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What's The Life Expectancy For People With A Leaking Heart Valve?
A leaking heart valve can lead to life threatening complications. However, the condition is often treatable with valve repair or replacement procedures, which can increase your life expectancy.
For your heart to function properly, its four valves need to be able to open correctly and close tightly to ensure that blood flows in the right direction through your heart's chambers.
A leaky heart valve, also known as valve regurgitation, means the blood can flow backward instead of moving forward. This raises the risk of blood clot formation and other complications such as arrhythmia and heart failure.
In mild cases, a leaking heart valve may have no symptoms and require no treatment other than regular checkups. But in more severe cases, valve repair or replacement may be necessary. When valve regurgitation symptoms are present, they can include:
The key to avoiding life threatening complications is to see a doctor or healthcare professional if you have any symptoms of valve regurgitation. They can diagnose the cause of your symptoms and develop the right treatment program for you. If valve regurgitation is more severe, you may need valve repair or replacement.
According to the Centers for Disease Control and Prevention (CDC), about 2.5% of the U.S. Population has some kind of valve disease, while about 13% of adults ages 75 and older have a valve disorder.
The outlook for someone with a leaking heart valve depends on which valve is affected and the severity of the regurgitation. The heart's four valves include the:
Any valve can develop regurgitation or the opposite problem, stenosis — a condition in which the valve becomes stiff and can no longer open wide enough to allow sufficient blood to flow through it.
Advancing age is just one factor that can affect life expectancy with heart valve regurgitation. Another important factor is the presence of other heart conditions, such as:
The longer serious heart valve regurgitation goes untreated, the higher the risk of cardiac complications.
The severity of valve regurgitation may also affect life expectancy, even if the valve is repaired or replaced.
If you need valve repair or replacement, another important consideration is the experience of the heart surgeon. For example, a 2017 study suggests that having mitral valve surgery performed by a heart surgeon who completes at least 25 mitral valve procedures annually significantly raises your odds of surgical success and living for more than a year after surgery.
The mitral valve allows blood to flow from the left atrium down to the left ventricle, the heart's main pumping chamber. A leaking mitral valve means the blood can flow back into the left atrium.
Without effective treatment, mitral valve disease can force the heart to work harder to pump blood out to the body, raising the risk of an irregular, rapid heartbeat, as well as heart failure.
A 2020 report suggests that the 1-year mortality rate for older adults who have severe mitral valve regurgitation but don't undergo valve repair or replacement is about 14%. The percentage of individuals who don't survive more than a year after their diagnosis increases substantially with age.
However, a 2020 study suggests that valve repair for severe mitral valve regurgitation may restore a person's life expectancy to that of someone in the general public between the ages of 40 and 89.
The aortic valve allows blood to pass from the left ventricle into the aorta and the rest of the body. If blood seeps back into the left ventricle — the definition of aortic valve regurgitation — the heart must pump harder to push enough blood out to meet the body's needs. This can lead to:
Research suggests that about 75% of people with severe aortic valve regurgitation, also known as aortic insufficiency, live at least 5 years after diagnosis with conservative treatment, but only 50% live 10 years. However, life expectancy estimates drop to about 2 years if severe aortic valve regurgitation isn't treated and leads to congestive heart failure.
According to a 2021 study, the average life expectancy for individuals ages 60 to 64 who undergo surgical aortic valve replacement is 16.2 years. For people 85 or older, the average life expectancy after valve replacement is 6.1 years.
The tricuspid valve separates the right atrium from the right ventricle, which pumps blood to the lungs to become oxygenated.
Tricuspid valve regurgitation means blood flows back up into the right atrium. The condition can cause significant pressure changes within the right ventricle. This can raise the risk of heart failure or the development of a common arrhythmia called atrial fibrillation.
According to a 2022 paper, the average 5-year mortality rate for severe tricuspid regurgitation (TR) with heart failure with reduced ejection fraction (HFrEF) is about 34%. HFrEF refers to heart failure caused by less blood being expelled from the left ventricle of the heart with each beat. Isolated primary TR can also lead to heart failure, with a 5-year mortality rate of 48%.
The pulmonary valve allows blood to pass from the right ventricle to the lungs, where it picks up oxygen before returning to the heart to be pumped out to the body.
With pulmonary regurgitation, blood flows back to the right ventricle before becoming oxygenated. This is the least common type of valve regurgitation.
Common causes of pulmonary regurgitation include:
Pulmonary regurgitation may lead to a heart murmur and, in rare cases, heart failure.
According to a 2021 study of individuals who underwent pulmonary valve replacement, the survival rate 10 years after the procedure was about 90%.
In some cases, a leaking heart valve can be repaired or replaced with a minimally invasive catheter procedure instead of open heart surgery. However, not everyone is a candidate for this type of procedure.
With a minimally invasive catheter procedure, a catheter (thin, flexible tube) is threaded through a blood vessel in your groin and up to your heart. The catheter will be equipped with tools that allow for either a repair or replacement of the affected heart valve.
If a doctor has recommended valve repair or replacement, ask them whether a minimally invasive catheter procedure is right for you.
In many cases, a leaky heart valve slowly gets worse over time. It's important to keep track of your symptoms and to take note of any changes. Some symptoms that could indicate that a leaky heart valve may be getting worse include:
If you have severe valvular heart disease, schedule an evaluation with your cardiologist to see if you need valve treatment. The doctor should order imaging tests like an echocardiogram to assess how your condition is progressing and the treatment you may need.
A leaking heart valve may be mild enough that it causes no symptoms and requires no treatment to restore healthy blood flow. In mild cases, a leaking heart valve may not have any impact on your life expectancy.
But in serious cases, a leaky heart valve often requires treatment such as a valve replacement or repair. Without a proper diagnosis and treatment, heart valve regurgitation can impact your life expectancy, especially if valve disease has led to other heart complications.
If you have symptoms of valve regurgitation, it's a good idea to visit a doctor. Getting treatment early, before other complications arise, can extend your life expectancy and improve the quality of your life.
PLAIN RADIOGRAPHIC DIAGNOSIS OF CONGENITAL HEART DISEASE
PLAIN RADIOGRAPHIC DIAGNOSIS OF CONGENITAL HEART DISEASEPLAIN RADIOGRAPHIC DIAGNOSIS OF CONGENITAL HEART DISEASE
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3b-1. Tetralogy of Fallot/ Absent pulmonary valve syndrome. (Legend.)A. The left and right pulmonary arteries are markedly prominent with slightly reduced peripheral vascular markings.
Congenital absence of the pulmonary valve leaflets in association with tetralogy of Fallot was first reported by Crampton in 1830. Between 2-6% of patients with tetralogy have co-existent absent pulmonary valve syndrome.
This is characterized by either a complete absence of the pulmonary valve leaflets or a rudimentary rim of tissue, typically in association with stenosis of the pulmonary annulus and infundibulum. The most characteristic feature of the syndrome however is aneurysmal dilation of the main pulmonary artery and the branch pulmonary arteries. The aneurysmal pulmonary arteries compress the bronchi and create a ball-like effect with resultant significant airway problems.
Associations: Commonly there is an associated defect including ASD, DORV, hypoplastic right ventricle, tricuspid atresia, transposition of the great arteries, Uhl's anomaly, coarctation or subaortic stenosis.
All patients must be screened for 22q11 deletion and associated DiGeorge syndrome.
Presentation: Newborns may present with cyanosis secondary to elevated pulmonary vascular resistance and reduced right ventricle compliance. Congestive cardiac failure secondary to left to right shunting through a VSD although this is often prevented by the right ventricular outflow tract obstruction. Typically recurrent chest infections are the presenting feature secondary to air-trapping from the bronchial and bronchiolar compression, resulting from the aneurysmal pulmonary vessels. Physical examination is characteristic for a high pitched systolic ejection murmur and a low pitched diastolic descrescendo murmur heard maximally in the third left intercostal space.
Treatment: There is little consensus to the optimum surgical treatment. Plication of the pulmonary arteries may provide temporary respite from intercurrent respiratory illness, although the natural history is for the development of recurrent aneurysmal dilation and respiratory morbidity. Whether a two-stage approach with initial pulmonary artery banding to reduce pulmonary arterial circulation followed by intracardiac repair and debanding is preferable remains unknown. There is also debate as to whether placement of a valve in the pulmonary position may improve prognosis. Generally the earlier surgical plication is required the worse the prognosis.
Medtronic Reports Positive Harmony Transcatheter Pulmonary Valve Data
Harmony treats severe pulmonary regurgitation (PR) in the native or surgically repaired right ventricular outflow tract (RVOT). The Medtronic analysis demonstrates strong clinical and hemodynamic outcomes for patients with a congenital heart defect of the RVOT. The current standard of care is either open-heart surgery or other interventions early in life to address malformations. Harmony TVP provides a minimally invasive treatment alternative.
Medtronic presented results at the Society for Cardiovascular Angiography & Interventions (SCAI) 2023 Scientific Sessions.
"Sharing these longer-term outcomes for the Harmony transcatheter valve is an important milestone to help offer more streamlined treatment options for patients living with congenital heart disease," said Dr. Mary Hunt Martin, director of adult congenital intervention at the University of Utah and Primary Children's Hospital in Salt Lake City. "The strong safety profile reflected in these findings is especially encouraging since prior to Harmony, many of these patients would have to undergo multiple surgeries early on in their life."
The non-surgical heart valve first received FDA clearance in March 2021. However, in April 2022, FDA designated a Class I recall for the system. Medtronic recalled the system because of issues with the delivery catheter. The bond holding the capsule at the end of the delivery catheter could break during TPV placement, the company found.
Medtronic relaunched Harmony in February of this year.
The data supporting the Medtronic Harmony valvePatients received a commercially available 22mm (TPV22) or 25mm (TPV25) Harmony valve as part of the Harmony Native Outflow Tract Early Feasibility Study (EFS), Harmony TPV Pivotal Trial, and Continued Access Study (CAS).
Eligible patients had severe PR by echocardiography or PR fraction greater than or equal to 30% by cardiac MRI and a clinical indication for pulmonary valve replacement. In the study, 86 patients received a TPV22 (42) or TPV 25 (44). All remained implanted for more than 24 hours.
Key findings included 0% vascular injury requiring intervention and 99% freedom from major stent fracture. Medtronic also reported 99% of patients with no/trace PR at two years.
"These findings help deepen our long-term evidence for Harmony TPV and underscore our commitment to providing solutions for congenital patients with complex anatomies," said Nina Goodheart, SVP and president of the Structural Heart & Aortic business at Medtronic. "Providing a system designed to reliably treat pulmonary regurgitation is an important way Medtronic innovations positively impacts this vulnerable patient population."
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