Heart Valve Disease
What is Heart Valve Disease?
Heart valve disease occurs when one or more of the valves in the heart fail to work properly. There are four valves in the heart that open and close with each heartbeat to control the flow of blood during the cardiac cycle. Blood flows out of the valves when they are open; when they are closed blood is prevented from flowing backward and re-entering the valve in the opposite direction. The ability of the heart valve to close may become less efficient due to two conditions that may or may not occur simultaneously:
- Regurgitation: Valve does not close completely, allowing the blood to flow backward through the valve
- Stenosis: Valve opening becomes stiff, narrowed, or does not form properly, inhibiting the ability of the heart to pump blood to the body.
Heart valves can have regurgitation and stenosis simultaneously. When a heart valve fails to open and close properly, blood accumulates where it does not belong, placing significant strain on the heart and hampering the heart’s ability to adequately pump blood to the body’s organs. Prolonged and severe strain on the heart can cause a range of complications that require medication, surgery or potentially a heart transplant. A long-term complication of a malfunctioning heart valve or heart valve disease is Congestive Heart Failure (CHF). If left untreated, heart valve disease and CHF may require a heart transplant because of irreparable heart damage
According to the American Heart Association, over 5 million people in the US suffer from CHF, with an annual healthcare cost of over $34.8 billion. In 2005, nearly 1.2 million Americans were discharged from short-stay hospitals with a diagnosis of heart failure. CHF is the most common diagnosis in hospital patients age 65 and older. One fifth of all hospitalizations for this age group have a primary or secondary diagnosis of heart failure. It is estimated that each year approximately 550,000 new patients are diagnosed with CHF in the US.
The current magnitude of CHF is large and it is expected to increase. As an increasing number of cardiac patients are able to survive longer with heart valve disease, their likelihood for developing CHF increases. The increasing number of Americans aged 65 and above will likely result in an increasing number of patients with heart failure, regardless of trends in the actual incidence of coronary disease.
A significant portion of CHF patients suffer from valvular heart disease and are candidates for surgery. Of these valvular disease cases, about one third of patients that are age 65 and above has echocardiography-detected mitral regurgitation (MR). The majority of patients with MR have the condition as a consequence of coronary artery disease.
Treatment options for heart valve disease include medication, and surgical repair or replacement of the valve. In some cases, if detected early medication alone is successful. As the condition progresses, surgical correction becomes necessary.
A less invasive option than valve repair/replacement surgery to treat pulmonary stenosis and in some cases of mitral stenosis is a non-surgical procedure called balloon valvuloplasty. Novel less invasive surgical approaches for valve repair are under development