# Treatment Methods for Heart Valve Diseases
The treatment of heart valve diseases depends on which valve is affected, how severe the disease is, and how well the heart is still functioning. Often, treatment begins with observation and medication, and later progresses to a procedure if the valve continues to deteriorate. This tab describes regular treatments per stage.
Observation and Medication in Early Stages
Many heart valve diseases do not cause symptoms at first. In this phase, the disease is usually monitored with regular echocardiograms (ultrasound examinations of the heart). The goal is to see whether the valve is deteriorating or remains stable.
If the valve begins to fail but the heart is still functioning well, certain medications can help:
**Low blood pressure** can reduce the burden on a leaking valve. This is done under the guidance of a cardiologist.
ProveniIncluded in official guidelines, or approved by EMA or FDA
ACE inhibitors and similar drugs are sometimes given for certain valve defects, especially in severe leakage where the heart has to pump harder. They help the heart work less hard. These medications can have side effects such as coughing, dizziness, or low blood pressure. They are always used under medical supervision.
ResearchediPositive results in clinical studies, not yet standard treatment
For many heart valve diseases: medications can reduce symptoms and relieve the heart, but cannot prevent the valve from eventually needing to be replaced or repaired.
Percutaneous (Catheter-Based) Procedures
In modern examination and treatment, a growing portion of treatments are catheter-based: the physician inserts thin tubes (catheters) through a blood vessel, without opening the chest cavity.
**Transcatheter Aorta Valve Implantation (TAVI)**
This is a procedure in which a new heart valve prosthesis is placed in the aortic valve via a catheter. The new valve is positioned where the old one is. This is done under X-ray guidance and/or CT guidance (scans that help with very precise placement).
ProveniIncluded in official guidelines, or approved by EMA or FDA
TAVI is usually used for severe aortic stenosis (narrowing of the aortic valve) when surgery carries a greater risk. Advantages include that the procedure is less burdensome than open-heart surgery.
Possible complications include infections of the heart valve prosthesis (endocarditis), leakage around the prosthesis, heart rhythm disorders, damage to blood vessels, and in rare cases stroke. Lung problems (such as interstitial lung disease) can also make the procedure riskier.
New navigation techniques, such as intraprocedural CT-fluoroscopy image fusion, help make placement increasingly precise, but are not yet standard everywhere.
**Transcatheter Mitral Edge-to-Edge Repair (TEER)**
This is a procedure in which a 'clamp' or 'clip' is placed between the two leaflets of the mitral valve so that they close better against each other. This is especially helpful for mitral regurgitation.
ProveniIncluded in official guidelines, or approved by EMA or FDA
The procedure is performed under ultrasound and X-ray guidance. It is less invasive than surgery. Complications can include infections of the heart valve prosthesis and leakages.
**Transcatheter Pulmonary Valve Replacement (TPVR)**
This is a catheter procedure in which a new heart valve prosthesis is placed in the pulmonary valve. This is done especially in patients who have had previous surgical pulmonary valve replacements and need a new valve again.
ProveniIncluded in official guidelines, or approved by EMA or FDA
The procedure is less burdensome than surgery again. Risks appear to be comparable to TAVI.
**Transcatheter Tricuspid Valve Replacement (TTVR)**
This is a new procedure for the tricuspid valve (right heart valve). It is still in the investigational stage and is mainly being applied in a research setting.
ExperimentaliOngoing in study setting, outcome still unknown
Surgical Valve Repair and Replacement
Open-heart surgery is still the standard treatment for many patients, especially younger ones and those with low operative risk.
**Mitral Valve Repair (Restoration)**
The surgeon attempts to repair the mitral valve instead of replacing it. This can be done by securing leaflets, narrowing the valve, or using other techniques. Minimally invasive approach (via smaller incisions) is increasingly used.
ProveniIncluded in official guidelines, or approved by EMA or FDA
The advantage is that the patient's own valve continues to work. Risks are the same as with any open-heart surgery: infections, blood loss, heart rhythm disorders, and rarely stroke. Recovery period typically lasts several weeks to months.
Newer techniques, such as robotic-assisted repair, can increase precision.
**Heart Valve Replacement (Surgical)**
A damaged valve is removed and replaced with a prosthesis. This can be a mechanical valve (artificial, very durable, but requires blood thinners) or a biological valve (from animal or human tissue, less durable, usually no thinners needed).
ProveniIncluded in official guidelines, or approved by EMA or FDA
The choice depends on age, kidney function, bleeding risk, and preference. Risks are in line with valve repair. With mechanical valves, lifelong anticoagulation therapy (blood thinning) is needed, with blood clotting checks. With biological valves, wear can occur years later, after which reoperation may be necessary.
**Aortic Stenosis Surgery**
If the aortic valve is severely narrowed and the patient is not suitable for TAVI, surgical replacement or in rare cases widening can be performed.
ProveniIncluded in official guidelines, or approved by EMA or FDA
The same principles of prosthesis choice apply.
Cardiac rehabilitation after procedure
After both catheter-based and surgical procedures, cardiac rehabilitation usually follows: guided exercise and education, in a clinic or at home.
ProveniIncluded in official guidelines, or approved by EMA or FDA
This helps the heart become strong again and restores patient confidence. Home-based programs are increasingly researched and appear to work well for many people.
Lifelong monitoring and medication
Regardless of which treatment, patients with heart valve disease usually need regular check-ups (echocardiogram, doctor visits).
With certain procedures, specific medications are needed:
- **Anticoagulants (blood thinners)** with mechanical heart valve prostheses (standard treatment).
ProveniIncluded in official guidelines, or approved by EMA or FDA
- **Anticoagulation prophylaxis** sometimes briefly after procedure to prevent blood clots.
ProveniIncluded in official guidelines, or approved by EMA or FDA
- **Antibiotic prophylaxis** (preventive antibiotics) before certain procedures in patients at high risk of heart valve infection, although there is discussion about its importance.
ResearchediPositive results in clinical studies, not yet standard treatment
Diabetes and aortic stenosis
Recent research suggests that type 2 diabetes is associated with faster progression of aortic stenosis. This means that diabetics need to be monitored more closely and may need treatment earlier. This does not change the type of treatment, but emphasizes the importance of regular check-ups.
Special situations
**Heart myxoma (tumor) causing valve symptoms**
In rare cases, a benign heart tumor (myxoma) causes valve dysfunction. This can be removed with minimally invasive surgery.
ProveniIncluded in official guidelines, or approved by EMA or FDA
**Infective endocarditis (heart valve infection)**
This is a serious infection of heart valves, often caused by bacteria. Antibiotics are the first approach. If the infection cannot be controlled or causes major damage, surgical intervention is needed. This is an emergency.
ProveniIncluded in official guidelines, or approved by EMA or FDA
---
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._