As a cardiovascular surgeon, one of the most frequently asked questions in recent years is:
“Is heart valve replacement without surgery possible?”
Short answer: Yes, it is possible.
Although valve replacements performed with traditional surgical methods are still among the most permanent and effective solutions, with the advancement of technology, some heart valve diseases can now be treated with non-surgical, interventional methods. In these treatments, the heart can be accessed through blood vessels without fully opening it and without the patient undergoing a major surgical procedure.
How Many Valves Are There in Our Heart?
There are a total of four heart valves in the human heart. These valves are:
- Aortic valve
- Mitral valve (both on the left side of the heart)
- Tricuspid valve
- Pulmonary valve (these two are on the right side of the heart)
Each of these valves ensures that blood flows in the right direction within the heart. Any stenosis or insufficiency developing in any valve can lead to serious heart problems. Fortunately, different catheter-based treatment options are being developed for all four heart valves today.
TAVI (Transcatheter Aortic Valve Implantation)
When discussing heart valve replacement without surgery, TAVI is one of the first methods that comes to mind. This method has been developed especially for aortic valve diseases. The most common scenario is elderly patients with aortic stenosis who are at high risk for traditional open-heart surgery.
How is TAVI performed?
During this procedure, a new biological valve is placed inside the existing damaged valve with the help of a catheter inserted through the groin. The procedure can be performed under local anesthesia without the need for general anesthesia. The operation time is shorter, and patients can usually be discharged within 1-2 days.
Mitral Valve: Clip and Catheter Methods
One of the most common heart valve diseases is mitral valve insufficiency. In this case, the clip method can be used instead of surgery. In this technique, known as MitraClip in medicine, the two leaflets of the mitral valve are clipped together, reducing valve leakage.
In recent years, catheter valve implantation techniques that allow for complete valve replacement, similar to the aortic valve, have been developed for the mitral valve. However, this method is still applied in limited centers and is preferred in special patient groups.
Interventional Treatment for Tricuspid and Pulmonary Valves
The clip method can now also be used for the tricuspid valve located on the right side of the heart. This procedure reduces leakage in the tricuspid valve and lightens the load on the right heart.
The pulmonary valve is usually affected in congenital heart diseases. In this case, pulmonary valve functions can be restored with biological valve prostheses inserted through the groin.
These techniques provide a great advantage, especially when congenital heart diseases treated in childhood require intervention again in later years.
Success Rate and Limitations of Non-Surgical Treatments
Although interventional methods are more comfortable and lower risk compared to surgery, their long-term success rates are not yet as high as classical open-heart surgery. Therefore, surgical methods are generally still preferred in young patients and those with low surgical risk.
However, non-surgical heart valve treatments are a very valuable alternative for elderly patients, those with additional diseases, those at risk of anesthesia, or those not suitable for open surgery. Particularly with the TAVI procedure in the aortic valve, extremely satisfying results are obtained.
Early Diagnosis Saves Lives
Early diagnosis and timely intervention are of great importance in valve diseases. Treatments applied before heart muscle function deteriorates both improve the patient’s quality of life and prevent irreversible complications such as heart failure.
In cases of delayed diagnosis, the heart muscle weakens, lung pressure increases, and the success of applied treatments decreases. Additionally, both surgical and interventional procedures become riskier.
Heart valve replacement without surgery is an effective and safe treatment option when applied to the appropriate patient group. Thanks to developing technologies, many heart valve diseases can now be treated without the need for major surgical intervention. However, the most suitable treatment method should be determined by evaluating each patient’s individual situation, and the process should always be managed by a heart surgeon.
Remember: Early diagnosis, correct treatment, and timely intervention save lives.
