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Valves are the gatekeepers of the heart. They act as doors, allowing blood to flow in and out of the heart, with every heartbeat. The American Heart Association says a healthy heart beats about 100,000 times a day, pumping around 2,000 gallons of blood. The AHA also says throughout an average 70-year lifespan, the heart beats around 2.5 billion times. That’s a lot of wear and tear for the heart’s valves.

Wear and tear on the heart’s valves can lead to valve disease. Medications can sometimes treat valve disease, but when medications aren’t suitable, surgery may be required. According to the American Heart Association, in 2003, more than 95,000 valve replacement surgeries were performed in the United States.

“The two most common valve diseases are valve stenosis, narrowing of the valve, and valve regurgitation, meaning the valve leaks,” says Vladimir Birjiniuk, M.D., chief of cardiothoracic surgery, at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School.

The heart has four valves: aortic, mitral, tricuspid and pulmonic. Stenosis and regurgitation are seen most commonly in the aortic and mitral valves, and can happen for several reasons, some of which include:

· Coronary artery disease

· Calcium deposits

· Growth of fibrous tissue

The aortic valve works closely with the left ventricle, which pumps blood everywhere except to the lungs (the right ventricle pumps to the lungs). Each ventricle has an “entrance” and an “exit” - one of the four valves. When functioning correctly, the aortic valve acts as the exit or outflow valve, allowing blood to leave. It closes quickly, making sure blood doesn’t “leak” back into the body.

In the case of aortic valve stenosis, Dr. Birjiniuk says the valve becomes narrow, mainly due to calcium deposits. When the valve becomes partially blocked its motions are restricted. The valve can’t swing open and close as much as it needs to in order to get blood back throughout the body. This forces the heart to work harder and eventually weakens the heart muscle. Symptoms of aortic valve stenosis may be:

· Coughing

· Fainting (particularly when exercising)

· Chest pains

· Shortness of breath

Medications are used to treat this disease; however if a patient requires surgery, the aortic valve is usually completely replaced.

Another common valve disease, says Dr. Birjiniuk, is called regurgitation, or “leakage”. The mitral valve allows blood to enter the heart from the lungs; it’s located on the left side. Regurgitation occurs when the mitral valve doesn’t close properly, allowing blood to leak back into the lungs, instead flowing in the one-way direction it’s supposed to be flowing. The more blood that flows backwards, the less blood that flows to the rest of the body. The heart has to work hard to make up for the backward flow. As time progresses, the heart becomes enlarged and weakens. Symptoms of mitral regurgitation include:

· Heart palpitations (the heart feels like it skips a beat)

· Shortness of breath

· Rapid breathing

· Chest Pain

· Coughing

· Fatigue

As with aortic valve stenosis, there are medications to relieve this disease; however, sometimes surgery is needed. In these instances, the mitral valve can be repaired rather than completely replaced.

During a valve repair procedure, the surgeon fixes the damaged valve, many times without using artificial parts. Dr. Birjiniuk says the benefits to valve repair include a reduced need for blood-thinning medication, a lower risk of infection, and less trauma on the heart.

Valve replacement surgery requires the surgeon to take out the original valve and completely replace it with a new, artificial valve. The artificial valve can either be mechanical or tissue, also known as biological. The tissue valve is made of human or animal tissue.

“Surgical procedures have really advanced in recent years, making valve replacement surgery safer and much more effective,” says Dr. Birjiniuk.

For a free Mount Auburn Hospital healthy heart pocket slider, please call us at 617-499-5094