The Valve Clinic at the Heart Institute of Doylestown Hospital combines the expertise of cardiologists, interventionalists, surgeons and a valve clinic coordinator, providing physicians and patients with prompt assessments and advanced treatment options.
Jennifer Harrar, CRNP, a dedicated nurse practitioner at The Valve Clinic at the Heart Institute of Doylestown Hospital collaborates with physicians and practice staff to evaluate patients, coordinate diagnostic studies and arrange for all necessary subspecialist appointments.
Heart Valve Problems
Defective or diseased heart valves can make it difficult to lead an active life. For some patients, it may be life-threatening. Your heart may have to work harder or blood may back up in your lungs or body (regurgitation). Problems that affect your valves include aortic stenosis, mitral valve prolapse and endocarditis.
Severe Aortic Stenosis
Your aortic valve opens to let blood flow out of your heart and into your aorta, the largest artery in your body. It closes to prevent blood from returning to your heart. If your aortic valve has narrowed and does not open all the way, this is called aortic stenosis. This means that your blood flows less freely. Calcium deposits or scarring may have caused the valve to become hardened or stiff. Congenital birth defects, age or infection of the valve can also cause stenosis.
Symptoms of heart valve disease or severe aortic stenosis:
- Chest pain
- Fatigue and shortness of breath
- Lightheadedness or fainting
- Difficulty when exercising
You may need to have a valve repair or valve replacement if you have heart valve disease. It is best to repair a damaged valve rather than replace it. A repaired valve lasts longer than a mechanical or biological valve replacement.
Mitral Valve Prolapse (MVP)
The mitral valve allows blood to flow from your heart’s left upper chamber (atrium) into the left lower chamber (ventricle). Mitral valve prolapse (MVP) occurs when the valve doesn't close properly.
In MVP, when the left ventricle contracts, one or both flaps of the mitral valve bulge back (prolapse) into the left atrium. A tight seal may not be able to form and blood may leak back into the atrium. This condition is called mitral valve regurgitation. This backflow does not happen for most people who have MVP. In rare cases, it can cause shortness of breath, irregular heartbeats (arrhythmias), endocarditis (an infection of the inner lining of the heart chambers and valves) or chest pain.
A test called an echocardiogram allows doctors to see MVP and detect backflow. This painless test uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart's chambers and valves are working. Very few people who have MVP require surgery. For those who do, we perform heart valve surgery to repair or replace the mitral valves.
Endocarditis is an infection of the inner lining of your heart chambers and valves. This occurs when germs (bacteria) enter your bloodstream and travel to your heart.
Symptoms may occur slowly. Classic symptoms include fever, chills and sweating. They can also include fatigue, weakness and muscle or joint aches.
Blood tests, an eye exam and an echocardiogram can help diagnose this infection.
Treatment includes antibiotics. Sometime, you may require heart valve surgery if
- The infection breaks off in little pieces, resulting in strokes
- You develop heart failure as a result of damaged heart valves
- There is evidence of more severe organ damage
Your doctor will monitor you closely and advise you on the best treatments.
Heart Valve Treatments
If your heart valve is diseased or damaged, it may make it hard for your heart to pump blood properly. Heart valve surgery will restore its function. Surgery may involve valve replacement or valve repair. Minimally invasive valve surgery is an option for many patients.
Minimally Invasive Valve Surgery
Cardiothoracic surgeon Joseph Auteri, MD, is the medical director of The Heart Institute. He is an expert in minimally invasive valve surgery. Nearly one in three of all our cardiac valve surgeries are minimally invasive, and that number is growing. This includes minimally invasive aortic valve repair or replacement and mitral valve repair and replacement.
If you are a candidate for minimally invasive surgery, the benefits are even greater. This type of surgery results in
- Less blood loss
- Reduced pain and trauma
- Lower risk of infection
- Shorter hospital and recovery times
- Smaller scars
During a valve replacement procedure, the surgeon removes your diseased heart valve and replaces it with an artificial heart valve. This artificial valve works much like a normal heart valve.
An artificial heart valve is either a mechanical valve or a tissue valve. Mechanical heart valves are made of a strong material such as titanium or carbon. Tissue heart valves are obtained from human donors or animal tissue that is strong and flexible.
You will likely notice an immediate improvement in how you feel. Complete recovery takes about 6 to 12 weeks. You can expect to resume a normal, healthy lifestyle.
Minimally Invasive Aortic Valve Surgery
Aortic valve surgery is done to replace the aortic valve in the heart. Blood flows out of your heart and into the aorta through the aortic valve. The aortic valve opens so blood can flow out and closes to keep blood from flowing backwards. If your aortic valve does not open or close all the way, it may require surgery. Minimally invasive aortic valve surgery is done using small incisions.
TAVR Procedure (also called TAVI)
Transcatheter Aortic Valve Replacement (TAVR) and Transcatheter Aortic Valve Implantation (TAVI) are two names for the same heart valve procedure. This is a procedure that replaces your severely diseased aortic valve without open heart surgery.
TAVR was approved by the FDA in November of 2011. The Heart Institute is one of only a few cardiac programs in the region to offer this advanced heart valve procedure for severe aortic stenosis. The surgery is performed by a team of cardiologists, interventional radiologists and cardiothoracic surgeons.
We actively evaluate patients who may be candidates for TAVR. If you are seeking heart valve surgery options, we can provide you with an expert consultation or a second opinion.
When possible, it is best to repair a valve rather than replace it. A procedure called a balloon valvuloplasty can relieve valve tightness. This is done as part of a cardiac catheterization. This is less invasive than general surgery or open heart surgery.