The human heart has 4 cavities. Each of them is connected through special holes - valves. They are needed so that the blood circulates evenly through the chambers. In case of diseases of the heart valves, the help of a cardiologist is required. In some cases, to eliminate the pathology, surgical intervention is necessary. Diseases of the valvular apparatus lead to circulatory failure. If left untreated, the pathology can lead to death.
What is a heart valve?
Valves of the heart are necessary to ensure one-way blood flow 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 flows from one chamber to another in the required amount. The valvular apparatus of the heart is formed by the following components:
- Fibrous ring.
- Muscle tissue and folds.
- Chords.
These formations are present in all valves. fibrous rings andpartitions between the cavities form the frame of the heart. It is represented by dense elastic and collagen fibers. The valve leaflets are necessary in order to ensure its opening at the time of systole. Under high pressure, blood is transferred from one chamber of the heart to another. So that it does not mix with each other, the valve flaps must slam shut in time. Chords are connective tissue strands. They connect the valve to the papillary muscles of the heart. Their function is to ensure tightness between the leaves.
Varieties of heart valves
There are 2 types of valves: atrioventricular and semilunar. The first - provide the relationship between the cameras. The semilunar valves are necessary to maintain proper blood flow in the major vessels of the heart, the aorta and pulmonary artery. The atrioventricular orifices include the following types of valves:
- Mitral.
- Tricuspid.
The mitral valve connects the left atrium and ventricle. It consists of 2 wings. The tricuspid valve is located on the border of the right chambers of the heart. Unlike the left atrioventricular orifice, it has 3 cusps. To pump blood from the heart to all the vessels of the body, an aortic heart valve is needed. It has 3 wings: right, left and back. The opening of the pulmonary trunk is located at the outlet of the right atrium. In order for the small and large circles of blood circulation to function, the coordinated work of all valves is important. Damage to one of them leads to cardiacfailure.
Valve disease
The cusp valves in the heart can be damaged in various ways. In some cases, there is an irregular structure of the holes between the chambers. This indicates the presence of congenital malformations of the heart, which are formed during the laying of organs in the fetus. These anomalies include:
- Ventricular septal defect.
- Open ductus arteriosus.
- Atrial septal defect.
- Aortic and pulmonary stenosis.
In addition to valvular defects, there may be a narrowing of the main vessels, their incorrect location, the absence of a heart chamber, etc. In some cases, a combination of several defects is diagnosed.
Valve disease can be acquired. They occur against the background of chronic infectious pathologies of the heart, systemic inflammatory processes. The main reasons for the formation of defects are: endo- and myocarditis, rheumatic fever, atherosclerosis, etc. Acquired disorders include stenosis and valve insufficiency. These pathologies are more often diagnosed in young and middle-aged patients.
Indications for surgical treatment
If the communication between the cardiac cavities is broken, a replacement of the heart valve is required. The operation will help to avoid the development of circulatory failure. This type of surgery is a seriousa procedure that is resorted to only in cases where other methods of treatment do not bring effect. The following indications for surgery are distinguished:
- Severe valve insufficiency. It is characterized by the fact that the flaps become weak and easily stretched.
- Valvular stenosis. It consists in narrowing the holes between the chambers of the heart.
Prosthetics is performed in cases where the valve tissue is severely damaged, and it is impossible to restore its structure. 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: shortness of breath at rest, fainting, angina attacks. Also, the valve is replaced if its opening is narrowed by more than 50% and is less than 1 cm. Prosthetics is performed in cases where there is calcification of the leaflets or papillary muscles.
What causes heart valve insufficiency?
Valve insufficiency develops against the background of chronic heart disease. It leads to a change in blood flow and its regurgitation - reverse reflux. Insufficiency is diagnosed when the heart valve does not close completely. In this case, the sashes become less elastic. In most cases, aortic and mitral valve insufficiency occurs.
To improve the functioning of the heart, valvuloplasty is performed. In severe cases, valve replacement is required. Aorticfailure leads to backflow of blood into the left ventricle. As a result, this chamber of the heart gradually stretches and loses its contractility. Mitral valve insufficiency 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 to do if the heart valve is damaged? The operation is performed in cases of severe dysfunction of the organ. If heart failure is compensated, conservative therapy is performed. Diseases of the valvular apparatus are not always indications for prosthetics. In some cases, the problem can be eliminated without the introduction of a transplant. Cardiac surgery includes the following operations:
- Balloon valvuloplasty. Performed to widen a narrowed valve in stenosis.
- Annuloplasty. It consists in restoring the valve frame with the help of a support ring. The indication for this operation is the expansion of the hole between the chambers, caused by insufficiency.
- Heart valve replacement - performed in cases of damage and calcification of the valves.
The choice of surgical intervention depends on the severity of the defect, the age and general condition of the patient.
Valvuloplasty technique
The term "valvuloplasty" refers to various operations on the heart valves. This type of surgery is performed ascongenital anomalies of the organ, and in the case of an acquired defect. Valvuloplasty is performed if there is stenosis or insufficiency of the valve without damaging its structure. Also, this method of surgical treatment is performed in the presence of contraindications for prosthetics.
The most common heart surgery for aortic or left AV stenosis 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 forced into the balloon located at its end. After that, the catheter is removed. The operation is carried out under the control of angiography. It does not require general anesthesia and connection of the patient to the ventilator.
In some cases, stenosis is treated with a commissurotomy. It consists in dissection of the fused valves.
Annuloplasty is performed for valve insufficiency. The indication is the expansion of the valves without their organic damage. The surgeon selects a support ring of the required size and fixes it to the endothelium with sutures.
Heart valve replacement
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 valves from animals - pigs or cows. It is believed that the risk of rejection of such prostheses is lower than synthetic materials. Another optionsurgical intervention is the transplantation of the valve of the pulmonary trunk to the site of the damaged aortic opening. This procedure is performed only for young patients, as it is a technically complex surgical procedure.
Life after heart surgery
Despite the fact that heart surgery is considered risky, it is often the only way to save a person's life. After valve prosthetics, constant monitoring of the patient's condition is required. Patients who have undergone surgery must take blood-thinning medications for life. These drugs include the drug "Warfarin". This is necessary to prevent blood clots in the prosthetic valve.
