There may be alternatives to heart valve replacement, depending on your condition.
Your alternatives to surgery will depend on the type of valve that’s affected and the problem with the valve.
If your valve problem isn’t too severe, your GP or cardiologist may recommend a “watchful waiting” approach, using medications to compensate for the valve that isn’t working properly, regular check-ups and ultrasounds.
In some cases, medication can be taken to help reduce the symptoms associated with a narrowed or leaky valve. These may include:
- ACE inhibitors open blood vessels and slow the effects of heart failure
- Anti-arrhythmic medications help restore the normal pumping rhythm when your heart isn’t beating properly
- Anticoagulants can help reduce the risk of blood clots from poorly circulating blood
- Beta-blockers reduce the workload on your heart and can lessen the feeling of palpitations
- Diuretics lower the workload on your heart by reducing the amount of fluid that it has to pump
- Calcium channel blockers open and relax blood vessels, reducing blood pressure and encouraging blood flow.
However, if you wait too long to have surgery, your heart muscle may become damaged which could impact your recovery after surgery or mean that you’re unable to have the procedure at all.
Heart valve repair
If your heart valve isn’t too badly damaged, you may be able to have it repaired and strengthened instead of replaced. There are a number of ways your surgeon can repair a valve without the need for open surgery.
This procedure can relieve a narrowed valve (with stenosis) and is often used on the mitral valve. A small catheter holding a collapsed balloon is threaded through an artery from your groin and placed inside the valve. Then the balloon is expanded, stretching open the valve.
Percutaneous mitral valve leaflet repair
A tiny clip is attached to the damaged part of your mitral valve, closing it tightly, so the rest of the valve can still open and close normally. The clip is used to minimise the amount of blood that regurgitates through the valve. To place the clip, the valve is accessed through a vein in your groin. This procedure is most commonly used for people who aren’t well enough for open heart surgery.
Other procedures for repairing congenital valve defects
Options include procedures to thicken or reshape the valve leaflets, remove calcium build-up from the leaflets, repair the cords that support the valves and patch holes or tears in the valve leaflets. If you have a congenital defect, ask your surgeon if you’re a candidate for one of these procedures.
An alternative heart valve replacement procedure
While most heart valve replacements are performed as open surgery, there’s a less invasive procedure where your surgeon replaces or repairs the valves through a catheter inserted in a vein. It’s called transcatheter aortic valve implantation (TAVI). Currently, it’s only offered to people who are elderly or unsuitable for open heart surgery. If you’d like to know more, ask your doctor if it’s right for you.