Heart valve: surgery for replacement and possible diseases

The human heart has 4 cavities. Each of them is connected by means of special holes - valves. They are needed for the blood to circulate in the chambers evenly. With heart valve diseases, a cardiologist is required. In some cases, surgical intervention is necessary to eliminate pathology. Diseases of the valve apparatus lead to circulatory failure. If you do not take action, the pathology can lead to death.

What is a heart valve?

Valves of the heart are necessary to provide a one-way flow of blood from one chamber to another. They consist of the inner layer of the organ - the endocardium. The heart valve serves as a window between the cavities. Thanks to him, blood comes from one chamber to another in the required quantity. Valve heart apparatus form the following components:

1. Fibrous ring.
2. Muscle tissue and valves.
3. Hordes.

These formations are found in all valves. Fibrous rings and septa between the cavities form the framework of the heart. It is represented by dense elastic and collagen fibers. Valve flaps are necessary to ensure its opening at the time of systole. Under high pressure, blood is transferred from one heart chamber to another. So that it does not mix with each other, the valve flaps must close in time. Chords are connective tissue bands. They connect the valve to the papillary muscles of the heart. Their function is to provide density between the flaps.

Varieties of heart valves

There are 2 types of valves: atrioventricular and semilunar. The first - provide the relationship between the cameras. Semi-lunar valves are necessary to maintain the correct flow of blood in the large vessels of the heart - the aorta and the pulmonary artery. Atrial ventricular openings include the following types of valves:

1. Mitral.
2. Tricuspid.

The mitral heart valve connects the left atrium and ventricle. It consists of 2 leaflets. The tricuspid valve is located on the border of the right chambers of the heart. Unlike the left atrioventricular orifice, it has 3 valves. To have blood pumped from the heart into all the vessels of the body, an aortic heart valve is needed. It has 3 leaves: right, left and back. The hole of the pulmonary trunk is located at the exit from the right atrium. In order for small and large circulatory systems to function, the coordinated work of all valves is important. Damaging one of them leads to heart failure.

Diseases of the valve apparatus

Valvular heart valves can undergo various injuries. In some cases, the structure of the holes between the chambers is irregular. This indicates the presence of congenital malformations of the heart, which are formed during the period of the laying of organs in the fetus. Such anomalies include:

1. Defect of interventricular septum.
2. Open the arterial duct.
3. Defect of the interatrial septum.
4. Aortic and pulmonary stenosis.

In addition to valvular defects, there may be a narrowing of the main vessels, their wrong location, the absence of a heart chamber, etc. In some cases, a combination of several defects is diagnosed.

Diseases of the valve apparatus can be acquired. They arise against the background of chronic infectious pathologies of the heart, systemic inflammatory processes. The main causes of the formation of defects are: endo- and myocarditis, rheumatic fever, atherosclerosis, etc. The acquired disorders include stenosis and valve insufficiency. These pathologies are more often diagnosed in patients of young and middle age.

Indications for surgical treatment

If the communication between the cardiac cavities is broken, a heart valve replacement is required. The operation will help to prevent the development of circulatory insufficiency. Such a surgical intervention is a serious procedure, which is used only in cases when other methods of treatment do not bring an effect. The following indications for the operation are distinguished:

1. Severe valve failure. Characterized by the fact that the valves become weak and easily extensible.
2. Stenosis of valves. It is the narrowing of the openings between the chambers of the heart.

Prosthesis is performed when the valve tissue is severely damaged and its structure can not be reconstructed. Basically, this is observed with severe stenosis. Surgical treatment is necessary if the patient is diagnosed with signs of severe heart failure. Symptoms of this condition include: dyspnea at rest, fainting, attacks of angina pectoris. Also, the replacement of the valve is made if its aperture is narrowed by more than 50% and is less than 1 cm. Prosthesis performs in cases where there is calcification of the valves or papillary muscles.

What causes a failure of the heart valve?

Valvular insufficiency develops on the background of chronic heart diseases. It leads to a change in the blood flow and its regurgitation - a reverse cast. Insufficiency is diagnosed when the heart valve does not close completely. In this case the leaflets become less elastic. In most cases, there is a deficiency of the aortic and mitral valve.

To adjust the work of the heart perform valvuloplasty. In severe cases, valve replacement is required. Aortic insufficiency leads to a reverse transfer of blood to the left ventricle. As a result, this chamber of the heart gradually stretches and loses its contractility. Insufficiency of the mitral valve is characterized by regurgitation of blood into the cavity of the left atrium. Each of these pathologies leads to heart failure.

Types of surgical interventions

What if the heart valve is damaged? The operation is performed in cases of pronounced disruption of the functioning of the organ. If heart failure is compensated, conservative therapy is performed. Diseases of the valve apparatus are not always indications for prosthetics. In some cases, the problem can be eliminated even without the introduction of a transplant. Surgery for the heart includes the following operations:

1. Balloon valvuloplasty. It is performed to expand the narrowed valve during stenosis.
2. Annuloplasty. It consists in the restoration of the valve frame by means of a support ring. The indication for this operation is the widening of the opening between the chambers, caused by insufficiency.
3. Prosthesis of the heart valve - is performed in cases of damage and calcification of the valves.

The choice of surgical intervention depends on the degree of severity of the defect, age and general condition of the patient.

Technique for performing valvuloplasty

By the term "valvuloplasty" is meant various operations on the valves of the heart. Such a surgical intervention is performed both in congenital anomalies of the organ, and in the case of the acquired defect. Valvuloplasty is performed if there is stenosis or failure of the valve without damaging its structure. Also, this method of surgical treatment is performed in the presence of contraindications to prosthetics.

The most common heart operation for stenosis of the aortic or left atrioventricular orifice is balloon valvuloplasty. It consists in the introduction of a special conductor through the femoral artery. When the tube reaches the valve opening, air is injected into the cylinder located at its end. The catheter is then removed. The operation is performed under the control of angiography. It does not require general anesthesia and patient connection to the ventilator.

In some cases, with stenosis, commissurotomy is performed. It consists in the dissection of the fused gates.

Annuloplasty is performed when the valve is inadequate. The indication is the expansion of the leaflets without their organic damage. The surgeon selects the supporting ring of the required size and fixes it to the endothelium with the help of sutures.

Prosthetic heart valve

The operation to replace the heart valve is performed when the atrioventricular orifice is narrowed to 1.5 cm, the aortic to 1 cm. Various materials are used as prostheses. In some cases, patients are transplanted heart valve animals - pigs or cows. It is believed that the risk of rejection of such prostheses is lower than synthetic materials. Another option for surgery is a pulmonary valve transplant to the site of the damaged aortic orifice. Such a procedure is performed only for young patients, since it refers to technically complex surgical manipulations.

Life after heart surgery

Despite the fact that heart surgery is considered risky, they are often the only way to save a person's life. After valve replacement, continuous monitoring of the patient's condition is required. Patients who have undergone surgery should take life-long medications that dilute blood. Such medicines include the drug Warfarin. This is necessary to prevent the formation of thrombi in an artificial valve.