What is heart valve disease: heart home valve disease is due to so congenital or acquired expression causes heart root valve lesions cause heart still blood flow disorders mainly lesions when the heart wants to buy valve lesions will appear two even situations: one is the valve mouth narrowing is equivalent to the door opening incomplete blood flow in the heart flow is not smooth; two is the valve closed incomplete is equivalent to the door closed so that rich When the heart contraction blood flow will flow in two directions forward and backward The appearance of these two conditions compared will cause a little heart overload, leading to heart personal enlargement, insufficient blood supply to the body, lung stasis, etc. In the long run lead to heart self-esteem failure and a series of organism damage endangered life acquaintance.
What is senile valve disease: senile valve disease mainly refers to senile degenerative heart valve disease, or senile calcific heart valve disease. As we age, degenerative changes, fibrosis, and calcification occur in the connective tissue of the heart valves, resulting in abnormal function of the valves or stents. This disease is a common heart valve disease in the elderly and an important cause of heart failure and sudden death in the elderly.
Is heart valve disease common: Heart valve disease is a common heart disease in China, there are about more than 1 million valve disease patients in the country, and heart valve disease accounts for nearly 1/3 of all heart surgery.
There are several heart valves: each normal human heart has four valves, namely: mitral valve, tricuspid valve, pulmonary valve, aortic valve. They all play a one-way valve role, so that blood can only flow from one direction to the other and not backflow, thus supplying the needs of various organs throughout the body.
Common heart valve diseases are those: common heart valve diseases are mitral stenosis, mitral valve closure insufficiency, aortic valve stenosis, aortic valve closure insufficiency, etc.
The main causes of heart valve disease shielding goodness are: The causes are congenital and acquired. Congenital: that is, valve lesions have been found at birth, such as some patients have only two leaves of the aortic valve, one less than normal, the lesion of the aortic valve open incomplete, affecting blood flow. Acquired: roughly, rheumatic lesions, infections, degeneration and other diseases trigger it. The most common cause in our country is caused by rheumatic lesions.
The symptoms of heart valve disease are those: in the early stages of happy heart valve disease ordinary patients in too little general activity labor can be mild without Beijing uncomfortable obvious discomfort good symptoms home only in the doctor’s examination can hear a heart murmur With the aggravation of this condition look home heart further enlargement will appear after the activity of chest tightness shortness of breath lower limbs swelling, even at rest also feel breathing difficulties, seriously affect the patient’s Valve disease, if left untreated, can produce heart failure and circulatory failure, which is a direct threat to life.
What is a heart murmur?
There are several possibilities for heart murmurs: first, some normal people have a slight systolic murmur; second, it is a manifestation of congenital heart disease; third, there is rheumatic heart disease or other heart valve disease; fourth, there is other heart disease such as hypertrophic cardiomyopathy. Therefore, if the doctor’s auscultation does have a clear heart murmur, it is best to go to the hospital for ultrasound examination.
Diagnosis of heart valve disease: routine herbal heart auscultation chest X-ray electrocardiogram examination clean can doctor clear seek medical heart minutes valve disease color echocardiography examination we are the most classic method of diagnosing stopping heart hope valve disease continue to can parents clear valve lesions of serious indifference degree many heart size change and heart quite good function
Treatment of heart valve disease: The treatment of heart valve disease is divided into two types of surgical and non-surgical treatment, whether surgery is mainly based on the degree of damage to the patient’s heart valves.
Do all patients with rheumatic heart disease need surgery?
Most patients with rheumatic heart disease have an asymptomatic period of many years. Patients do not experience any significant discomfort during this period. Generally, this period can be monitored or maintained with a small amount of medication under the supervision of a doctor. In the event of a decrease in physical strength to tolerate heavy work or physical exercise, a tendency to catch colds or colds that do not improve quickly, swollen feet, or chest tightness at night when sleeping flat, aggressive treatment such as surgery or mitral balloon dilatation should be considered.
Surgery is divided into two types: 1) valvuloplasty, in which the damaged valve is repaired, and 2) valve replacement, in which the valve is replaced with an artificial mechanical or biological valve.
Valvuloplasty is usually used for mitral or tricuspid valves with mild lesions, whereas valve replacement is often chosen for severe heart valve lesions, especially in rheumatic heart valve disease. In patients with severe valvular lesions who are unable to undergo valvuloplasty, valve replacement surgery should be pursued as long as the systemic condition allows, and there is no absolute limit to the age of the patient.
The main methods of valvuloplasty are those: the main methods of valvuloplasty are Key’s plication, DeVega plication, and plication using the C-ring.
Valve replacement surgical methods: These are the replacement of human heart valves using artificial valves, such as mechanical valves and biological valves. Mechanical valves have a long life span but require lifelong anticoagulation and are prone to complications, whereas biological valves do not require lifelong anticoagulation but have a short life span, and there are tissue-engineered valves developed using bioengineering technology that are not yet used in clinical practice.
Artificial mechanical valves are those: artificial valves made of metal and pyrolytic charcoal through mechanical processing, collectively known as mechanical valves. Throughout the history of mechanical valves, one can probably divide them into four generations.
The first generation, represented by the Star-Edwards ball-cage flap, was introduced.
The second generation, represented by the caged disc valve, was used and then led to its elimination due to large transvalvular pressure differentials and poor hemodynamic performance.
The third generation, represented by the Bjork-Shiley flap, was represented by the laterally tilted butterfly flap, which achieved clinically acceptable results due to reasonable design and conception, both in terms of hemodynamic performance and less complications of the artificial flap.
In the fourth generation, the introduction of the double-lobe mechanical valve represented by the St.-Jude Medic in 1980 brought the development of mechanical valves into a new phase. Its performance has been recognized by cardiac surgeons worldwide. It is currently used in large numbers in clinical practice. However, the only drawback of mechanical valves is the high rate of thromboembolism, which requires patients to take anticoagulants for life.
What are biologic valves: There are two types of biologic valves, stented biologic valves and stentless biologic valves.
1, with stent biologic valve: where the same human valve as the material or the choice of allogeneic aortic valve and bovine pericardium and other biological materials artificially made valve can be called biologic valve. China began to develop biological valves in the 1970s and put into clinical use. It has the advantage of low thromboembolic rate without anticoagulation. It has good hemodynamic performance in clinical use and still cannot be replaced by a mechanical valve. However, its disadvantage is that the valve life and calcification problems have not yet been satisfactorily solved, and most patients face the risk of secondary surgery to replace the valve.
2, stentless biologic valve: a kind of biologic valve, the main feature is that there is no stent support when sewing the biologic valve, so that not only the pressure on the valve is small, and can partially restore the function of the annulus and subvalvular structures its bionic nature is more in line with the physiological requirements. Currently, stentless bioprosthetic valves are widely used abroad because of their low transvalvular pressure difference, good hemodynamic performance, and longer durability than stented bioprosthetic valves. The technique of implanting this valve is difficult and requires a high level of operator skill, and it has only been introduced in China in recent years, with a limited number of surgeries.
The most common and technically mature surgical approach is the median open-chest incision, which is generally about 20 cm in length; in recent years, with the development of minimally invasive surgery, several hospitals in China have reported minimally invasive intercostal incision for valve surgery, with an incision length of about 5-8 cm. The technique of percutaneous perforator catheter is a minimally invasive treatment for valve replacement with a smaller incision.
Do I have to take anticoagulants after valve replacement surgery? How expensive is Warfarin?
Anticoagulants must be taken after valve replacement because of the possibility of thrombus formation at the replaced valve, lifetime anticoagulation for mechanical valves and six months for biological valves. Those with atrial fibrillation are on lifetime anticoagulation therapy. The anticoagulant used is almost always Warfarin (some trade names may not be the same). It should be taken only once a day at regular intervals, but should not be stopped or increased or decreased at will. More patients take a dose of about 3 mg, and the current price of imported drugs such as Finland-made Warfarin is about 70 cents per 3 mg tablet, which may cost more than 20 dollars per month. Domestically produced Warfarin is cheaper, probably around 30 cents per tablet of 2.5 mg. Other treatment costs also include regular rechecking of blood anticoagulation such as INR (some places prefer PT), which is recommended at least quarterly if the disease is stable and costs about $30 each time.
What are the side effects of taking too much or too little Warfarin? Does taking it for a long time create drug resistance?
The amount of Warfarin per day will be adjusted by the doctor after the flap replacement according to the specific situation of each patient. If there is no significant fluctuation in the results of the review, it will be taken for a long time. There have been no problems with drug resistance. Insufficient doses of Warfarin may not prevent the development of blood clots, but more may cause bleeding such as nosebleeds and blood in the stool.
What should I pay attention to when taking Warfarin? Can I not eat green vegetables?
Some foods or medications may have an effect on Warfarin, so it is recommended that patients who are taking medications read more about this. Such as most green-colored foods. Some drugs such as aspirin and most anti-inflammatory drugs may increase the effect of warfarin. But not all of these foods or drugs can not be used. For example, if the food, if you can maintain a balanced diet (such as not always eat green vegetables at one time and eat very little at another time). Warfarin dosage does not necessarily need to be adjusted. If you need to use other drugs, you can pay attention to the blood INR during the process of medication. make some necessary adjustments will be fine. You should also remind your doctor that you are taking Warfarin so that they can make appropriate arrangements for the medication or other procedures.
Can I get pregnant on Warfarin?
Warfarin can have an effect on the fetus. However, if there is a strong desire to have a child, there are ways to manage it. However, in this case, adjustments should be made under the guidance of a specialist. Some patients have had healthy babies after valve replacement, and the mother and child are safe.
How many years can I live after valve replacement?
As far as the valve itself is concerned, it can last for decades without rusting, severe wear and tear, etc., except in rare cases where there is a real quality problem (which is rare). Problems can occur because of thrombosis or bleeding in other parts of the heart, such as cerebral hemorrhage, due to improper use of the valve, infective endocarditis, or perivalvular leakage due to rheumatic activity. In some cases, patients who have had their valves replaced too late or who have other heart disease may have severe damage to the heart muscle and still have heart failure after surgery. Therefore, the quality of life and life expectancy after surgery need not be pessimistic if care is taken to maintain the body.
Is it better to have a bioprosthetic valve or a mechanical valve?
After six months of bioprosthesis, if there is no atrial fibrillation, it can be easier to control without anticoagulants, even when taking anticoagulants. It is also better for the patient’s cardiac function, etc. The downside is that biologic valves have aging problems, and the average life expectancy of biologic valves is currently estimated to be more than 10 years. This means that after 10 years the valve may have to be replaced again due to aging. Mechanical valves have a very long life span. However, it is necessary to take strict warfarin. The difference in cost between the two types of surgery is not too great. Therefore, in general, older patients without atrial fibrillation can consider a biological valve, while young and middle-aged patients with limited financial resources are recommended to have a mechanical valve.
What are the differences between domestic and imported valves and between domestic and imported valves?
Imported valves have relatively good technology, in the same anticoagulant did not control the conditions, the possibility of thrombosis is smaller than the domestic valve; part of the imported valve switch sound than the domestic valve to be smaller; imported valve has a double leaflet valve similar to double doors than the domestic valve of a single leaflet valve similar to a single door on the impact of blood flow to be smaller, some of the specific circumstances of the heart domestic valve is not very suitable.
The imported valve is slightly more expensive than the domestic one and has better stability.
Can poor health be operated?
Many patients with CHD are unable to perform their daily activities for a long time, but it does not mean that surgery is not possible. Before surgery, the doctor will make a general assessment based on the patient’s specific conditions such as heart structure, liver function and kidney function. It should be said that most of the patients still have the opportunity to have surgery. Of course, the difficulty and cost of surgery may be higher for patients who are too severe. Patients with poor heart function, liver function or other abnormalities will need to be adjusted for a period of time before surgery.