Female Speaker: I couldn't make it to bed. I couldn't stand, see, I would have to sit down a couple of times before I finish the dishes. Dr. Dean Edell: There is no underestimating the power of a healthy heart. Just ask any of the one in seven people with significant heart valve trouble, a condition that makes normal life difficult, if not impossible. New techniques to fix faulty heart valves make life's simple pleasures possible again. The human heart beats more than 2 billion times over the course of the lifetime. Michael Rinaldi: The heart is a pump and its job is to pump blood forward to your body and like all pumps it has valves that keep the blood from flowing backwards. Dr. Dean Edell: Four chambers work in rhythm to transport blood throughout the body. As this chamber contracts, valves open and close moving blood in and out. When valves fail, so can the heart. Dr. John Puskas: The most common heart valve diseases are those who live it to the aortic valve and the mitral valve. As we get older, are more likely to have a problem with one of our heart valves. You can think of them as simply wearing out. Dr. Allen Graeve: Heart valve disease is usually manifested by either a chest pain or shortness of breath. Dr. Dean Edell: There are no medicines to treat heart valves. Dr. John Puskas: Eventually, if valves, a valve disease progresses and becomes severe, the only present available treatment is surgery. Dr. Dean Edell: Either a valve repair -- Dr. John Puskas: Repairs imply leaving in most of the native valve in the heart and working on the valve itself. Dr. Dean Edell: -- Or a replacement. Dr. John Puskas: Valve replacement of course means that we take out the patient's own diseased valve and replace it with another valve. Dr. Dean Edell: One option is a biologic valves made of heart tissue from pigs and cows. They have some advantages. Dr. Mark Groh: The tissue valves generally don't require long-term anticoagulation. Dr. Dean Edell: Which means patients would not need to take a blood thinner like coumadin, but these tissue valves have a limited lifespan of 10-15 years. Dr. John Puskas: Patients who are very young looking to avoid a second heart operation, would typically choose a mechanical valve. Dr. Dean Edell: Mechanical valves come with a lifetime prescription for blood thinners. Dr. John Puskas: We are always balancing the risk of too much coumadin, which causes bleeding complications, but if you take too little, you've risk for clots forming on your mechanical valve. Dr. Dean Edell: Advances on heart valve technology look to change that. Dr. Allen Graeve: We are determining whether you can use no coumadin in certain patients or lower coumadin in others. Dr. Dean Edell: Clinical trials are now underway in the U.S., following promising overseas trials, looking at whether a specific type of mechanical valve called the On-X valve can reduce or eliminate the need for coumadin. Dr. John Puskas: The smoother the surface on the mechanical valve, the less likely the blood is to clot on it. Dr. Dean Edell: That smoother surface comes from a purified cover that doesn't contain silicon like the older valves. Also specially designed pivots keep blood from stagnant. Dr. John Puskas: The flow through the valve smoother, less turbulent, produces less likelihood of clotting. Dr. Dean Edell: Gary Peterson's part of the clinical trial. His dose of coumadin have been replaced with less potent blood thinners, plavix and aspirin. Gary Peterson: I am not on coumadin and therefore I don't have a fear of being caught in having blood thin down so much that they can't stop. Dr. Dean Edell: Now Gary is always on the go. Gary Peterson: I do 10-12 ks on weekends and then I also do some swing and ballroom dancing. Dr. Dean Edell: Valve replacement usually requires open heart surgery which is risky for older patients. Dr. John Lasala: Their age alone will give you very, very high mortality. Dr. Dean Edell: That was a