New Treatments for Your Heart Valves

Repairing valves less invasively with fewer complications

High-Tech Procedure Restores Normal Heart Rhythms

Each year, more than five million people in the United States are diagnosed with diseases involving the valves that control blood flow through the heart. A variety of new procedures and techniques are making it possible for cardiac surgeons to treat these diseases less invasively, with fewer complications and shorter recovery times.

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Most heart valve problems occur in the aortic valve and the mitral valve. The most common valve diseases are stenosis (a narrowing of the valve) and regurgitation or leaky valve.

Sutureless surgery for aortic valves

To treat aortic stenosis, which affects about 1.5 million people in the U.S., thoracic and cardiovascular surgeon Jose Navia, M.D. and his colleagues at Cleveland Clinic have been participating in clinical trials of a new stent that has a “self-expandable” frame. The frame expands in response to normal body temperature after it is placed in the aortic annulus (the ring of fibrous tissue surrounding the valve). The stent unblocks the valve as the self-expandable frame opens. Body temperature keeps the device open, eliminating the need for sutures.

One of the key benefits of this sutureless technique is that the stent can be placed within only two to three minutes, compared to the 20 minutes required with traditional methods. This procedure improves safety by reducing the time on cardiopulmonary bypass and the length of ischemic time (the time during which blood is not flowing through the heart).

“This procedure is a step forward in technology to reduce trauma to the patient,” says Dr. Navia. The technique can be used for any person who is a candidate for surgery for aortic stenosis. The device has been used in Europe for several years and is expected to receive Food and Drug Administration approval in the U.S. soon.

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Exchangeable valve leaflets

Patients who have already had heart valve replacement surgery might need surgery again after several years when one or more leaflets of the valve replacement become calcified. A technique developed by Cleveland Clinic cardiac surgeons makes it possible to replace only the damaged leaflet while keeping the base of the original valve replacement intact.

The less invasive procedure reduces the time of surgery, recovery time and the risk of complications.

New hope for mitral valves

Mitral regurgitation (MR) is one of the most common heart valve diseases. An estimated 2-2.5 million people in the U.S. have moderate or severe MR, and that number is expected to grow to 5 million by 2030.

A new procedure shows promise in the treatment of MR for people who cannot be treated with open surgery. The procedure repairs the mitral valve with a clip made of titanium (a biocompatible metal) that connects the front and back valve leaflets. This connection prevents blood from flowing back into the heart.

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The procedure is done percutaneously by an interventional cardiologist and cardiac surgeon, who use an x-ray technique called fluoroscopy to guide the clip through a catheter that has been placed through the thigh artery via a small incision. The MitraClip® received FDA approval in 2013.

Dr. Navia and his colleagues at Cleveland Clinic are also working on a procedure to replace the mitral valve percutaneously (through a small incision and placement of a catheter in a major vein in the thigh). Stay tuned for more exciting advances in the near future!