The human heart has 4 cavities. Each of them is connected through special holes - valves. They are needed so that the blood circulates through the chambers evenly. With 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 measures are not taken, pathology can be fatal.
What is a heart valve?
Heart valves are needed to provide a one-way flow of blood 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 quantity. The valvular apparatus of the heart is formed by the following components:
- Fibrous ring.
- Muscle tissue and sash.
- Chords.
These formations are present in all valves. Fibrous rings and partitions between the cavities form the heart frame. It is represented by dense elastic and collagen fibers. Valve flaps 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 be slammed in time. Chords are connective tissue cords. They connect the valve to the papillary muscles of the heart. Their function is to provide density between the wings.
Varieties of heart valves
There are 2 types of valves: atrioventricular and lunar. The first - provide interconnection between cameras. Lunar valves are necessary to maintain proper blood flow in the large vessels of the heart - the aorta and pulmonary artery. Atrial ventricular openings include the following types of valves:
- Mitral.
- Tricuspid.
A mitral heart 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 foramen, it has 3 wings. In order for blood to be pumped 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 exit of the right atrium. In order for the small and large circles of blood circulation to function, the coordinated operation of all valves is important. Damage to one of them leads to heart failure.
Valvular diseases
Flap heart valves can undergo various injuries. In some cases, there is an incorrect 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. Similar anomalies include:
- Ventricular septal defect.
- Open ductus arteriosus.
- Atrial septal defect.
- Aortic and pulmonary stenosis.
In addition to valvular defects, narrowing of the great vessels, their incorrect location, lack of a heart chamber, etc. can be observed. In some cases, a combination of several defects is diagnosed.
Valvular diseases can be acquired. They occur against the background of chronic infectious pathologies of the heart, systemic inflammatory processes. The main causes of 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 heart valve replacement is required. The operation will help to avoid the development of circulatory failure. Such surgical intervention is a serious 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 extensible.
- Valve stenosis. It consists in narrowing the openings between the chambers of the heart.
Prosthetics are 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 severe heart failure. The 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 are performed in cases where there is calcification of the valves or papillary muscles.
What causes heart valve failure?
Valvular insufficiency develops against a background of chronic heart disease. It leads to a change in blood flow and its regurgitation - reverse casting. Insufficiency is diagnosed when the heart valve does not close completely. In this case, the flaps become less elastic. In most cases, aortic and mitral valve insufficiency occurs.
To improve the work of the heart, valvuloplasty is performed. In severe cases, valve replacement is required. Aortic insufficiency leads to the return 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 violation of the functioning of the body. If heart failure is compensated, conservative therapy is performed. Diseases of the valve apparatus are not always indications for prosthetics. In some cases, the problem can be eliminated without the introduction of a graft. The following operations are referred to surgical interventions on the heart:
- Balloon valvuloplasty. It is performed to expand the narrowed valve with stenosis.
- Annuloplasty. It consists in restoring the valve frame using a support ring. The indication for this operation is the widening of the aperture between the chambers caused by failure.
- Prosthetics of the heart valve - 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. Such surgical intervention is performed both with congenital abnormalities of the organ, and in the case of acquired defects. Valvuloplasty is performed if there is stenosis or insufficiency of the valve without damaging its structure. Also, this method of surgical treatment is performed if there are contraindications to prosthetics.
The most common heart surgery for stenosis of the aortic or left atrioventricular orifice 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 blown into the cylinder located at its end. After this, the catheter is removed. The operation is carried out under the control of angiography. In this case, general anesthesia and connecting the patient to the ventilator are not required.
In some cases, with stenosis, a commissurotomy is performed. It consists in dissecting the fused flaps.
Annuloplasty is performed with valve insufficiency. The indication is the expansion of the valves without their organic damage. The surgeon selects the support ring of the required size and fixes it to the endothelium using sutures.
Heart valve prosthetics
The operation to replace the heart valve is performed by narrowing the atrioventricular orifice to 1.5 cm, the aortic orifice to 1 cm. Various materials are used as prostheses. In some cases, patients receive transplanted heart valves of animals - pigs or cows. It is believed that the risk of rejection of such prostheses is lower than synthetic materials. Another option for surgical intervention is a transplant of the valve of the pulmonary trunk to the site of the damaged aortic orifice. Such a procedure is performed only for young patients, as it relates to technically complex surgical procedures.
Life after heart surgery
Although heart surgery is considered risky, it is often the only way to save a person’s life. After valve replacement, constant monitoring of the patient's condition is required. Patients who have undergone surgery should take blood thinning medications for life. Such drugs include the drug "Warfarin." This is necessary to prevent blood clots in the artificial valve.