Heart valve problems, which lead to heart failure

Although muscle growth occurs in valve stenosis, heart failure occurs in valve insufficiency. Valve stenosis is a disease that complains a little more. But valvular insufficiency can lead to a very advanced heart rate, which often does not cause any complaints. Professor of Cardiovascular Surgery for Arctic Valve Disease. Dr. Baris Kayanak says …

The aortic valve is a one-way valve between the heart and the aorta. When the heart pumps blood, when it is compressed, it gives all the blood to the aorta. This blood then goes to the head, arms and then all the internal organs and legs. When the heart contracts, the aortic valve opens, pumping blood upwards; This allows all the blood to flow into the aorta. Then, when the heart is relaxed, that is, where it needs to be replenished with blood, it closes so that the heart is replenished with blood, and then when it is compressed again, it returns to the whole body. This is why there is a one-way opening cover process. When this process is disrupted, serious problems with the heart occur.

When calcified, it is difficult to pump blood

There are two types of aortic artery disease. First, the lid may become calcified, especially with age, and after calcification, a stenosis of the lid occurs. Normally, when this valve is opened, it should reach a diameter of 4-6 cm so that when the heart contracts, it can easily carry all the blood to the aorta and from there it can enter the body. But if the aortic valve leaflets can no longer open, if it is severely calcified and if the valve diameter drops below one centimeter, the heart has great difficulty pumping blood through this gap. Because the heart is an organ made up of muscles. Diagnosis is made by ultrasound of the heart, which we call ECO. On ultrasound, the pressure difference between the aorta and the heart is measured and it tells us that the valve is not open. When it reaches a certain point, the valve surgery is decided.

Improved heart growth

There are also valve insufficiency. In this, the valve opens, blood is pumped upwards, but not closed. This time, the blood fills the aorta again. In this case, the blood comes to the heart, pumps it and sends it. Then, when the blood from the lungs fills up again, the blood from the aorta also fills up. There is an increase in the heart during this time. Although muscle growth occurs in valve stenosis, heart failure occurs in valve insufficiency. Valve stenosis is a disease that complains a little more. However, valvular insufficiency can lead to a very advanced heart rate, which often does not cause any complaints.

Failure is an important symptom

Aortic valve stenosis and insufficiency is an insidious disease. Most of the time, they give no symptoms. The patient learns randomly. For example, when a doctor goes for an examination and listens to the heart for whatever reason, he hears sounds emanating from the pressure difference there and then directs him to the heart doctor. The first thing to do is to do an ultrasound of the heart and determine the hardness condition here. Most of the time, patients come to us during surgery. And they are surprised that they have such advanced heart disease when they have no complaints. Especially when the advanced valve is compressed it becomes unconscious. This is because when the heart does not pump enough blood to the place where it should pump more blood, the brain shuts off the switch and the person becomes unconscious.

The patient flat is not liable

Second, it can cause chest pain. Although the arteries of the heart are normal, the person still feels chest pain. This is because the muscle mass has increased too much and the heart is no longer able to feed those vessels and that muscle mass enough. Heart failure can also cause complaints such as shortness of breath, fluid retention in the lungs, and swelling of the legs and abdomen. But these are always too late symptoms. People with severe aortic stenosis do not expect these symptoms. If it is diagnosed by ultrasound, surgery is planned to replace the valve if necessary. Insufficiency of aortic valve is a more serious disease. There are no such symptoms. But the heart has grown so much that; It will no longer be able to cope with that growth. This time, his contractions are interrupted and he becomes heart failure. The first symptoms, then, are usually fatigue or shortness of breath. The patient said he could not lie down and he woke up at night with shortness of breath. Diagnosis can be made by ultrasound performed at these points.

The cover needs to be replaced

Since aortic valve stenosis is usually caused by calcification, valve replacement is absolutely necessary. The calcified cover is thoroughly cleaned and an artificial covering is placed there. A cover that can be opened and closed by itself and which can provide good cover opening is attached. Sometimes aortic valve leaks can be caused by augmentation of the aortic vessels. In other words, as the aorta, which is a vein connected to the heart, dilates, these leaflets do not end at this point and there is a leak. At that point, when replacing the aorta, it is possible to replace it by repairing its valve.

What is the difference between mechanical and biological cover?

“There are two types of valves,” said Professor of Cardiovascular Surgery. Dr. Barış Çaynak said, “The mechanical coating is made of titanium. There are also biological valves. These are caps made from organic matter derived from animal tissues and adapted to the human body. A mechanical metal valve requires lifelong blood thinning. The higher the blood thinning dose, the greater the risk of bleeding, and the lower the risk of clotting. Its dose needs to be adjusted. However, it has the advantage of being a lifetime cover. The advantage of biological valves is that there is no need to thin the blood. However, since it is a biological component of the body, it can worsen again in about 10-15 years and may require a second surgery. Generally, biological valves are used over 65 years of age. This is because the calcium mechanism in the body decreases with age and the risk of erosion of this valve decreases with age. But if installed at a young age, these caps can get worse in 15 years. Therefore, mechanical valves are recommended for young patients and biological valves for older patients. However, a biological valve can be used for a group of young patients for whom it is not advisable to use blood thinners. “

Surgery closed by four-inch injection

All heart surgeries, including bypass, mitral valve and aortic valve surgery, are now performed without opening the sternum. Since the whole heart is reached in the operation performed by opening the sternum, all operations can be performed there. But there is another place to stop this surgery. When aortic valve surgery is closed, the aortic vein reaches from the right side, in the middle of the ribs, about 4 cm from the upper side, and it closes from here. So, Stern does not open in any way. Sometimes it is structurally more difficult to reach the aortic valve or there is something that we need to change the aortic vessel; That is, there are patients with aortic aneurysms. These can be made by opening 2 cm above the sternum, but with a small cut in the space of 4 cm, by not opening the sternum.

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