Surgery for valvular heart disease
Surgery for valvular heart disease Valvular heart disease (VHD) involves damage or defect in one or more of the heart’s four valves: the aortic, mitral, pulmonary, or tricuspid valves. These valves ensure unidirectional blood flow through the heart, maintaining efficient circulation. When they malfunction—either by narrowing (stenosis), leaking (regurgitation), or both—heart function can be compromised, leading to symptoms such as fatigue, shortness of breath, chest pain, or even heart failure. Surgical intervention often becomes necessary when medical management no longer suffices to alleviate symptoms or prevent disease progression.
The primary goal of surgery for valvular heart disease is to restore normal valve function, thereby improving blood flow and reducing the strain on the heart. The two main surgical options are valve repair and valve replacement. The choice between these depends on the extent of the damage, the specific valve involved, patient age, and overall health.
Surgery for valvular heart disease Valve repair is generally preferred over replacement whenever feasible because it preserves the patient’s native valve, maintains better heart function, and reduces the risk of blood clots associated with artificial valves. Repair techniques vary depending on the valve. For example, mitral valve repair may involve techniques such as re-suspending prolapsed leaflets, removing excess tissue, or reinforcing the annulus with a ring. Aortic valve repair can include procedures like patching a bicuspid valve or enlarging a valve to improve opening.
Surgery for valvular heart disease When repair is not possible, valve replacement becomes the alternative. This involves removing the diseased valve and substituting it with either a mechanical valve or a bioprosthetic (tissue) valve. Mechanical valves are durable but require lifelong anticoagulation therapy to prevent blood clots. Bioprosthetic valves, made from animal tissue, tend to have limited longevity but usually do not necessitate long-term anticoagulation.
The surgical approach depends on various factors. Traditional open-heart surgery, involving a sternotomy (vertical chest incision), provides direct access to the heart and is commonly performed for complex cases. Advances in surgical technology have introduced minimally invasive techniques, such as thoracoscopic or robotic-assisted surgeries, which aim to reduce recovery time and minimize surgical trauma. Surgery for valvular heart disease
In some cases, especially for high-risk patients or those with contraindications to open surgery, transcatheter procedures like Transcatheter Aortic Valve Replacement (TAVR) have emerged as less invasive alternatives. TAVR involves delivering a collapsible valve via a catheter, usually through the femoral artery, and deploying it within the diseased valve. This method has expanded treatment options for elderly or frail patients who might not tolerate traditional surgery. Surgery for valvular heart disease
Postoperative care is crucial to ensure optimal recovery and long-term success. Patients are typically monitored closely for signs of bleeding, infection, or valve dysfunction. Medications such as anticoagulants or antiplatelet agents may be prescribed. Regular follow-up with echocardiography helps assess valve function over time. Surgery for valvular heart disease
While surgical intervention carries inherent risks, the advancements in techniques and patient management have significantly improved outcomes. Early diagnosis and timely surgical intervention are key to preventing irreversible cardiac damage and enhancing quality of life for those affected by valvular heart disease.
