Non-Surgical Treatments for Leaky Heart Valve

A leaky heart valve, or heart valve regurgitation, occurs when one or more of the heart’s valves don’t close properly, causing blood to flow backward into the heart. This condition can put strain on the heart, leading to symptoms like shortness of breath, fatigue, and palpitations.

While surgery is often considered the go-to solution for severe cases, many individuals are opting for non-surgical treatments, which can be just as effective depending on the severity of the condition.

Heart valve regurgitation is a symptom of valvular heart disease. Typically diagnosed in people 65 or older, valvular heart disease can produce symptoms which could be dismissed as signs of typical aging or other easily manageable conditions – but could signal something potentially much more serious, explains Nish Patel, M.D., an interventional cardiologist at Baptist Health Miami Cardiac & Vascular Institute  who specializes in catheter-based therapies for valvular heart disease. Those symptoms could include fatigue, shortness of breath, dizziness or an irregular heartbeat.

“At this point, the cardiologist and our community of structural heart specialists are focused on those fatigue symptoms where the patient may just blame it on their age,” said Dr. Patel. “But the symptoms may be associated with underlying valvular heart disease. So, anytime a patient 65 and above have these symptoms, they should seek cardiology evaluation.

“And, if the cardiologist or other primary care physician finds something unusual, such as a murmur, then they will arrange an echocardiogram for the patient, and the echocardiogram would give us information if there's any issues with any of the valves. That's how we would find the valvular heart disease.”

Why Choose Non-Surgical Treatments?

The decision to pursue non-surgical treatments for a leaky heart valve is often based on several factors:

1. Mild to Moderate Regurgitation: If the regurgitation is not severe, your doctor may recommend a conservative approach to monitor the condition and manage symptoms without immediate surgery.
2. Risk Factors for Surgery: Surgery, especially for older adults or individuals with other underlying health conditions, carries inherent risks. Non-surgical options can provide relief without the need for an invasive procedure.
3. Improved Quality of Life: Non-surgical treatments can help alleviate symptoms and improve overall well-being, potentially postponing or eliminating the need for surgery.
4. Advances in Medical Technology: Non-surgical interventions, such as transcatheter procedures, have become increasingly effective in recent years. These methods can help address valve issues without the need for traditional surgery.

Non-Surgical Treatment Options

If you’ve been diagnosed with a leaky heart valve and are exploring alternatives to surgery, here are some of the most commonly used non-surgical treatments:

1. Medications

While medications don’t cure valve disease, they can play a vital role in managing symptoms and preventing further complications. Common medications used for leaky heart valves include:

• Diuretics: These help reduce fluid buildup in the body, easing symptoms such as swelling in the legs and difficulty breathing.
• Beta-blockers and ACE Inhibitors: These medications help lower blood pressure and reduce the workload on the heart, which is essential when dealing with a leaky valve.
• Blood Thinners: In some cases, anticoagulants like warfarin may be prescribed to prevent blood clots that can form due to valve dysfunction.

Medications are typically recommended when the regurgitation is mild or when surgery is not immediately necessary.

2. Lifestyle Changes

Making certain lifestyle adjustments can significantly improve heart health and manage the effects of a leaky valve. These changes can also help reduce your risk of developing complications that could require surgery. Some key lifestyle changes include:

• Regular Exercise: Physical activity, such as walking or swimming, helps improve cardiovascular health and overall stamina, which can reduce symptoms of heart failure.
• Healthy Diet: Eating a diet low in sodium and rich in fruits, vegetables, and whole grains can help manage blood pressure and reduce the strain on the heart.
• Weight Management: Maintaining a healthy weight reduces the burden on the heart, especially if you have additional conditions such as high blood pressure or diabetes.

While lifestyle changes are important for overall heart health, they should be seen as complementary treatments, rather than stand-alone solutions for valve disease.

3. Transcatheter Valve Repair or Replacement (TAVR)

For individuals who cannot undergo traditional open-heart surgery due to age or other health conditions, transcatheter procedures offer a promising non-surgical option. These minimally invasive techniques are particularly useful for those with aortic valve regurgitation but can be applied to other types of valve issues as well.

• Transcatheter Aortic Valve Replacement (TAVR): This procedure involves inserting a new valve through a catheter inserted into a blood vessel, typically through the groin or chest, to replace a damaged aortic valve.
• Mitral Valve Repair or Replacement: In some cases, transcatheter mitral valve interventions can repair or replace a faulty mitral valve. The procedure involves inserting a device through a catheter to either repair the valve or replace it with a new one.

These procedures are generally safer than traditional open-heart surgery and have shorter recovery times, making them an excellent choice for patients with other health concerns or those at high surgical risk.

4. Cardiac Rehabilitation

Cardiac rehabilitation programs are designed to help patients with heart disease regain strength and improve heart function after a health event. For individuals with a leaky heart valve, cardiac rehab can be part of a broader treatment plan to improve overall heart health.

A typical rehab program includes supervised exercise, education on heart-healthy living, and counseling. It helps patients recover from symptoms, enhance cardiovascular fitness, and avoid further complications.

When to Consider Surgery

Even though many non-surgical treatments can effectively manage a leaky heart valve, surgery may still be necessary in certain circumstances. Here are a few signs that surgery might be the best option:

• Severe Symptoms: If symptoms such as shortness of breath, fatigue, or chest pain become debilitating or do not improve with non-surgical treatments, surgery may be needed.
• Progressive Valve Damage: If the valve damage worsens over time, surgery may become unavoidable to prevent further damage to the heart.
• Heart Failure: If a leaky valve leads to heart failure and non-surgical treatments fail to help, surgical intervention may be required to avoid long-term complications.

If you’ve been diagnosed with a leaky heart valve, you don’t necessarily need to be rushed into surgery. Non-surgical treatments, including medications, lifestyle changes, and minimally invasive procedures like TAVR, offer effective alternatives to traditional surgery. Discussing your condition with a healthcare provider is essential to determine the most appropriate treatment plan based on your specific situation and health profile.

Nish Patel, M.D., interventional cardiologist at Baptist Health Miami Cardiac & Vascular Institute.

Early intervention and proactive management of a leaky heart valve can significantly improve quality of life, delay or eliminate the need for surgery, and ensure better long-term heart health.

Dr. Patel emphasizes that Baptist Health Miami Cardiac & Vascular Institute is unique in South Florida because it has a team of structural heart specialists that make up a Valve Clinic where patients have access to a multi-disciplinary team once they are diagnosed with severe valvular heart disease.

“It’s a multi-disciplinary clinic where the structural heart specialist and the cardiothoracic surgeon see the patient on the same day, and they would have the appropriate test done prior to that appointment,” said Dr. Patel. “When patient leaves the office visit, they would have a plan on how to approach their valvular heart disease after having a comprehensive evaluation.”

For more information on heart valve disease and treatment options, visit Baptist Health Heart and Vascular Care.