What Are Heart Valve Diseases in Children? Heart valves are structures that ensure blood flows in the correct direction through the heart. There are four heart valves: the mitral, aortic, tricuspid, and pulmonary valves. If these valves do not open or close properly, the heart may have to work harder and blood circulation may be disrupted. Heart valve diseases in children may be present at birth or develop later due to infections, rheumatic diseases, or other heart problems. The Most Common Heart Valve Diseases in Children 1. Aortic Valve Stenosis This is the narrowing of the aortic valve, which allows blood to be pumped from the heart to the body. Severe stenosis can increase pressure in the left ventricle and impair heart function. 2. Pulmonary Valve Stenosis This is the narrowing of the pulmonary valve, which carries blood from the heart to the lungs. Mild cases may require only monitoring, while severe stenosis may be treated with balloon dilation or surgery. 3. Mitral Valve Regurgitation This occurs when the mitral valve does not close completely, allowing some blood to flow backward. In advanced cases, the heart chambers may enlarge, and shortness of breath and heart failure may develop. 4. Aortic Valve Regurgitation This occurs when the aortic valve does not close sufficiently, causing some blood to flow back into the heart. Severe, long-standing leakage can enlarge the left ventricle and affect heart function. 5. Tricuspid Valve Diseases These are structural abnormalities of the tricuspid valve, which is located on the right side of the heart. In congenital conditions such as Ebstein anomaly, severe valve leakage, bluish discoloration of the skin, or heart rhythm disturbances may occur. What Are the Symptoms of Heart Valve Diseases in Children? Symptoms may vary depending on which valve is affected and how severe the disease is. - Getting tired easily and weakness - Shortness of breath or rapid breathing - Sweating and fatigue during feeding - Poor weight gain - Chest pain - Palpitations - Dizziness or fainting - Bluish discoloration of the lips in advanced cases Some children may have no symptoms for a long time, and the condition may be discovered when a heart murmur is heard during a routine examination. When Is Surgery Necessary for Heart Valve Diseases in Children? Not every heart valve disease requires surgery. Mild valve abnormalities can be monitored through regular cardiology checkups. However, intervention may become necessary in certain situations. 1. Severe Valve Stenosis Intervention may be needed when significant narrowing of a heart valve prevents blood from flowing normally. 2. Severe Valve Regurgitation When the amount of blood flowing backward through a valve increases, the heart chambers may enlarge and the heart’s pumping function may deteriorate. 3. Development of Heart Failure Shortness of breath, feeding difficulties, impaired growth, and deterioration in heart function may affect the treatment decision. 4. Enlargement of the Heart Chambers Significant enlargement of the heart or loss of function detected by echocardiography may indicate the need for intervention. 5. Insufficient Response to Medication or Catheter-Based Treatment For some valve diseases, medication can relieve symptoms, or catheter-based treatment can relieve the narrowing. However, surgery may be considered when these methods are unsuitable or do not provide sufficient results. Can Heart Valve Diseases Be Treated Without Surgery? Yes. Some children can be treated using non-surgical methods. In particular, a catheter procedure called balloon valvuloplasty may be used for pulmonary valve stenosis and selected cases of aortic valve stenosis. During this procedure, a special balloon is advanced through a blood vessel in the groin and used to widen the narrowed valve. However, not every valve disease is suitable for this procedure. The choice of treatment depends on the valve’s structure and the severity of the disease. How Is Heart Valve Surgery Performed in Children? The main goal of surgery is to restore the heart valve’s function as much as possible so that it can support normal blood flow. The main surgical methods include: Valve Repair This involves preserving the damaged valve as much as possible and restoring its function. It is one of the options considered first for suitable pediatric patients. Valve Replacement When repair is not possible, the diseased valve may be replaced with a mechanical or biological valve. The decision to replace a valve in children requires careful consideration. Growth, valve durability, and the need for long-term blood-thinning medication with certain types of valves are important factors. Valve Enlargement or Reconstruction This involves widening or reshaping valves that are narrowed or structurally abnormal through surgical techniques. Is Heart Valve Surgery Risky? Heart valve surgeries in children are major procedures performed by experienced pediatric cardiac surgery teams. Surgical risks vary according to the child’s age, weight, type of disease, heart function, and any other health conditions. Possible complications include bleeding, infection, heart rhythm disturbances, problems with valve function, and the need for further intervention in the future. Recovery After Surgery Children who undergo heart valve surgery are monitored in a pediatric cardiac intensive care unit after the operation. During recovery: - Heart rhythm and function are assessed. - Breathing and oxygen levels are monitored. - Valve function is checked using echocardiography. - Feeding and physical development are monitored. - Necessary medications are adjusted. The length of the hospital stay and recovery period may vary depending on the type of surgery performed. Can Children Live Normally After Heart Valve Surgery? After successful treatment, many children can return to their daily routines, school, and age-appropriate physical activities. However, some children may need long-term medication or additional procedures in the future. In children who have undergone valve replacement, growth and the function of the implanted valve should be assessed regularly. For this reason, it is important not to miss scheduled pediatric cardiology appointments. Why Are Early Diagnosis and Appropriate Treatment Important? When heart valve diseases are detected early, the structure and function of the heart can be monitored regularly. This helps avoid unnecessary interventions while allowing the appropriate time for treatment to be identified in cases of serious valve abnormalities. Timely treatment can help prevent complications such as heart failure and permanent impairment of heart function. Remember: Not every heart valve disease in children requires surgery. What matters is accurately assessing the effect of the disease on the heart and intervening at the right time when necessary. Early diagnosis, specialist monitoring, and appropriate treatment are essential for children’s healthy development.