Heart valve care in Salt Lake City, Utah
St. Mark’s Hospital’s cardiologists and cardiovascular surgeons in Salt Lake City, Utah have extensive expertise in treating heart valve problems.
For more information about our heart valve services, or to schedule an appointment, please call (801) 266-3418.
Your heart's job is to pump blood through your body. That job starts with pumping blood through the heart itself. Inside your heart, blood passes through a series of one-way gates called valves. If a valve works poorly, not enough blood moves forward.
Types of heart valve problems
A heart valve problem may consist of one or both of the issues below:
- Problems opening (stenosis): When a valve doesn't open all the way, the problem is called stenosis. The leaflets may be stuck together or too stiff to open fully. When the valve doesn't open fully, blood has to flow through a smaller opening. So, the heart muscle has to work harder to push the blood through the valve.
- Problems closing (regurgitation): When a valve doesn't close tightly enough, the problem is called regurgitation or insufficiency. The valve itself may be described as leaky. Leaflets may fit together poorly. Or, the structures that support them may be torn. Some blood leaks through the valve back into the chamber it just left. So, the heart has to move that blood twice.
Common causes of valve problems
Men and women of any age can have heart valve trouble. You may have been born with a problem valve, or a valve may have worn out as you've aged. It may not be possible to pinpoint what caused your valve problem, but common causes include:
- Buildup of calcium or scar tissue on a valve
- Rheumatic fever and certain other infections and diseases
- High blood pressure
- Other heart problems, such as coronary artery disease
Symptoms of heart valve problems
You can have a problem heart valve for decades, yet have no symptoms. If you do have symptoms, they may come on so slowly that you barely notice them. In other cases, symptoms appear suddenly. You might have one or more of these symptoms:
- Problems breathing when you lie down, exert yourself or get stressed emotionally
- Pain, pressure, tightness or numbness in your chest, neck, back or arms (angina)
- Feeling dizzy, faint or lightheaded
- Tiredness, especially with activity or as the day goes on
- Waking up at night coughing or short of breath
- A fast, pounding or irregular heartbeat
- A fluttering feeling in your chest
- Swollen ankles or feet
Dr. Yaganti on TAVR vs Surgery for Treating Aortic Stenosis
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Dr Yaganti on What is Mitral Regurgitation
Treatments for heart valve problems in Salt Lake City, Utah
Our Salt Lake City heart doctors will suggest a treatment depending on your specific heart valve problem and conditions. Heart valve treatments at St. Mark’s Hospital include:
Valve repair or replacement
Heart valve problems will require different treatments. Your cardiovascular surgeon will discuss the best treatment for you, however, the treatment plan may change once the surgery has started.
There are three main ways to surgically treat a problem heart valve:
- Repair the valve: If possible, your St. Mark’s surgeon will repair the valve instead of replace it. Commonly, the repair involves sewing a ring around the valve entrance to improve its size and shape. Another repair option is to cut tissue, so leaflets can open and close better. If repair isn’t an option, the valve will be replaced.
- Replace with a mechanical valve: Mechanical valves (made of metal or carbon) can last for decades, however, blood tends to stick to them, which can form clots. If you have a mechanical valve replacement, you’ll need to take a medication, typically Coumadin, for life to prevent blood clots.
- Replace with a tissue valve: A tissue valve is usually taken from a pig or cow, and blood does not easily clot on tissue valves. A medication to prevent blood clots may only be needed for a short amount of time with a tissue valve replacement. However, tissue valves do not last as long as mechanical valves.
How a valve replacement works
- Your St. Mark’s surgeon will make an incision down the center of your chest. Your breastbone will be separated, however, if your surgeon plans to reach your heart another way, they will discuss it with you.
- Your blood will be oxygenated by a heart-lung machine, so your heart and lungs can remain still during surgery.
- The surgeon will then repair or replace the valve.
- The breastbone is then reattached with wires, and the bone will typically heal in six to eight weeks.
- You’ll remain in the intensive care unit (ICU) for at least a day and in a general hospital room for five to six days. You’ll be given care instructions upon being discharged to go home.
Risks of heart valve surgery
Most heart valve procedures have positive outcomes, however, any major surgery comes with risk. Potential complications with valve surgery include:
- Blood clot
- Heart rhythm problems, stroke, heart attack or death
- Need for blood transfusion
- Lung or kidney problems
- Repaired or replaced valve failure
- Damage to the heart
Recovering from heart valve surgery
Call your healthcare provider if you experience any of the following during your recovery:
- Shortness of breath while resting or after only a little exertion
- Fast, slow or skipping heart beats (palpitations)
- Weight gain of more than two pounds in one day or five pounds in seven days
- Swollen legs
- Dizziness or lightheadedness
- Fever of 100°F or higher
- Changes in your incision, such as swelling, oozing or getting red or tender
- Pain in your chest or shoulder that gets worse instead of better
- Clicking or grinding in your breastbone
Transcatheter aortic valve replacement (TAVR)
Edwards SAPIEN Transcatheter Heart Valve
Transcatheter aortic valve replacement is an innovative heart valve procedure, and St. Mark’s Hospital was among the first to offer it in Utah.
In fact, we are one of only 150 hospitals in the U.S. approved to perform this promising new procedure for patients considered too high risk for traditional heart valve replacement or patients who were previously considered inoperable. This procedure is used to treat severe symptomatic aortic valve stenosis.
How TAVR works
The TAVR procedure is as follows:
- An incision is made near the groin, and a catheter is inserted into the artery and moved toward the stenotic valve.
- A medical balloon is inflated partially to reopen the valve.
- A TAVR device is implanted in the narrowed aortic valve to immediately improve blood flow through the valve.
Understanding the risks of TAVR
TAVR is an extensive procedure requiring general anesthesia. The placement of the valve is associated with serious adverse effects, including the risk of stroke, artery damage, major bleeding, death and other life-threatening conditions.
The longevity of the valve’s effectiveness is not currently known. Your TAVR team will weigh the risks and benefits and discuss your options with you, so you can make the best decision.
Septal defect closure
There are four chambers within the heart, and an atrial septal defect (ASD) is a hole in the wall that divides the two upper chambers. An ASD causes blood to flow through the defect, which causes more blood than usual to pass into the right chamber, called a left-to-right shunt. Overtime, this puts pressure on the pulmonary arteries.
An ASD is a congenital heart defect, meaning you are born with the condition. In some cases, the ASD will close itself within the first years of a child’s life. If an ASD is left untreated, it can lead to permanent lung problems in adulthood.
Types of atrial septal defects:
- Sinus venosus, a defect in the outer part of the atrial septum
- Secundum, a defect in the middle part of the atrial septum
- Primum, a defect next to the heart valves in the atrial septum
Symptoms of atrial septal defects
Some children have an ASD but have no symptoms. Present symptoms include:
- Slow growth
- Frequent pneumonias
- Trouble breathing
- Tiring easily during exercise
Treating an atrial septum defect
Your child’s pediatrician will perform a physical exam to check for a heart murmur, which is an extra noise in the heartbeat due to blood not flowing correctly. If the pediatrician suspects an issue, you’ll be referred to a pediatric cardiologist for further testing and examinations.
Because some ASDs close on their own, the pediatric cardiologist may wish to monitor your child’s condition before suggesting an atrium septum closure.
After an atrial septum closure, your child will be as active as other children. Regular visits with a cardiologist are necessary. The child may need to take antibiotics before any surgery or dental work up to six months after the procedure to avoid any infection.