Inova’s Minimally Invasive Surgical Options Help Patients with Heart Valve Disease

Eric L. Sarin, MD, is a cardiac and thoracic surgeon with Inova Heart and Vascular Institute (IHVI). He is Section Chief of Adult Cardiac Surgery, Co-Director of the Structural Heart and Valve Program and Co-Director of Cardiovascular Research. 

Matthew W. Sherwood, MD, MHS, is an Inova interventional cardiologist, Director of Inova’s Left Atrial Appendage Closure/WATCHMAN Program and Co-Director of Inova’s Structural Heart Disease Program. Dr. Sherwood is board-certified in interventional cardiology, cardiovascular disease. 

Inova’s Structural Heart Valve Disease Program has a long history of surgically correcting heart and valve conditions. We’re national leaders, performing a high volume of minimally invasive heart valve procedures – in the top 2 percent of hospitals in the US. Our experts use the most advanced technology to treat complicated heart conditions in minimally invasive ways.

What Is Heart Valve Disease?
The human heart has four valves: the mitral, tricuspid, aortic and pulmonic valves. They keep blood flowing in the right direction between the four chambers of the heart and the blood vessels. Heart valve disease (also called valvular heart disease) occurs when any of the valves don’t function properly.

There are two common types of heart valve disease:

• Regurgitation: Also known as “leaky valve,” regurgitation is when a valve doesn’t close properly, causing blood to flow backward.
• Stenosis: Stenosis is the narrowing of a valve, resulting in reduced blood flow into or out of one of the heart’s chambers.

Valvular diseases are named based on which valve is affected. For example, a narrowing of the aortic valve is called aortic stenosis. When blood flows back to the heart from the mitral valve, it’s called mitral valve regurgitation.

Heart Valve Disease Risk Factors and Symptoms

Valvular heart disease is more common among older people. As we age, heart valves can become lined with calcium deposits that make them stiffer and weaker.

Other risk factors for developing heart valve disease include:

• Congenital heart defects
• History of rheumatic fever
• Heart murmur

Symptoms of heart valve disease often start subtly and then increase over time. Symptoms may include:

• Fatigue and shortness of breath
• Frequently feeling faint or lightheaded
• Chest discomfort
• Palpitations or feeling like your heart is skipping beats
• Swelling in feet or ankles

How Inova’s Structural Heart Valve Disease Program Helps Patients with Heart Valve Disease

Patients are typically diagnosed with heart valve disease after a primary care doctor refers them to a cardiologist for an echocardiogram (ultrasound of the heart).

At Inova, patients with moderate or severe valve disease are referred to Inova’s Structural Heart Valve Disease Program. Using the combined expertise of a team comprising cardiac surgeons, cardiologists and nurse practitioners, we develop personalized treatment plans tailored to each patient. In some cases, we can manage valve damage with medications. Often, the treatment plan includes a procedure or surgery.

Minimally Invasive Surgical Options at Inova

Historically, valve repair and replacement has been done with open-heart surgery. But we can now offer minimally invasive techniques using tiny incisions and small catheters for many patients. These procedures offer lower risk of complications, shorter hospital stays and faster recovery: More than half of Inova patients undergoing catheter-based procedures only stay in the hospital for one night, compared to the typical four- to seven-day stay for open-heart surgery. Patients also have a much quicker return to normal activities.

Minimally invasive surgical options for valve replacement at Inova include:

• Transcatheter aortic valve replacement (TAVR): Surgeons can replace a damaged aortic valve with a new, prosthetic (man-made) valve. The new valve is attached to the end of a catheter that is inserted into a vein in the leg or artery in the chest and guided to the heart.
• Transcatheter mitral valve therapies:
  • MitraClip®: This procedure involves threading a catheter with a MitraClip® through a vein in a patient’s leg up to their heart. An interventional cardiologist clips a small area of the mitral valve using the MitraClip® to reduce the amount of blood that flows back into the heart.
  • Intrepid ™ Transcatheter Mitral Valve Replacement (TMVR): This minimally invasive procedure is an alternative to open-heart surgical repair. It is available to select high-risk patients that are not eligible for conventional mitral valve surgery.
• Prosthetic paravalvular leak (PVL) repair: In rare instances, artificial replacement valves may wear down over time and start to leak blood back into the heart. Our interventional cardiologists can perform PVL repair by inserting a catheter into the groin area and up to the blood vessels by the leaky valve. They use a tiny closure device to stop the leak.

Promising Tricuspid Valve Repair Clinical Trials

Inova participates in leading clinical research, such as the TRILUMINATE Pivotal Trial, a research trial using the TriClip™ Tricuspid Valve Repair System. The tricuspid valve has three flaps, which makes it difficult to clip with previous methods. Additionally, the valve is located in an area that has been difficult to image. The TriClip system uses new imaging technology and devices to treat tricuspid regurgitation.

Inova’s hybrid operating rooms (ORs) were renovated in 2021 to have the most advanced technology. A hybrid OR combines advanced imaging technology with the traditional capabilities of a heart and vascular operating room. These ORs allow our doctors to perform minimally invasive procedures with the latest technology. The high-tech imaging enables them to see the body in real-time, critical for placing medical devices like heart valves. [SH1] 

Inova’s Heart Valve Surgery is Recognized Nationwide

Patients can feel confident receiving heart valve care at Inova. The Structural Heart Disease Program regularly receives national recognition and awards, including:

• The Mitral Valve Repair Reference Center Award recognizes centers that demonstrate a superior level of mitral valve repair outcomes. Inova is one of only 20 programs in the country earning this award.
  
• A three-star rating from the Society of Thoracic Surgeons (STS) is the highest honor bestowed from STSfor open aortic valve surgery.

• US News & World Report High-Performing Hospital recognition for cardiology and heart surgery means Inova’s heart program is in the top 10 percent of heart centers in the US.

Patients come from all over Virginia, Maryland and DC to receive care here. Learn more about Inova’s Structural Heart Valve Disease Program.

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