What is percutaneous valve replacement procedure?
A percutaneous valve replacement is a minimally invasive procedure to replace a diseased heart valve. The malfunctioning valve is removed and replaced with a manufactured valve, which may be mechanical. Other valve replacements may be crafted from animal tissue, or human tissue harvested from the patient’s own membrane enveloping the heart (pericardium).
A flexible tube (catheter) carries the valve to the heart through blood vessels, and then deploys the valve in place. The catheter may be inserted
- through the ribs into the apex of the heart (transapical),
- an artery in the wrist (transradial),
- neck (transjugular), or the
- groin (transfemoral).
The cardiologist uses ultrasonography and continuous X-ray (fluoroscopy) images for guidance.
Developments in percutaneous heart valve replacement
Percutaneous repair and replacement of heart valves is currently a developing field. While repair and balloon dilation of heart valves (valvuloplasty) are being performed extensively now, many of the valve replacement devices and techniques are still in developmental stages.
Currently, percutaneous valve replacement is performed only on patients who are at high risk for open heart surgery. Studies are ongoing to make it available as a less-invasive option to low-risk patients.
The heart has four valves that regulate the blood flow:
- Aortic valve between the left ventricle and aorta
- Mitral valve separating left atrium and left ventricle
- Pulmonary valve between right ventricle and pulmonary artery
- Tricuspid valve separating right atrium and right ventricle
Current stages of development in percutaneous replacement of the four heart valves are as follows:
Percutaneous aortic valve replacement/implantation (PAVR/PAVI) also known as transcatheter aortic valve replacement/implantation (TAVR/TAVI) is a well-established treatment under certain conditions. Balloon valvuloplasty is widely performed as a temporary treatment for aortic calve narrowing (stenosis).
Percutaneous balloon valvuloplasty is widely performed to dilate the mitral valve, but other procedures are in testing and clinical trial phases. Percutaneous mitral valve repair has been performed only in clinical trials, while percutaneous replacement is yet to be performed on humans.
Clinical experience in percutaneous pulmonary valve replacement is the largest among all percutaneous valve replacements. Pulmonary valve replacement is performed primarily for congenital heart disease.
At present percutaneous tricuspid valve repair procedure is under clinical trials and valve replacement is in early stages of development.
Why is percutaneous valve replacement performed?
Percutaneous procedure is a minimally invasive procedure for patients with serious heart valve disease who are elderly or those with significant other coexisting conditions (comorbidities) that preclude open surgery.
Currently, only aortic and pulmonary valve replacements are performed percutaneously. Only valve repairs and dilatation are percutaneously performed in the mitral and tricuspid valves.
Percutaneous valve replacement is performed to treat the following conditions:
- Backflow of blood from the aorta into the left ventricle (aortic regurgitation) due to
- Deterioration of the valve
- Bacterial infection (endocarditis)
- Obstruction of blood flow due to aortic valve stenosis
- Congenital heart disease with malformed aortic valve that leads to regurgitation or obstruction
- Pulmonary hypertension and dysfunctional pulmonary valve that results in pulmonary regurgitation
Health Solutions From Our Sponsors
Top Percutaneous Valve Replacement Procedure Related Articles
A-Fib SlideshowAFib symptoms like heart racing, fluttering, and irregular heart beat may be caused by heart disease, obesity, alcohol use, thyroid disease, and other conditions. AFib medications may include blood thinners, drugs to control heart rate or convert the heart to a normal rhythm. AFib surgery is also a treatment possibility.
Coronary Heart Disease Screening Tests (CAD)
Coronary heart disease or coronary heart disease (CAD) screening tests can be used to potentially prevent a heart attack or cardiac event in a person without heart disease symptoms, and can assist in diagnosing heart disease in individuals with heart disease symptoms. Examples of coronary heart disease tests include:
- electrocardiogram (ECC, EKG),
- exercise stress test,
- radionuclide stress test,
- stress echocardiography,
- pharmacologic stress test,
- CT coronary angiogram, and
- coronary angiogram.
Heart Attack (Myocardial Infarction)A heart attack happens when a blood clot completely obstructs a coronary artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical instability of the heart.
Heart Attack Symptoms and Early Warning Signs
Recognizing heart attack symptoms and signs can help save your life or that of someone you love. Some heart attack symptoms, including left arm pain and chest pain, are well known but other, more nonspecific symptoms may be associated with a heart attack. Nausea, vomiting, malaise, indigestion, sweating, shortness of breath, and fatigue may signal a heart attack. Heart attack symptoms and signs in women may differ from those in men.
Heart Attack Treatment
A heart attack involves damage or death of part of the heart muscle due to a blood clot. The aim of heart attack treatment is to prevent or stop this damage to the heart muscle. Heart attack treatments included medications, procedures, and surgeries to protect the heart muscle against injury.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include:
- High blood pressure
- High cholesterol
- Family history
Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
CAD SlideshowWhat is heart disease (coronary artery disease)? Learn about the causes of heart disease. Symptoms of heart disease include chest pain and shortness of breath. Explore heart disease diagnosis, treatment, and prevention.
Heart Disease SlideshowHeart disease prevention includes controlling risk factors like diet, exercise, and stress. Heart disease symptoms in women may differ from men. Use a heart disease risk calculator to determine your heart attack risk.
Heart Disease QuizTake our Heart Disease Quiz to get answers and facts about high cholesterol, atherosclerosis prevention, and the causes, symptoms, treatments, testing, and procedures for medically broken hearts.
Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include
- congested lungs,
- fluid and water retention,
- fatigue and weakness, and
- rapid or irregular heartbeats.
There are two types of congestive heart failure, systolic or left-sided heart failure; and diastolic or right-sided heart failure. Treatment, prognosis, and life-expectancy for a person with congestive heart failure depends upon the stage of the disease.
Heart Failure QuizWhat is heart failure? Learn about this dangerous condition, as well as who is at risk, and what to do about it.
Heart SymptomsHeart attacks symptoms vary greatly for men and women, from anxiety and fatigue to nausea and sweating. Learn the warning signs of a heart attack and know the symptoms that may require an immediate trip to the hospital.
Illustrations of the HeartThe muscle that pumps blood received from veins into arteries throughout the body. See a picture of the Heart and learn more about the health topic.
What Is a Heart Transplant?Heart transplant consists of three operations: 1) harvesting the heart from the donor, 2) removing the recipient's damaged heart, and 3) the implantation of the donor heart. The selection and distribution of donor hearts is a careful process so that the hearts are distributed fairly. For the patient requiring a heart transplant, all other important organs in the body must be in good shape. The most common complication of heart transplant is organ rejection.
Heart Valve Disease SurgeryHeart valves that are diseased can be treated both surgically (traditional heart valve surgery) and non-surgically (balloon valvuoplasty). The mitral valve is the most commonly repaired heart valve, but the aortic, pulmonic, and tricuspid valves may also undergo some of these repair techniques.
How Long Does It Take to Recover from A Transradial Heart Catheterization?Transradial Cardiac catheterization is performed using local anesthesia, and may take an hour or more, depending on the procedure performed. The patient usually feels nothing more than a short stinging pain from the initial numbing injection. The patient will be administered painkillers and mild sedation before the procedure. There might be a certain amount of post-procedural soreness that can be resolved with painkillers.
What Are The Four Heart Sounds?Heart sounds are generated by blood flowing in and out of the heart’s chambers through the valves as they open and close. Listening to the heart sounds through a stethoscope (auscultation) is one of the first steps a physician takes in evaluating a patient’s medical condition. Heart sounds provide the doctor valuable information about heart function. Auscultation is used to detect abnormal heart sounds and decide on further course of action.