MIRTAL VALVE SURGERY
There are four valves in the heart. On the left side of the heart are the aortic and mitral valves, and on the right are the tricuspid and pulmonary valves. The aortic and tricuspid valves have three leaflets, the mitral and pulmonary valves have two leaflets. The mitral valve is located between the left atrium and the left ventricle.
Diseases can occur in a single valve or in more than one valve. Disease that starts in one valve can affect other valves over time.
Causes of heart valve diseases; It is divided into two main groups as congenital or acquired.
Rheumatic Disease is in the first place among the diseases that occur later. It often causes stenosis (Stenosis) in the lids. In cases where leaflets or valves thicken, deform, stick to each other, and become hard and calcified over time, there is a decrease in the area and opening of the valve that prevents the passage of blood. Stenosis is the name given to this condition. is pathology. If the valve area goes below a critical level, surgery is required.
Responsibility: In the hinge (annulus) tissue holding the valves around the valve, expansion, relaxation and in the structures holding the valves ( As a result of deformation or elongation, the closure of the valve cannot be fully realized and some opening remains and blood flows back. Surgical intervention is required if the amount of blood escaping back, the enlargement of the relevant parts of the heart, and the extra blood supply to the lungs increase the lung pressure above a certain level. We will examine this issue in detail.
Symptoms in Mitral Valve Disease
Dyspnea is the most common . The effort capacity of patients decreases with time. It is typical for them to complain, "I used to climb four flights of stairs, now I can barely climb two flights of stairs." In addition, palpitations, rhythm disturbance, chest pain, fainting, swelling in the legs, spitting up bloody sputum (in very advanced cases) and inability to lie down There may be symptoms such as >. One of these symptoms is present together with being in the foreground. Determined in the decision of surgery The weight of the tissues is important.
Diagnostic Methods
Echocardiography, the structure of the valves, the sizes of the heart parts and the heart performance is evaluated. If individuals are in the risk group for Coronary Artery Disease in terms of age and other factors, catheterization and angiography are required for diagnosis.
There is no requirement that every valve patient will have surgery. For the mitral valve, stenosis and insufficiency usually coexist.
Stenosis progresses over time. Age and calcification around the lid play an important role in this. Calcium is responsible for calcification. Valve patients who do not require surgery are followed up every six months with echocardiography.
Mitral valve insufficiency is common in patients and even in normal individuals. These are reported as "minimal failure" or "primary failure" in reports. These are also seen in normal individuals up to 7% of the population. There is no rule that individuals will have surgery in the future.
What are Mitral Valve Surgery?
1) Replacement (Replacement) ,
2) There are two options as Reconstruction (Repair).
Mitral valve replacement: The valve is removed and replaced mechanically or biological prosthetic valve is attached.
Biological caps, on the other hand, are generally produced with biological materials such as pig caps, calf or pig pericardium.
Biological caps There is a risk of deterioration compared to mechanical covers. With both the response of the immune system, which perceives the biological valve as a foreign substance, and the work against pressure, deterioration in its structure, deformation and degeneration are observed over time.
What is Mitral Valve Repair?
If the main cartilage structure of the mitral valve leaflets is not very damaged, if there is not much calcification and especially if the valve is seated if there is insufficiency due to enlargement (annulus); repair is possible. In the repair, the expanding frame of the door is narrowed, the excesses in the flaps are removed and the narrowed door frame is strengthened with a metal ring. cover deed The prices can be made with classical incisions as well as incisions under the right breast or under the armpit.
What are the Risks of Mitral Valve Surgery?
The sooner the surgery, the lower the risk. The risk varies between 1-2% in cases of Mitral Stenosis and 2-4% in cases of regurgitation. The most important risk factors are increased lung pressure with excess blood in the lungs or decreased cardiac contractility function.
One of the general criteria is to perform surgery without disturbing the heart rhythm.
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