The life of a person depends on the work of the heart muscle. But normal blood circulation can only be ensured if the heart valves function correctly. The greatest load falls on the aortic valve, which, after some diseases, may cease to function normally. Thus, a heart defect develops, which leads to serious disturbances in the blood circulation, and therefore in the work of the whole organism.
Aortic valve replacement is currently possible. In the article, we consider what indications for this exist, how the operation is performed, and what its consequences are.
Causes of Valve Problems
This valve is located between the left ventricle and the aorta, which will carry oxygen-rich blood throughout the body. During the process of filling the heart muscle with blood, this valve should be closed. When the ventricle contracts, it opens and passes blood into the aorta.
Replacement of the aortic valve of the heart is necessary when it cannot function correctly, which leads to circulatory disorders. Sometimes aortic valve deformity is observed from birth - this is a congenital malformation. But there are times when he worked normally for many years, and then begins to not fully open and close, then they talk about acquired pathology of the aortic valve. This can happen due to wear with age, as a result of the buildup of calcium salts on the valve, which disrupts its operation.
Some diseases can also lead to a malfunction of the valve, these include:
- Complications after diseases, for example, streptococcal infection, may well have a negative effect on the valve.
- Endocarditis, when an infection affects the heart and its valves.
- Aortic aneurysm.
- Hemorrhage into the aortic wall.
- Stenosis of the aortic valve, in which it is so stiff that even blood under pressure is not able to fully open it.
- A condition where the valve is not able to close completely after the discharge of blood, and part of it returns to the ventricle again.
All of these diseases and pathologies can lead to the need for an aortic valve replacement operation.
Features of valve replacement operation
This type of surgery is considered the most difficult. Not every surgeon will be able to 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, so there is no way to provide timely assistance to all those in need of such operations. Replacing the aortic valve of the heart is for many the only way to save life, but, unfortunately, not everyone is waiting in line.
But there are also foreign cardiology centers that are ready to receive foreign patients and provide them with the necessary assistance, thereby saving their lives.
Types of valves
Even the possibilities of modern science and technology still do not allow creating the perfect valve. Those varieties that are used now have their pros and cons. Surgeons use several types of prostheses to replace:
- Mechanical valves. Create them from modern alloys of high strength. 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 their installation, taking blood-thinning drugs is not required, but the prosthesis's service life is only 10-15 years, and then a second operation is needed.
- Donor valves are received 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 health.
- For what reason valve replacement is required.
- The presence of other chronic diseases.
- Does the patient have the opportunity to take anticoagulants for life.
Once the type of valve is selected, it will be a difficult operation to replace it.
Types of surgical intervention
Until recently, the operation to replace the aortic valve on the heart necessarily required cardiac muscle arrest and opening of the chest. These are the so-called open operations. During surgery, the patient’s life is maintained using a cardiopulmonary bypass.
But at present, in some clinics, it is possible to replace the aortic valve without opening the chest. These are minimally invasive operations in which cardiac arrest is not required, as well as large incisions.
Of course, I must say that carrying out such surgical interventions requires the surgeon's real skill. For example, Israeli clinics are famous for their cardiac surgeons, so many patients, if funds permit, are sent to this country for such an operation.
Preparation for surgery
Aortic valve replacement requires careful preparation of the patient. After contacting a doctor, a number of studies are prescribed for the patient:
- The first step is an examination by a doctor.
- Blood tests are being taken.
- An echocardiogram is performed, in which the movement of the heart and its valves is detected.
- An electrocardiogram is performed to track the heart rate.
- Cardiac catheterization is done - this is the introduction of a thin tube through which a contrast medium 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 comply with the following recommendations:
- Stop taking anti-inflammatory drugs and aspirin.
- Do not take anticoagulants.
- The day before surgery, only light food should be included in the diet.
- On the day of surgery, you can’t eat at all.
- Clothing should be prepared without restraining movements.
Only after all the necessary preparations for the operation, the doctor prescribes the time for surgery and the aortic valve will be replaced.
Operation
When the patient is on the operating table, they give him general anesthesia, and he falls asleep. If the operation is performed with an opening of the chest, then in the middle the surgeon makes an incision and spreads the chest so that you can reach the heart.
Cardiac arrest is required so that it is possible to carry out a replacement, so the patient is connected to a heart-lung machine. The doctor in the aorta makes an incision, removes a worn or damaged valve, and installs a new one in its place. After this, the aorta is sutured, the heart muscle starts, the rib cage connects and sutures.
After aortic valve replacement surgery
Once the operation is completed, the patient is sent to the intensive care unit. Here he is taken out of anesthesia and control over vital functions:
- The heart rate is determined.
- Tracked respiration and blood pressure.
- Checks the oxygen content in the blood.
- A tube is inserted into the mouth and lungs to provide additional ventilation.
- A drainage is installed to drain fluid from the chest.
- The patient is placed a catheter in the bladder to drain urine.
- Anesthetics, fluids and electrolytes are injected directly into the vein.
After replacing the aortic valve, the patient usually spends 5-7 days in the hospital if there are no complications.
Complications during the operation
Surgery on the heart is always a big risk. When aortic valve replacement is planned, the following complications are possible:
- Infection.
- Possible bleeding during the operation.
- The appearance of clots if there was a stroke or there are problems with the kidneys.
- Complications of anesthesia.
There are other factors that increase the risk of complications during surgery:
- The presence of heart disease.
- Lung diseases.
- Hypertension.
- Diabetes.
- Obesity.
- Smoking.
- The presence of infections in the body.
Complications after surgery
For any surgeon, not only the process of the operation and its outcome, but also the recovery period, which can also be accompanied by serious complications, is important:
- Overgrowth of scar tissue. There are cases when, after an operation, the patient quickly grows fibrous scar tissue at the place of valve replacement. This process is not even dependent on the type of valve and can lead to thrombosis. But thanks to modern methods of surgery, such a complication is quite rare.
- Bleeding with anticoagulants. Moreover, it can occur not only in the valve area, but also in any organ, for example, in the stomach.
- Thromboembolism. It can be recognized by the following manifestations:
- The patient has shortness of breath.
- Clouding of consciousness.
- Lost vision and hearing.
- Numbness and weakness in the body.
- Dizziness.
4. Infection of the delivered valve. Even the most sterile valve, once inside, can be infected. That is why, if the body temperature suddenly rises, respiratory problems appear, then you must urgently inform the doctor in order to conduct tests and exclude infection of the valve.
5. Hemolytic anemia. When it occurs, a large number of red blood cells are damaged during contact with the valve material. There is a strong weakness, fatigue, which does not pass after rest.
As a rule, in the presence of heart disease, the patient has a particular disability group. All this is determined by a special commission of doctors. If the aortic valve is replaced, the disability can be lifted if the consultation of doctors considers that you are healthy and you do not need special payments from the state. In some cases, leave group 3.
Postoperative period
Over the course of several days, the patient is given injections of painkillers after valve replacement surgery to reduce pain. But after a while they are canceled. In addition, the patient may encounter the following problems:
- Swelling of the extremities.
- Pain in the incision.
- The inflammatory process in the place where the incision was made.
- Nausea.
- Joining an infection.
If all these manifestations last too long, then it is worth telling the doctor. Aortic valve replacement surgery (patient reviews say so) bring noticeable improvements after a couple of weeks. Significant positive changes occur 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 does not spend the recovery period at home, but in a specialized institution, for example, in a sanatorium or in a cardiology rehabilitation center.
There, under the supervision of doctors, there is a restoration of the body, each is selected an individual program. Rehabilitation may take a variety of time. It all depends on the general condition of the patient, the complexity of the operation and the recovery abilities of the body.
Without fail, the doctor prescribes medications to the patient after surgery. Their reception must be carried out strictly according to the scheme and can not be canceled independently.
If various physiotherapeutic procedures, medical interventions are required, then it is imperative to report that there is an artificial aortic valve.
If there are concomitant heart diseases, then valve replacement does not cure them; therefore, it is necessary to visit a cardiologist and carry out appropriate therapy.
Home Rehabilitation Therapy
If the patient does not have the opportunity to go to the sanatorium for recovery after surgery, then all the recommendations of the doctor at home should be strictly observed.
- If a mechanical valve is installed, then it is imperative to take anticoagulants, and this will have to be done all my life.
- If there is a dental intervention or other surgical operations, then it is imperative to take antibacterial drugs in front of them in order to prevent inflammation in the valve area.
- Be sure to control the balance of fluid in the body.
- Do special exercises on the recommendation of a doctor, which will help normalize respiratory function.
- Carry out hardware prophylaxis of pneumonia.
Only following all the doctor’s recommendations will help make life after replacing the aortic valve normal and complete.
Lifestyle change
Any surgical intervention on the heart muscle requires a radical review of your lifestyle. Replacing the aortic valve (reviews only confirm this) is no exception. Patients after surgery:
- Exclude from your life all bad habits, unless, of course, life is dear. Smoking, drinking alcohol and consuming large amounts of caffeine are not compatible with the artificial valve, and indeed with heart pathologies.
- You will have to practically eliminate fatty foods from your diet.
- Minimize salt intake, not more than 6 grams per day.
- Food should be balanced and contain more fresh vegetables and fruits.
- Drink plenty of clean water but no gas.
- Gradually introduce loads that will help strengthen the heart muscle.
- Every day, in any weather, take walks in the fresh air.
- Exclude from your life psycho-emotional overload, stress.
- 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. Unpleasant symptoms that did not give rest disappeared, heart function returned to normal.
Aortic valve replacement (reviews confirm this) is not an obstacle to future pregnancy. Many women suffering from heart disease did not even hope 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 not to put an end to one’s life even in the presence of serious pathologies in the heart, so do not give up. One should always hope for the best, and a miracle will happen - your heart will work long and reliably. Take care of yourself and be healthy.