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THINK OF THE blood flowing through your AN OPEN- HEART HEALTH
heart like cars traveling on an interstate. AND-SHUT
Traffic moves smoothly as long as everyone PROBLEM while listening to a patient’s heart during
drives in the right direction. If drivers a physical exam,” Dr. Elmore says. “An
from one side of the highway crossed over Flexibility is often a good thing, but echocardiogram then allows us to see how
into the opposite lanes and drove against too much of it can be bad for an much stenosis or leakiness is present.”
the flow of traffic, it could cause serious important part of your heart: the
problems. mitral valve. OUT WITH THE OLD, IN WITH THE NEW
In the same way, the heart works As the gateway between the Medication can’t fix a faulty aortic
best when everything flows in the right heart’s left atrium and left ventricle, valve, so surgery to replace it is the
direction, and it has four valves to keep the mitral valve helps blood flow most common treatment. For many
blood from going the wrong way. One of from the top of your heart to the patients, the surgery is a standard,
them, the aortic valve, is the gateway from bottom with each heartbeat. When open-heart operation. Certain people,
the heart to the aorta, the body’s largest closed, the valve’s two leaflets form however, can’t have open-heart surgery
artery. The aorta takes oxygen-rich blood a seal to keep blood from flowing because the risk is too great.
from the heart and moves it to the other backward. If the flaps bend too
arteries and vessels that make sure blood much, the valve doesn’t shut all “Patients for whom open-heart surgery
gets to every corner of the body. the way. This is called mitral valve is too risky, because of age and other
prolapse (MVP), a condition that health problems, can have a minimally
“The aortic valve has three flaps called affects about 2 percent of people, invasive procedure called transcatheter
leaflets that open to let blood flow into according to the American Heart aortic valve replacement [TAVR],”
the aorta and close to keep it from Association. For some people with Dr. Elmore says. “Instead of full sedation
leaking back into the heart,” says Julius MVP, blood can leak back through and a large incision in the chest, as open-
Elmore, MD, interventional/structural the poorly closed valve and cause heart surgery requires, TAVR involves
cardiologist at Navicent Health. problems. minimal sedation and a small incision in
“Problems can happen if the leaflets lose the groin.”
the ability to bend like they should.” “Most people who have MVP
are born with it,” says Erskine To do the TAVR procedure, surgeons
STIFFENING UP James, MD, FACC, cardiologist use catheters to send a replacement
at Navicent Health. “Some go valve through the patient’s blood
When your knees get stiff, you have a their whole lives and never know vessels to the aortic valve. When the
tough time walking until they loosen up. they have it, but others develop new valve is in place, its leaflets push
The same thing can happen to the aortic symptoms if there’s backward blood the damaged ones aside.
valve’s leaflets—except they don’t relax flow. The most common signs
on their own. are shortness of breath and rapid “TAVR’s minimally invasive approach
heartbeat, which often occur during usually allows patients to go home in 24
“Over time, calcium deposits and the periods of anxiety.” to 48 hours, much sooner than with open-
wear and tear of aging can make the valve heart surgery,” Dr. Elmore says. “TAVR also
stiff so it doesn’t open well and blood Not everyone with MVP needs carries less risk of complications.”
has a hard time flowing into the aorta,” treatment. For those who do,
Dr. Elmore says. “The valve can also become medication often helps. If symptoms Twelve weeks of outpatient cardiac
leaky if calcium and plaque collect on the keep getting worse, though, rehabilitation help patients complete
leaflets and make them rigid. Stiffness, also surgery—usually to replace the their recoveries. With a new aortic valve
called stenosis, is more common, but quite valve—may be needed. in place to direct traffic, the blood has a
a few patients develop leakiness at the smoother journey.
same time.” “Replacement valves are
mechanical or made of animal or “We’ve made great strides in treating
Aortic valve disease doesn’t always cause human tissue,” Dr. James says. aortic valve disease,” Dr. Elmore says. “Our
symptoms. When it does, it’s because the “The surgeon decides which type treatment options, such as TAVR, have
heart has to work harder to pump blood to to use based on the patient’s age become less invasive and more effective,
the rest of the body. Symptoms can include: and health. Once the new valve is and that trend will continue.”
»» Chest pain in place, the surgeon uses imaging
»» Dizziness to make sure it works correctly WITH A THREE-STAR RATING
»» Fainting and closes tightly before finishing FROM THE SOCIETY OF THORACIC
»» Shortness of breath during the operation. Mechanical valves SURGEONS, HEART CENTER,
last a lifetime. Biological ones can NAVICENT HEALTH IS THE
exercise or when lying in bed last 10–20 years before needing REGION’S PREMIER PLACE FOR
»» Swollen legs replacement.” CARDIOVASCULAR CARE. VISIT
»» Tiredness WWW.NAVICENTHEALTH.ORG
AND SEARCH “HEART CENTER” TO
“Physicians usually diagnose aortic LEARN ABOUT EVERYTHING THE
valve disease when they hear a murmur CENTER HAS TO OFFER.
5SPRING 2018 | navicenthealth.org 
