)—This test uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
  • Pulmonary Function Test—Pulmonary function tests (PFTs) are noninvasive tests that show how well the lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange. This information can help your healthcare provider diagnose and decide the treatment of certain lung disorders.

How is heart valve disease treated?

In some cases, your doctor may want to closely watch the heart valve problem over a period of time. Other options include medicine or surgery to repair or replace the valve. Treatment varies depending on the type of heart valve disease, and may include:

Medicine

Medicines are not a cure for heart valve disease, but treatment can relieve symptoms. Medicines may include:

  • Beta-blockers, digoxin, and calcium channel blockers to reduce symptoms of heart valve disease by controlling the heart rate and helping to prevent abnormal heart rhythms.
  • Medications to control blood pressure, such as diuretics (remove excess water from the body by increasing urine output) or vasodilators (relax the blood vessels, decreasing the force against which the heart must pump) to ease the work of the heart.

Surgery

Surgery may be needed to repair or replace the malfunctioning valve(s). Surgery may include:

  • Heart valve repair—In some cases, surgery on the malfunctioning valve can help ease symptoms. Examples of heart valve repair surgery include remodeling abnormal valve tissue so that the valve works properly or inserting prosthetic rings to help narrow a dilated valve. In many cases, heart valve repair is preferable, because a person's own tissues are used.
  • Heart valve replacement—When heart valves are severely malformed or destroyed, they may need to be replaced with a new valve. Replacement valves may be either tissue (biologic) valves, which include animal valves and donated human aortic valves, or mechanical valves, which can consist of metal, plastic, or another artificial material. This usually requires heart surgery. Certain valve diseases such as aortic valve stenosis or mitral valve regurgitation may be managed using nonsurgical methods.
  • Balloon valvuloplasty—This is a nonsurgical procedure in which a special catheter (hollow tube) is threaded into a blood vessel in the groin and guided into the heart. At the tip of the catheter is a deflated balloon that is inserted into the narrowed heart valve. Once in place, the balloon is inflated to stretch the valve open, and then removed. This procedure is sometimes used to treat pulmonary stenosis and, in some cases, aortic stenosis.

View Heart Valve Repair: Percutaneous video.

Ongoing Support

American Heart Association: Heart Valve Support Group

Program Directors

Keith Allen, MD, Structural Heart Surgical Director

A. Michael Borkon, MD, Valve Program, Surgical Director

Adnan K. Chhatriwalla, MD, Structural Heart Medical Director

David G. Skolnick, MD, Valve Program, Medical Director

News

MEDIA COVERAGE: Saint Luke’s study acclaims alternative to heart valve replacement surgery
Saint Luke’s was one of the first hospitals to perform TAVR after it was approved roughly six years ago. See how this procedure helped a former professional baseball player.
Valve replacement: Two Sisters, Two TAVRs, Two Weeks
Sisters outlived their heart valves and had TAVRs two weeks apart. Read how this simple procedure helped them get back to life.
Reuters: Less-invasive Heart Valve Replacement Tied to Better Quality of Life

People who get minimally-invasive surgery to replace damaged heart valves have an easier time completing daily tasks and a better quality of life a

Valve Center at Saint Luke’s streamlines diagnosis and treatment

Building on a tradition of excellence in the treatment of heart valve disease, Saint Luke’s Mid America Heart Institute has established a comprehensive multidisciplinary Valve Center dedicated to the use of new transcatheter valve replacement therapies for patients with complex valvular disease. The center unites a highly skilled team of cardiologists and cardiovascular surgeons offering diagnosis, evaluation, and treatment in one convenient location.

Heart Valve Replacement without Invasive Surgery

Light filters through decorative glass bottles and casts pools of color on stacks of books, past issues of the Smithsonian and New Yorker magazines, and programs from operas, plays, and concerts. The Brookside home of Rosemary Iwersen reflects the many interests of the 86- year-old woman.