Valvular heart problems involve primarily narrowing (stenosis)
or leakage (insufficiency or regurgitation)
of the aortic valve (primary outlet valve of the heart)
or mitral valve (primary valve between the upper and
lower chambers of the heart). All blood pumped by the heart
passes through these valves. Problems can be caused by rheumatic
fever or simply by degenerative changes occurring over many
years of opening and closing every second of the day. Certain
systemic illness and disease can contribute to the development
of valve problems including auto immune disease such as arthritis,
infections and kidney failure.
Mitral valve disease may be due to rheumatic disease
but currently is caused most often by mitral valve prolapse
syndrome, a poorly understood phenomena in which the valve
slowly becomes thickened, elongated and begins to regurgitate
blood back into the upper chamber of the heart causing heart
failure. The mitral valve somewhat resembles a parachute
in that long chords hold it in place. These chords may rupture
and result in sudden worsening of the valve leakage.
Thanks to advances in modern surgical techniques, most cases
of mitral valve prolapse can undergo repair of the
valve thus preventing the need for placement of an artificial
valve. Repair can be performed in 90-95% of cases of mitral
leakage due to prolapse syndrome. This allows the patient
to be treated postoperatively with simple blood thinners such
as baby aspirin rather than the more powerful anticoagulant
Coumadin required after most valve replacements and which
has some potentially serious side effects.
Dr. Ott and his team have one of the world's largest experiences
with mitral valve repair and replacement and can discuss the
options carefully and honestly with the patient.