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The Cleveland Clinic

Valve Disease Treatment

Diseased heart valves can be treated both surgically (traditional heart valve surgery) and non-surgically (balloon valvuloplasty).

What Happens During Traditional Heart Valve Surgery?

During traditional heart valve surgery, a surgeon will make an incision down the center of your sternum (breastbone) to get direct access to your heart. Often, the surgeon and cardiologist (heart doctor) will use a probe that is passed down the esophagus to help determine the functioning of the valve before and after surgery. If your valve can be repaired, your surgeon will perform any of the following types of valve repair procedures.

  • Commissurotomy. Fused valve leaflets are separated to widen the valve opening.
  • Decalcification. Calcium deposits are removed to allow the leaflets to be more flexible and close properly.
  • Reshape leaflets. If one of the leaflets is floppy, and bows back into the left atrium, a segment may be cut out and the leaflet sewed back together, allowing the valve to close more tightly.
  • Repair of chordae or papillary muscles. If the chordae or papillary muscles are torn or stretched out, they will not give the valve leaflets support. The surgeon may transfer or shorten the chordae to the correct length to provide support for the leaflet, allowing the valve to seal tightly.
  • Annulus support. If the valve annulus (the ring of tissue supporting the valve) is too wide, it may be reshaped or tightened by stitches or sewing a ring structure to the annulus. The ring may be made of tissue or synthetic material.
  • Patched leaflets. The surgeon may patch any leaflets with tears or holes with tissue patches.

What If My Valves Cannot Be Repaired?

If your valves cannot be repaired, your doctor will replace the valve.

During the surgery, the old valve is removed and a new valve is sewn to the annulus of your old valve. The new valve can be a:

  • Mechanical valve. It is made totally of mechanical parts that are tolerated well by the body. The bi-leaflet valve is used most often. It consists of two carbon leaflets in a ring covered with polyester knit fabric.
  • Biological valve. Also called a tissue or bioprosthetic valve, it is made of tissue taken from pigs or cows. It may also have some artificial parts to help give the valve support and sew it in place.
  • Homograft valve. This type of valve may be used to replace a diseased aortic or pulmonic valve. A homograft is an aortic or pulmonic valve that has been removed from a donated human heart, preserved and frozen under sterile conditions.


Next: What are the advantages and disadvantages of each type of valve? »

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