Heart Valve Diseases
Our heart has four covers. It opens and closes all day long without rest. However, it causes various health problems when it is not opened or closed.
Moreover, sometimes at the beginning of the disease may not give any symptoms. For years, there are many people who are living with these problems but are unaware.
What is a Heart Valve ? What are Heart Valve Diseases?
The heart valves are structures that guide the blood flow in the heart chambers and open and close with each heart beat.
There are four Heart Valves:
Mitral, aortic, tricuspid, pulmonary valve. Heart valve disease occurs when the heart valve structure fails to function.
In the valves, the disease may develop in two ways, narrowing and / or failure of the lid (backward blood loss).
The cause of valve diseases is very diverse, such as genetics, advanced age, infection, heart muscle diseases.
Heart valve diseases can be asymptomatic for many years. During the examination, your doctor can be detected by chance as a result of a murmur.
Since valve diseases are mechanical problems, they cannot be treated with drugs, drug treatments can only lead to disease progression or relieving symptoms.
Heart valve diseases are generally slow, but may lead to severe heart failure, stroke, arrhythmia, and sometimes sudden death. Therefore, it is necessary to determine the time of valve surgery by monitoring the echocardiography of the valve patients at intervals.
In the long term, surgical intervention for the heart valve will be necessary, such as repair or complete replacement of the valve.
What Are The Symptoms ?
Complaints in valve diseases vary depending on which valve is the problem.
In the early stages of the disease, the person may not have any complaints at all, and sometimes he can live like this for years. As the valve disorder increases, the person begins to appear.
These are generally;
- Quick fatigue,
- Weakness,
- Palpitation,
- Congestion,
- Shortness of breath
- It is manifested by swelling in the feet, which is an indicator of fluid accumulation in the body.
- Some of the valve diseases, dizziness, chest pain, or even fainting complaints can be seen.
What are the diagnostic methods?
The diagnosis of valvular diseases can be made completely by chance, as the patient starts to go to the doctor for any reason and the murmur is heard while listening to his heart in his normal examination and the symptoms can also be revealed with some diagnostic methods.
Diagnostic methods
Electrocardiography (ECG): It starts with the withdrawal of the heart rhythm. Here, the speed of the heart, regular fluctuations, heart problems in the vessels and whether there is a problem specific to the valve diseases are examined.
Chest X-ray: The size of the heart and the status of the lungs are evaluated.
Echocardiography: This method, which has a heart ultrasonography, provides imaging with sound waves. As with the normal ultrasound of the patient while lying on the chest, a gel is applied to his chest to open the heart without opening the images as the images are obtained.
The size of the chambers of the heart, whether the heart suffers enough muscles, increased wall thickness, vessel structures and their congenital anomalies and diameters and the condition of the caps are examined. The murmurs heard during listening are evaluated.
Cardiac Catheterization: Most of the time there is no need. A procedure without patient sleep. Coronary angiography method is added to the coronary angiography in cases where surgery is required with the help of thin catheters.
Heart Valve Disease Treatment Methods
Valve Repair
The methods used in cover repair are as follows.
- Placement of tissues that support the cover structure.
- Repairing the cover tissue and providing better closure
- Release of the flaps can be summarized as.
Each valve cannot be repaired, sometimes repair surgeries may be more challenging than valve replacement. While mitral valves can be repaired more frequently, aortic and pulmonary valve should be replaced frequently.
Cardiologists can treat the narrowed caps by a method called ”balloon valvuloplasty Dar. Similar to angiography, a catheter (a thin tube) with a balloon at its end is advanced to the narrowed valve level.
At this stage the balloon is enlarged and the narrowed valve is expanded. During the procedure, deep anesthesia is not performed and the patient may return to normal life after one night of hospital follow-up. Balloon valvuloplasty can give very positive results especially in patients with mitral valve.
Heart Valve Replacement
Valvular diseases are most commonly treated by valve replacement surgery. During this operation, the patient is removed and replaced with mechanical or biological valve
Biological (bioprosthesis) caps are made of bovine, pig or human tissue. Biological valve use does not require the use of blood thinning medication, however, the caps may need to be re-operated in the average 10-15 years.
In this respect, they are not preferred for young patients. Mechanical caps can be used unchanged for life, but on the one hand it requires you to use serious blood thinning medication.
Failure to take blood thinning medications may cause clogging or stroke by mechanical clutches. In cases where the aortic valve needs to be changed, the heart valve formed from the patient’s own pericardium can be used as an alternative.
With the “Ozaki” procedure dedicated to the surgeon who performed this technique for the first time, the patient does not need to use blood thinners.
In addition, “coagulation in the valve” problems that may occur in other prosthetic valves are generally not seen after this technique.
Transcatheter Valve Therapy
Interventional cardiologists can repair or replace the caps with the help of clips or catheters passed through large blood vessels.
In patients with mitral valve leakage, by using the method called hast mitra clip lar, the valves are attached with a latch from their ends to prevent the blood from escaping.
Mitra clip method is much shorter in patients than in patients who underwent surgery.
TAVI
Recent current valve application is the application of transcatheter aortic valve replacement (TAVI) for aortic valves.
In this method, the catheter enters the groin vein from the middle of the balloon.
Then the balloon is extinguished and taken together with the catheter and the new lid is placed in place.
The TAVI method has been developed for patients with advanced age and high surgical risk. With the advances in this technology, it has become a preferred method in medium-risk patients.
