Medically Reviewed by Robert H. Messier, Jr., MD, PhD

The flow of blood in your heart is controlled by four important valves. McLeod Cardiothoracic Surgeon Robert Messier, MD, PhD, explains what can be done if those valves won’t close properly or they develop a build up with calcium and lose their flexibility.

Here are highlights of Dr. Messier’s comments:

With the natural process of aging, heart valves, frequently the aortic valve, can have its hinges, the area on the valve which allows it to open and close, become encrusted with calcium. It becomes increasingly difficult for the valve to open until something needs to be done to relieve what becomes an obstruction. 

On the other side of the spectrum, we have leaky heart valves. A common example of this is mitral valve prolapse. The ventricle, the pumping chamber of the heart, is forced to overwork because the valve is leaking. Either situation, leaky or obstructive, can occur from genetics or wear and tear, but either can reach the point where surgery is necessary for repair or replacement.

Surgery usually takes place after a period of medical management. Pharmacology developments over the past 30 years have allowed us to treat many patients for an extended period before they require surgery. Generally, once a valve has progressed to becoming either too tight or too loose, it has gotten to a point where surgery is required. The surgery may be a replacement, where the actual valve tissue is removed and a new substitute valve is sewn in.

Those are two surgical approaches to replacement of heart valves. Repair of heart valves is often a more complex process, but has the advantage of retention of one’s own tissues. We perform those procedures through minimally invasive incisions rather than the standard down the middle division of the breastbone. We are able to do mitral and aortic valve procedures through small incisions on the right side of the chest, which makes the whole process less traumatic to the patient.

A new aortic valve can be implanted through a needle and catheter in the groin. Patients are very satisfied with a minimally invasive approach. The recovery is shorter. Their complication rates are lower. The cosmetic look is better. But either through the minimally invasive approach or through the standard down-the-middle of the chest approach, valve replacements and repairs can become necessary as the disease processes.

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