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Originally published February 9, 2026
Last updated February 9, 2026
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Think of the heart as a one-way highway.
Blood enters and moves through the heart along a set path so that it can pick up oxygen before returning and delivering that oxygen to the rest of the body. Along the way, the heart valves’ leaflets open and close with every heartbeat — ensuring blood flows only in the right direction and doesn’t flow backward.
But blood cannot travel smoothly through the heart, and might even move against the proper traffic flow, in hearts with diseased valves.
Serge S. Kobsa, MD, PhD, a cardiac surgeon with the USC Cardiac and Vascular Institute, part of Keck Medicine of USC, explains common heart valve problems and their causes and treatments.
Of the four heart valves, the two that more often develop problems are the aortic and mitral valves.
One of the most common heart valve diseases is a leaky mitral valve, or mitral regurgitation. When the mitral valve’s leaflets don’t fully close, blood leaks backward into the lungs.
Similarly, over time, the aortic valve can become very narrow, or stenotic. When that happens, the heart has to work harder to squeeze blood through the valve, which can weaken the heart muscle. “If left untreated, it can be a very serious problem,” Dr. Kobsa says.
Aging can lead to both leaky mitral valves and stenotic aortic valves, as well as other heart valve problems. “The most common valve problems have a lot to do with the fact that people are living a lot longer these days,” Dr. Kobsa says.
If the heart becomes weak or develops abnormal rhythms, that can lead to leaking of the mitral valve — which in turn makes the heart even weaker.
Meanwhile, whether from calcification over time or from birth abnormalities, a stenotic aortic valve’s leaflets can become fused so that only two of the valve’s three leaflets are functional. This tends to accelerate calcification and stenosis.
People with heart valve problems often experience shortness of breath and a lack of stamina. They may find they get tired a lot more quickly — just from walking a few blocks or climbing stairs.
Other possible symptoms include blurry vision, dizziness and swelling in the legs and ankles. Patients might even experience syncopal episodes, or passing out.
“If any of these symptoms appear and don’t go away, patients should bring it to their doctor’s attention because it certainly could be a heart valve problem,” Dr. Kobsa says. “If these problems become severe, they can be life-threatening.”
Patients with potential heart valve problems should get referred to a cardiologist or a cardiac surgeon, who will evaluate them using an echocardiogram, which Dr. Kobsa calls “the gold standard for diagnosis.”
“The echocardiogram shows definitively what the problem is and, to some extent, what the cause may be,” he explains.
“With leaking mitral valves, we always try to repair as opposed to replace,” Dr. Kobsa says. Repairing part of the damaged mitral valve enables the valve to close and not leak.
For stenotic aortic valves, repair or medication is not an option, so treatment involves replacement.
For most cases, there are two main approaches to replacing an aortic valve. One is a transcatheter aortic valve replacement (TAVR), which involves entering the legs’ blood vessels to reach the heart and deploy the new valve “from the inside.” The other approach is open-heart surgery: opening the aorta to replace the diseased valve with a prosthetic valve.
As a minimally invasive approach, the TAVR generally requires just a few days in the hospital and a couple of weeks of recovery. Patients who have an open-heart operation can spend four to seven days in the hospital and take four to six weeks to fully recover. Which of the two approaches is better depends heavily on the specifics of the problem, complex anatomic details and other patient details.
In any case, prosthetic valves don’t last forever, so patients may need another procedure in the future. Physicians, like those of the USC Cardiac and Vascular Institute, will determine the best approach for each patient by considering the individual’s specific problem as well as age, lifestyle, preferences and any other medical conditions.
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