Heart Valve Center
This center offers comprehensive evaluation of all types of valvular disorders and timing and delivery of appropriate management in a multidisciplinary set-up. The types of valvular diseases include rheumatic, degenerative, drug induced, valve problems associated with cardiomyopathy, mitral valve prolapse etc. The members of the team include Ramdas G.Pai, MD (medical director and cardiologist with special interest in valves and advanced cardiac imaging), Vaughn Starnes, MD (surgical director and Chairman of Cardiothoracic Surgery), Padmini Varadarajan, MD (cardiologist with special interest in valves and advanced cardiac imaging), Anil Mehra, MD (percutaneous valve therapies), and Alex Durairaj, MD (percutaneous valve therapies). Dr Starnes is a pioneer in the field of valve repairs, minimally invasive valve surgery, robotically assisted valve repairs and the Ross procedure. Dr.Pai is expert in echocardiographic assessment of valvular lesions including mechanisms of failure, using both transthoracic and transesophageal echocardiography.USC Heart Valve Center Provides:
- Assessment of known or suspected valve problems
- Follow up of patients with valve problems
- Transesophageal echocardiography for evaluation of valves
- Follow up of patients after valve repair or replacement
- Evaluation of patients for percutaneous valvuloplasty
- Evaluation of patients by Dr Starnes for minimally invasive valve repairs
- Evaluation of patients by Dr Starnes robotically assisted valve repairs
- Complex mitral valve repairs and Ross procedure by Dr Starnes
Commonly asked questions:1. How do I know if I have a valve problem?
Answer: A disorder of a heart valve problem is most commonly suspected when a murmur is heard by your doctor. A murmur is a noise produced by blood flowing through an abnormal valve and heard with a stethoscope. The most common symptom is shortness of breath. The diagnosis is confirmed by echocardiography.2. How serious is the diagnosis of a valve problem?
Answer: This severity of a valve problem can vary from trivial to severe. Trivial and mild lesions do not significantly affect the heart function. Severe lesions may need an intervention based on symptoms and their impact on heart function. Some may need careful follow-up. Patients with valve problems need endocarditis prophylaxis and impeccable dental care.3. What is echocardiography?
Answer: This is a method of examination of the heart using ultrasound to gain information about the structure of the heart and valves, blood flow and pressures inside the heart. This is the best modality to evaluate the heart valve. Images are generally obtained by placing an ultrasound probe on the chest wall. But in certain instances better images may be obtained by passing a small tube into the esophagus ( e.g., the food pipe) to see the heart from behind. The latter test is called transesophageal echocardiography (TEE). This TEE is performed with sedation.4. What type of valve interventions are available?
Answer: Percutaneous balloon valvuloplasty is feasible for most of the patients with mitral stenosis. For a leaky mitral valve, repair is always preferable to valve replacement as there is no need for a blood thinner with repair, and it uses your own valve. When replacement is needed broadly two types of valves are available-tissue valves which generally do not require blood thinners and mechanical valves which require life long anticoagulation.
There are also options when the aortic valve requires repair: 1) tissue valves; 2) metallic valves; 3) homograft (human cadaveric aortic valves); 4) autograft (Ross procedure which involves transplanting your own pulmonary valve to the aortic position and putting a homograft in the pulmonary position and; 5) valve sparing aortic root repairs. Appropriateness and selection of procedures will be done by the cardiac surgeon in conjunction with a thorough discussion with the patient.5. Do I need to be on a blood thinner after valve surgery?
Answer: When the patient?s valve is repaired or when the valve is replaced with a bioprosthetic valve blood thinners are usually not necessary (maybe necessary if the condition is accompanied by a trial fibrillation). Metallic valves need anti-coagulation. The use of anti-coagulation, i.e., blood thinners, requires close monitoring.6. How can I get more information?
Answer: The following information and website should be helpful.
- Valvular guidelines from American Heart Association/American College of Cardiology: http://www.acc.org/clinical/guidelines/valvular/dirIndex.htm