Guest Columnist
by
Heart Surgeon Roxanne Newman, M.D.
MeritCare Heart Center
Heart valve repair: Highly successful and today's standard
When all four valves of your heart function properly, you don't even realize it. The blood flows where it should, the heart pumps efficiently and you have energy to carry you through the day. But when a valve doesn't properly open and close, which can happen for several reasons, including wear and tear from aging, the difference eventually becomes noticeable. To a patient, early symptoms may be decreased endurance and a gradual decline of energy. To a doctor, a key sign will be the sound of a heart murmur.
In the past, when patients were diagnosed with a regurgitant heart valve (a valve that allows a backflow of blood), the usual course of treatment was medication to manage the condition, sometimes for years. Surgery was delayed as long as possible because it involved replacement, and replacement was complex, involving 10 days in the hospital, a large incision down the chest, possible rejection of the artificial valve and the need for lifelong blood thinners. If patients eventually underwent this complex surgery, it wasn't until they showed severe, debilitating symptoms of valvular disease. By this time, they had likely already sustained permanent damage to the heart muscle, impacting the success of the surgery and in particular the recovery.
Over the last five years, we've seen remarkable changes. Today, valve repair — rather than replacement — has become the standard of care. And the success rate for repair has been overwhelming, to the point it has changed the timing of surgical intervention. Today, when patients start showing moderate to severe regurgitation, as shown during an imaging study called an echocardiogram, we advocate repairing it, even if the patient does not yet have symptoms. At MeritCare Heart Center, we perform this highly successful procedure on adults of all ages — from their 20s to their 80s, all with a high rate of success. Each year, we perform approximately 165 procedures related to valve disease.
MeritCare also performs valve repair using a minimally invasive approach. This can be an excellent option for people who are not obese and whose surgery is limited to repair only. The difference is not so much in the surgery itself, but in the recovery. Patients who undergo the minimally invasive approach experience a more rapid recovery — and really appreciate it.
Patients who have heart valve surgery can expect to be hospitalized for about four to five days. Shortly after hospitalization, they begin outpatient cardiac rehab. By one month after surgery, they're about 80 to 90 percent recovered. Most patients are back to work without limitations in four to six weeks. And six months after surgery? Patients are often amazed at the difference. Compared to pre-surgery, their capacity for endurance has improved and their energy has increased. They often tell me, "I had no idea how sick I was. I just thought I was out of shape and getting old."
If you'd like more information about heart valve surgery, please call (701) 234-2371 or (800) 437-4010 or visit heart.meritcare.com to learn more about MeritCare Heart Center.
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