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.
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You don’t need a physician referral.
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
- 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.
- 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.
- 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:
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 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.