Treatment horizons for heart valve disease
Heart valve disease is a growing concern in the UK, with prevalence expected to increase significantly in the next few years due to the ageing population. Early identification, referral and subsequent treatment are essential for patients with heart valve disease, because if left untreated, half of those patients will die within two years of developing symptoms.i
There are a variety of effective treatments available for heart valve disease patients, including valve repair or replacement. There are two types of valve for replacement, but more and more patients are opting for tissue heart valves. The drawback with this type of valve is that they wear out after 10 – 20 years (depending on the age of the patient). Occasionally, mechanical valves are used, which don’t wear out, but require the patient to take a lifelong blood-thinning medication.ii
Heart valve disease patients now live longer than ever before and want to continue to lead active lives, which has dictated the need for more resilient, longer-lasting tissue valves. This is particularly important for younger patients, who do not wish to undergo multiple valve replacements for the remainder of their lifetime. Major advances have been made in minimally invasive procedures such as transcatheter aortic valve implantation (TAVI), where a valve can be floated through the blood circulation system from a small cut in the groin or chest to the heart, often whilst the patient remains awake.iii These procedures are recommended for patients who are deemed too high risk to undergo open heart surgery. Tissue valves will eventually wear out through calcification (hardening), however, latest processes reduce calcification and potentially double the life expectancy of the valve.
When tissue valves fail, instead of patients requiring further open-heart surgery, this problem can increasingly be treated by floating the new valve through the circulation and locking it into the frame of the old valve, called valve-in-valve transcatheter aortic valve implantation (ViV-TAVI).
“These new innovations for heart valve disease are fantastic news for patients, who want to get back on their feet as quickly as possible and lead a healthy, active life post-treatment,” comments Mr Chris Young, Consultant Cardiothoracic Surgeon, Guys and St Thomas’. “With the introduction of longer-lasting valves, and the possibility of valve-in-valve treatment once the previous one reaches the end of its life-span, patients are being given the option of fewer procedures which are also minimally invasive.”
For more information about heart valve disease and the treatments available, please visit www.heartvalvevoice.org.
i Spaccarotella C et al. Pathophysiology of aortic stenosis and approach to treatment with percutaneous valve implantation. Circulation Journal. 2011;75:11-19.
ii American Heart Association. Type of replacement heart valves. Available at: http://www.heart.org/HEARTORG/Conditions/More/HeartValveProblemsandDisease/Types-of-Replacement-Heart-Valves_UCM_451175_Article.jsp#.V8fu7igrLIU. Last accessed October 2016
iii Royal Brompton Hospital. TAVI for aortic stenosis. Available at: http://www.rbht.nhs.uk/patients/condition/transcatheter-aortic-valve-implantation/. Last accessed October 2016
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