Heart Valve Disease Program

The Heart Valve Disease Program specializes in disorders in which heart valves are either too narrow or leaking. A dedicated team of multidisciplinary professionals offer the latest methods of diagnosis and treatment.

Cutting-edge ultrasound, X-ray, and computed tomography (CT scan) techniques are available to detect heart valve disease. In addition to standard heart valve surgery techniques, Cleveland Clinic Abu Dhabi offers minimally invasive procedures for heart valve repair and replacement, which can mean less trauma and faster healing for the patient. Our program was the first to introduce the transcatheter aortic valve replacement (TAVR) procedure to the region, an innovative treatment option for high-risk patients requiring mitral valve repair. Surgical procedures can be performed through the groin using catheters, or through small incisions in the chest using videoscopic and robotically-assisted surgery techniques.

What We Treat

The heart valves allow blood to flow through the heart and into the lungs and around the body. There are four heart valves: the aortic, mitral, tricuspid, and pulmonic valves. If diseased, these heart valves are either too narrow (stenosis), or begin leaking (regurgitation).

Patients are sometimes born with heart valve disease or can develop it as a result of rheumatic disease, infection, or aging. A weak heart muscle and corresponding dilatation of the heart can also lead to heart valve dysfunction. If left untreated, heart valve disease can cause heart rhythm abnormalities, heart failure, or death.

Common types of heart valve disease:

Heart valve disease generally falls into two categories: stenosis, the narrowing of the heart valve, and regurgitation, the leaking of the heart valve.

Mitral regurgitation (MR) is the most common heart valve problem. Primary mitral regurgitation can be caused by a variety of underlying conditions, such as congenital birth defects, acquired degenerative heart valve diseases, or inflammatory diseases or infections. Secondary mitral regurgitation occurs due to incorrect blood flow to the heart muscle or dilatation of the left heart chamber.

Aortic valve stenosis (AS) is a condition where the aortic valve narrows and limits blood flow. It is most commonly found in elderly patients and develops over time. Congenital aortic valve stenosis is a rare condition that is present at birth, in which the heart valve may function normally for several years before requiring treatment.

Pulmonary stenosis and tricuspid regurgitation are the most common valve defects of the right heart.

Diagnosis of Heart Valve Disease

Patients with heart valve disease usually experience shortness of breath, chest pain, and irregular heartbeats. In the clinic, the physician listens to the heart and may hear heart ‘murmurs’, or irregular heartbeats. The diagnosis is usually confirmed through diagnostic testing, such as:

• Echocardiogram: A test that uses sound waves to reveal the size, shape, and functioning of the heart.
• Computed tomography (CT scans): A scan that provides detailed pictures of the inside of the heart.
• Magnetic resonance imaging (MRI): A scan that uses radio waves and magnets to provide images of the heart.
• Ultrasounds: High-frequency sound waves used to view images of the heart.
• Cardiac catheterization: A test in which a catheter is placed in the heart and arteries to observe blood flow and blood pressure.

Treatment of Heart Valve Disease

Moderate grades of heart valve disease can, in most instances, be treated with medication. If the disease is severe, heart valve surgery, such as valve repair or valve replacement, may be necessary. In valve repair, the patient’s own valve is preserved. For valve replacement, biological tissue valves or mechanical valves are used. While mechanical valves last longer, patients will require blood thinning medication to prevent blood clots.

The traditional way to perform heart valve surgeries is through a midline chest incision, with a heart lung machine used to maintain circulation during surgery. If certain criteria are met, the operation can be carried out through small non-invasive incisions in the chest. Another surgery option is catheter-based valve intervention, in which catheters are inserted into the heart valve through the groin or the chest. These minimally invasive surgery approaches mean less trauma and faster healing for the patient.

During their medical practice at Cleveland Clinic in the US and at other respected institutions, our interventional cardiologists and heart surgeons developed and practiced new treatment methods for catheter-based valve interventions and robotically-assisted minimally invasive heart valve surgery. This expertise has been brought to our hospital through their full-time presence at Cleveland Clinic Abu Dhabi.

Special surgical techniques available include:

• Robotically-assisted mitral valve repair
• MitraClip implantation
• Transcatheter Aortic Valve Replacement (TAVR)
• Transcatheter Aortic Valve Implantation (TAVI).