A person's life depends on the work of the heart muscle. But normal blood circulation can only be ensured if the valves of the heart are functioning correctly. The greatest load falls on the aortic valve, which, after some previous diseases, may cease to function normally. This is how heart disease develops, which leads to serious disorders in blood circulation, and hence in the work of the whole organism.
Aortic valve replacement is currently possible. In the article, we will consider what indications for this exist, how the operation is performed and what are its consequences.
Causes causing valve problems
This valve is located between the left ventricle and the aorta, which will carry oxygenated blood throughout the body. During the process of filling the heart muscle with blood, this valve must be in a closed state. When the ventricle contracts, it opens and lets blood into the aorta.
Replacement of the aortic valve of the heart is necessary when it cannot function properly, resulting in poor circulation. Sometimesdeformity of the aortic valve is observed from birth - this is a congenital defect. But there are times when it worked normally for many years, and then it begins to not fully open and close, then they talk about acquired pathology of the aortic valve. This can happen due to wear and tear with age, as a result of the buildup of calcium s alts on the valve, which disrupts its operation.
Some diseases can also lead to disruption of the valve, these include:
- Complications from past illnesses, such as streptococcal infection, may well have a negative impact on valve function.
- Endocarditis, when the infection affects the heart and its valves.
- Aortic aneurysm.
- Hemorrhage into the wall of the aorta.
- Stenosis of the aortic valve, in which it is so hard that even pressurized blood cannot open it fully.
- A condition where the valve is unable to close completely after the ejection of blood, and some of it returns to the ventricle.
All these diseases and pathologies can lead to the need for aortic valve replacement surgery.
Features of the valve replacement operation
This type of surgery is considered the most difficult. Not every surgeon can perform open heart surgery. Such an intervention requires modern equipment and highly qualified doctors.
Currently in our country there are not enough clinics equipped with the latest technology,therefore, it is not possible to provide assistance in a timely manner to all those in need of such operations. Aortic valve replacement is for many the only way to save a life, but, unfortunately, not everyone is waiting for their turn.
But there are also foreign cardiology centers that are ready to receive foreign patients and provide them with the necessary assistance, thereby saving lives.
Varieties of valves
Even the possibilities of modern science and technology still do not allow creating a perfect valve. Those varieties that are used now have their pros and cons. Surgeons use several types of prostheses to replace them:
- Mechanical valves. They are made from modern high strength alloys. Their advantage is their indefinite functioning, but the patient will have to take anticoagulants throughout his life to prevent the formation of blood clots.
- Biological prostheses are made from animal valves. After insertion, no blood thinners are required, but the life of the prosthesis is only 10-15 years, and then a second operation is needed.
- Donor valves come from a deceased person. Such valves also cannot last forever.
When aortic valve replacement is required, the choice of variety depends on several factors:
- Age group of patients.
- General he alth.
- For what reason the valve needs to be replaced.
- Presence of other chronicdiseases.
- Does the patient have the opportunity to take anticoagulants for life.
Once the type of valve has been selected, a difficult operation to replace it is ahead.
Types of surgery
Until recently, an operation to replace an aortic valve on the heart required stopping the heart muscle and opening the chest. These are the so-called open operations. During surgery, the life of the patient is supported by a heart-lung machine.
But currently in some clinics it is possible to replace the aortic valve without opening the chest. These are minimally invasive surgeries that do not require cardiac arrest, as well as large incisions.
Of course, it must be said that such surgical interventions require real skill from the surgeon. For example, clinics in Israel are famous for their cardiac surgeons, so many patients, if funds allow, are sent to this country for such an operation.
Preparation for surgery
Aortic valve replacement requires careful patient preparation. After contacting a doctor, the patient is prescribed a series of studies:
- The first thing is a doctor's examination.
- Blood tests done.
- An echocardiogram is performed to check the movement of the heart and its valves.
- An electrocardiogram is taken to monitor the heart rhythm.
- A heart catheterization is done - this is the introduction of a thin tube through which a contrast agent is injected and then a picture is taken that allows you to determine if there are problems with the functioning of the aortic valve.
A few days before surgery, the patient must follow the following recommendations:
- Stop taking anti-inflammatory drugs and aspirin.
- Do not take anticoagulants.
- Only light food should be included in the diet the day before surgery.
- Don't eat at all on the day of surgery.
- Clothes should be prepared to allow movement.
Only after all the necessary preparations for the operation, the doctor appoints the time of surgery and the aortic valve will be replaced.
Operating
When the patient is on the operating table, he is given general anesthesia and falls asleep. If the operation is performed with an opening of the chest, then in the middle the surgeon makes an incision and pushes the chest apart so that you can get to the heart.
A cardiac arrest is required to allow replacement, so the patient is connected to a heart-lung machine. The doctor makes an incision in the aorta, removes the worn or damaged valve, and installs a new one in its place. After that, the aorta is sutured, the heart muscle is triggered, the chest is connected and sutured.
After replacement surgeryaortic valve
Once the operation is completed, the patient is sent to the intensive care unit. Here he is taken out of anesthesia and monitored for vital functions:
- Heart rate is determined.
- Respiratory and blood pressure monitored.
- Checking the oxygen content in the blood.
- A tube is inserted into the mouth and lungs to provide additional ventilation.
- A drain is installed to drain fluid from the chest.
- The patient is placed with a catheter in the bladder to drain urine.
- Inject pain medications, fluids and electrolytes directly into a vein.
After an aortic valve replacement, the patient usually spends 5-7 days in the hospital if there are no complications.
Complications during surgery
Surgery on the heart is always a big risk. When an aortic valve replacement is planned, the following complications are possible:
- Infection.
- Possible bleeding during surgery.
- Appearance of clots if there was a stroke or kidney problems.
- Complications of anesthesia.
There are other factors that increase the risk of complications during surgery:
- Presence of heart disease.
- Lung diseases.
- Hypertension.
- Diabetes mellitus.
- Obesity.
- Smoking.
- Presence of infections in the body.
Complications after surgery
For any surgeon, not only the process of the operation and its outcome are important, but also the recovery period, which can also be accompanied by serious complications:
- Growth of scar tissue. There are cases when, after surgery, a patient has a rapidly growing fibrous scar tissue at the site of a valve replacement. This process does not even depend on the type of valve and can lead to thrombosis. But thanks to modern methods of the operation, such a complication is quite rare.
- Bleeding while taking anticoagulants. Moreover, it can occur not only in the valve area, but also in any organ, for example, in the stomach.
- Thromboembolism. You can recognize it by the following manifestations:
- Patient becomes short of breath.
- Blurred consciousness.
- Sight and hearing are lost.
- Numbness and weakness in the body.
- Dizziness.
4. Infection of the delivered valve. Even the most sterile valve, once inside, can become infected. That is why, if the body temperature suddenly rises, respiratory problems appear, then it is urgent to inform the doctor in order to conduct tests and exclude infection of the valve.
5. hemolytic anemia. When it occurs, damage to a large number of red blood cells during contact with the material of the valve. There is a strong weakness, fatigue that does not go away after rest.
As a rule, in the presence of a heart disease, the patient has one or another group of disabilities. All this is determinedby a special committee of physicians. If an aortic valve has been replaced, disability can be removed if the council of doctors considers that you are he althy and you do not need special payments from the state. In some cases, group 3 is left.
Post-operative period
For several days after the valve replacement surgery, the patient is given injections of pain medication to reduce pain. But after a while they are cancelled. In addition, the patient may also face the following problems:
- Swelling of limbs.
- Pain in the incision area.
- Inflammatory process in the place where the incision was made.
- Nausea.
- Accession of infection.
If all these manifestations continue for too long, then you should tell your doctor. Aortic valve replacement surgeries (patients say this) bring noticeable improvements in a couple of weeks. Significant positive changes come in a few months.
After the operation, doctors recommend observing the regime of work and rest and strictly dosing physical activity.
It is best if the patient spends the recovery period not at home, but in a specialized institution, for example, in a sanatorium or in a cardiological rehabilitation center.
There, under the supervision of doctors, the body is being restored, each individual program is selected. Recovery can take varying amounts of time. It all depends on the general conditionthe patient, the complexity of the operation and the recovery abilities of the body.
Without fail, the doctor prescribes medications to the patient after surgery. They must be taken strictly according to the scheme and cannot be canceled on your own.
If various physiotherapeutic procedures, medical interventions are required, then you should definitely inform that there is an artificial aortic valve.
If there are concomitant heart diseases, valve replacement does not cure them, so it is necessary to visit a cardiologist and carry out appropriate therapy.
Rehabilitation therapy at home
If the patient does not have the opportunity to go to a sanatorium for recovery after surgery, then all recommendations of the doctor at home should be strictly followed.
- If a mechanical valve is installed, then it is mandatory to take anticoagulants, and you will have to do this for life.
- If you have a dental intervention or other surgical operations, then be sure to take antibacterial drugs before them to prevent inflammation in the valve area.
- Be sure to control the balance of fluid in the body.
- Do special exercises recommended by the doctor to help normalize respiratory function.
- Perform hardware prevention of pneumonia.
Only following all the doctor's recommendations will help make life after aortic valve replacement normal and full.
Lifestyle change
Anysurgery on the heart muscle requires a radical review of your lifestyle. Aortic valve replacement (reviews only confirm this) is no exception. Patients after surgery:
- Exclude all bad habits from your life, unless, of course, life is dear. Smoking, drinking alcohol and drinking large amounts of caffeine are not compatible with an artificial valve, and indeed with heart pathologies.
- You will have to practically eliminate fatty foods from your diet.
- Reduce s alt intake to a minimum, no more than 6 grams per day.
- Meals should be balanced and contain more fresh vegetables and fruits.
- Drink enough clean water, but no gas.
- Gradually introduce loads that will help strengthen the heart muscle.
- To take walks in the fresh air every day in any weather.
- Exclude psycho-emotional overload, stress from your life.
- Create a daily routine with your doctor and stick to it.
- Use vitamin preparations to maintain mineral balance.
If you look at the reviews of patients who underwent valve replacement surgery, you can see that most of them were able to return to a normal lifestyle. Disappeared unpleasant symptoms that haunted, the work of the heart returned to normal.
Replacement of the aortic valve (reviews confirm this) is not an obstacle to future pregnancy. Many women with heart disease do not evenhoped to become mothers, and such an operation gives them such an opportunity.
In such a situation, the most important thing is to find a competent specialist, then you can be sure of a positive outcome of the operation. Modern science and medicine allow you not to put an end to your life even in the presence of serious pathologies in the heart, so you should not give up. We must always hope for the best, and a miracle will happen - your heart will work long and reliably. Take care of yourself and stay he althy.
