EP235: Fixing Valves in 2022

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Podcast Summary Introduction Dr. Warrick Bishop is a practicing cardiologist and author dedicated to improving patient care through heart health education. In this episode, he explores the four main valves of the heart and discusses cutting-edge technological advances—particularly percutaneous and transcatheter techniques—that are revolutionizing how valve problems are treated without major surgery. The focus is on emerging non-invasive approaches for aortic, mitral, and tricuspid valve issues and their growing role in modern cardiology. Key Takeaways: The heart has four main valves (tricuspid, pulmonary, mitral, and aortic) that control blood flow and can deteriorate over time, causing leaking or narrowing. Aortic valve narrowing affects approximately 1% of the population and becomes increasingly common with age, making non-invasive treatment options increasingly valuable. Transcatheter aortic valve implantation (TAVI) allows deployment of new valves through blood vessels in the leg, avoiding major chest surgery and becoming standard practice for high-risk and intermediate-risk patients. Transcatheter edge-to-edge repair for leaking mitral valves is available but currently less advanced than aortic technology, with higher mortality rates (4% at 30 days) and is typically reserved for very high-risk surgical candidates. Tricuspid valve repair using percutaneous transcatheter techniques shows the most promise because the lower-pressure right heart system allows devices to work more effectively with less strain. Early intervention with transcatheter tricuspid repair can prevent severe regurgitation that leads to dangerous organ congestion and extremely high mortality rates in advanced stages. Regular echocardiogram screening and baseline heart imaging are essential preventative measures to detect valve problems early before they progress. Blood pressure control is critical for valve health, as elevated pressure increases wear and tear on valves and should be monitored with a 24-hour blood pressure monitor. Patients should maintain regular check-ups with their GP and consider consulting a cardiologist for preventative care and baseline cardiac imaging.