<s>[INST] How is Heart Valve Disease Treated? [/INST] Treatment for heart valve disease aims to protect your valve and heart from additional damage while reducing symptoms caused by valvular heart disease. Early treatment options may include medication and lifestyle changes, but often surgery is necessary to repair or replace the damaged valve or valves. Valve surgery involves two major categories—valve replacement and valve repair.

Medical experts will help decide the best treatment course based on the type of valve disease, severity of valve damage and a patient's age and medical history.

Pre-Surgery Treatment Options

Doctors may prescribe both medications and lifestyle changes to alleviate symptoms before the need for heart valve surgery. Doctors may also want time to monitor the heart valve before deciding on repair or replacement. Medications used include beta blockers to control heart rate and blood pressure medications to reduce the heart's workload.

Repair of Valves with Valvular Heart Disease

A repair of a diseased heart valve repair aims to fix the valve without a full replacement. A valve repair procedure often comes with a lower level of after-surgery monitoring and medication because the procedures are commonly less invasive with the use of catheters. A valve repair may include sculpting abnormal valve tissue to improve the function of the valve, patching holes, separating fused valve leaflets, replacing supportive cords or removing excess tissue. Surgeons may use clips or plugs and could add a ring to reinforce the valve.

What Are the Types of Replacement Valves?
Valve replacement involves removing the native valve and replacing it with an artificial valve made of either mechanical parts or biological tissues. The choice between a mechanical valve and a biological valve is based on many factors, including:

Patient preference
Age
Overall health
Medical history
Severity and form of the disease
Tolerance for specific medications or procedures
Expectations for course of the disease
Presence of other conditions
A heart valve replacement may involve a biological (from animal tissue), mechanical, or homograft (from a human cadaver donor) prosthesis. Types of prosthetic valves used in valve replacement include:

Mechanical valves­: Made of graphite and pyrolytic carbon, or other synthetic materials, which are non-reactive and tolerated well in the human body. While designed to last as long as 30 years, mechanical valves require lifelong blood thinning medications to avoid blood clots forming on the valve, which can cause stroke and other complications. Because of the need for lifelong blood thinning medications, patients with a mechanical valve carry a higher risk of bleeding complications following surgery.
Biologic (tissue) valves: Made from animal tissue (pig or cow) or a donated human heart. The animal tissue valves are sterilized and chemically treated for human use and then sewn onto a frame (stented) or left intact (stentless). These types of valves last approximately 10-20 years or longer, depending on the age of the patient at the time of implant. An additional replacement, therefore, isn’t uncommon in younger patients. Long-term blood-thinning medications are not required following valve replacement with biological valves, but may be needed in the first four to six weeks following the surgery.
Homograft: Available from a human cadaver donor.
Surgeons at Brigham and Women’s Hospital will walk you through this decision process, the expected outcomes, and address any and all concerns throughout your pre-operative assessment. Source: BRIGHAM AND WOMENS. Link: https://www.brighamandwomens.org/heart-and-vascular-center/diseases-and-conditions/heart-valve-disease. Field: Cardiovascular. Disease: Heart Valve Disease </s>