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Memorial Hermann Heart & Vascular Institute-Texas Medical Center Heart valve disease, or valvular disease, refers to any dysfunction or abnormality of one or more of the heart’s valves. The heart has four valves: the mitral, aortic, tricuspid and pulmonic valves, that function as gates in the heart to keep blood flowing. Our medical team cares for patients with congenital, degenerative, rheumatic and ischemic valvular heart disease, as well as those whose disease is related to valve endocarditis. As faculty members at The University of Texas Medical School at Houston, physicians on staff at Memorial Hermann Heart & Vascular Institute-Texas Medical Center serve as principal investigators in national and international research trials, and publish and present scholarly articles worldwide. As a result, our patients have access to new medical therapies, innovative devices and technology very quickly after their introduction, and those who qualify have the opportunity to participate in clinical trials of treatments not otherwise available. Our program is unique in Houston in its primary focus on less-invasive approaches to valvular surgery. Scope of Expertise Catheter-based Procedures - Percutaneous mitral valve repair for mitral stenosis
- Percutaneous aortic valve repair for aortic stenosis
- Mitral valve annular and leaflet procedures for mitral regurgitation
- Insertion of closure devices for prosthetic paravalvular leaks
- Balloon aortic, balloon mitral and balloon pulmonary valvuloplasty
Minimally Invasive Open Procedures - Mitral and aortic valve reconstruction
- Mechanical valve replacement
- Bioprosthetic valve replacement
- Annular enlargement procedures for aortic valve replacement in small hearts
- Valve-sparing aortic root replacement
- Apico-aortic conduits for aortic stenosis
Treatments At the Memorial Hermann Heart & Vascular Institute-TMC, heart and vascular specialists are using mini-incisions to replace and repair cardiac valves, allowing many patients to avoid the traditional sternotomy, a type of incision in the center of the chest that separates the sternum (chestbone) to allow access to the heart. Cutting the sternum and spreading the breastbone extends healing time and increases the risk of infection and complications. Minimally invasive approaches to valve repair and replacement benefit patients by decreasing the need for blood transfusions, reducing length of stay in the hospital and allowing for an earlier return to work. Disorders such as mitral or aortic valve regurgitation or stenosis require valve replacement or repair. When possible, valve preservation is preferred. If replacement is necessary, however, surgeons at the Institute can perform the most advanced techniques:
Minimally Invasive Valve Repair/Least Invasive Valve Surgery (LiV) The surgeon makes a small incision on the right side of the chest, below the breast fold, and under direct vision repairs the valve. Valve replacement can also be performed through this incision. Advantages include reduced surgical trauma, less blood loss, less chance of infection and faster recovery. The approach has been used in thousands of patients nationwide and can be used to treat both aortic and mitral valve disorders. Mitral Valve Repair with Evalve® Memorial Hermann Heart & Vascular Institute-TMC is the only hospital in Houston and one of three in Texas chosen to participate in the nationwide Endovascular Edge-to-Edge Repair Study, or EVEREST II, investigating the minimally invasive Evalve® Cardiovascular Valve Repair System for the treatment of mitral regurgitation (MR). Using this system, cardiologists deploy a tiny clip delivered by a catheter into the heart to repair the malfunctioning mitral valve. The heart beats normally during the procedure; heart-lung bypass is not required, and patients return to normal activity within several days. In addition to improving blood flow through the heart, the procedure may also relieve symptoms such as fatigue and shortness of breath, common conditions in patients with significant MR. The device may improve quality of life and help MR patients avoid surgery or delay it, preserving surgical options – valve repair or replacement – should surgery become necessary. A new use of valvuloplasty – inserting a special balloon into a narrowed mitral valve – may also delay surgery in mitral stenosis patients for eight to 10 years. Advanced Aortic Valve Replacement Renowned for pioneering aortic surgery techniques, surgeons here are aggressive in their approach to aortic valve treatment, an area where valve replacement, rather than repair, is often required. Surgeons at the Heart & Vascular Institute-TMC use bioprosthetic heart valves, a recent advancement that allows appropriate patients to avoid anticoagulant therapy. Percutaneous Aortic Valve Replacement For patients who are not considered candidates for open aortic valve replacement, new less-invasive or endovascular approaches are currently in development. When clinical trials of the new percutaneous aortic valve replacement procedures begin in the United States, cardiac interventionalists at the Heart & Vascular Institute-TMC will offer them to appropriate patients. In the interim, alternative therapies are available, including balloon aortic valvuloplasty.
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