Heart valves are structures located within the heart and allow blood flow between the heart chambers. The blood pumped by our heart contracting an average of one hundred thousand times a day circulates through the valves in these chambers that open and close. Heart valves work in a certain harmony and systematically among themselves. In this regard, heart valve diseases occur when these valves located in the heart do not work adequately and efficiently, alone or together.
Before discussing the artificial heart valve and its types, which are among the heart valve options used for the treatment of heart valve diseases, it will be useful to touch upon the health problems that occur in the heart valve.
Heart Valves and What are their functions?
Heart valves are structures located within the heart that ensure systematic and regular blood flow. Heart valves; There are four: mitral, aortic, pulmonary and tricuspid. Of these four rooms in our heart, two are small and the other two are large. Small rooms; Atrium and large chambers; It is called ventricle. At the same time, these valves, which have certain functions based on their location, allow the passage of clean blood in the chambers on the left and of dirty blood in the chambers on the right.
-The gate on the left side of the heart, which allows blood to pass between the small chamber and the large chamber. ; It is called 'mitral valve'. The door through which the blood coming out of the large chamber on the left is thrown into the body is called the 'aortic valve'.
-The door located on the right side of the heart, which allows blood to pass between the small and large chambers, is called 'tricuspid'. The door through which blood passes from the large chamber on the right side to the lungs for cleaning is called the 'pulmonary valve'.
Heart gates operate in a certain harmony among themselves. During the relaxation of the heart, the doors between the small room and the larger rooms open and the other doors close. In cases where the heart contracts and therefore pumps more blood to the body, there is a difference between small rooms and large rooms. The following doors are closed and all other doors are closed. In this regard, dysfunctions in the heart valves that are present at birth or occur later as a result of various factors cause heart valve diseases.
Heart valve diseases in general; It is examined in two parts: valve stenosis or heart failure. Heart valve stenosis is a health problem that occurs as a result of the heart valve not opening fully. This condition may occur due to deformation of the heart valves due to advancing age, calcium accumulation around it, rheumatic fever diseases, or congenital diseases. Heart valve failure is a health problem that occurs as a result of the structural deterioration of the valves that make up the heart valve and their inability to close completely. When heart valve stenosis and insufficiency diseases reach a stage where the patient cannot be relieved despite the use of medication, surgery becomes a necessity. At this stage, the diseased or malfunctioning heart valve is replaced with an artificially produced valve through surgery.
Heart Valve Surgery
In cases where the heart valve is diseased or cannot fully perform its functions, it is replaced with an artificially produced valve. The surgeries performed are called heart valve surgery or heart valve replacement.
Artificial (Prosthesis) Heart Valve Types
1)Mechanical (Metal) Heart Valves
Mechanical heart valves; It is one of the artificial heart valve types preferred especially in young patients.
After mechanical heart valves are installed on the patient, the patient must use blood thinners for life. The dose of Coumadin medication should be adjusted according to the patient. Values called INR are measured for each patient's blood level. For example; In patients with mitral mechanical artificial valve, the INR value should be kept between 2.5-4 on average. In cases where an aortic mechanical artificial valve is installed, the INR value is kept between 2-3. If it falls below these values, clotting may occur on the valve. consequences such as paralysis and death may occur. As long as the blood is diluted, no clotting occurs in the mechanical artificial heart valve. Likewise, if an excessive dose of blood thinner is used, minor bruises, stomach bleeding or more serious bleeding may occur on the body. In this regard, if a mechanical heart valve, one of the artificial heart valve types, is applied, the patient must have regular blood checks and use blood thinners.
2)Biological Heart Valves
Biological heart valves, which are another type of artificial heart valve, are used when the patient is unable to use blood thinners or preferably blood thinners. It is preferred in cases where one does not want to use it.
Biological artificial heart valves are generally preferred in the following cases;
-Especially in patients aged 70 and over, that is, in the advanced age group
-In people with bleeding disorders.
-For female patients who want to have children. The reason is that the use of the blood thinner drug Coumadin during pregnancy is unsafe in these patients.
We can say that biological valves have a much shorter lifespan than mechanical heart valves. On average, biological valves deteriorate within 10-15 years. These deteriorations occur especially in the mitral biological valves. According to research, approximately 15% deterioration may occur in mitral biological valves within ten years compared to the artificial aortic biological valves applied. In this regard, biological heart valves are preferred in older patients.
Unlike mechanical heart valves, it is not necessary to use blood thinners in biological artificial heart valves. If the patient does not have any other reason that requires blood thinner treatment (such as heart rhythm disorder, clotting in the leg vein), the patient does not need to use blood thinners for life after biological artificial heart valve application.
With developing technology, it is now possible to install biological valves without surgery. In the TAVI technique, it is entered through the groin, as if angiography is performed in case of aortic stenosis. We can install the aortic valve. The other method is to insert a seamless aortic valve by entering from the armpit.
With these techniques, the duration of surgery is shortened and patients can be discharged early and return to normal life.
Read: 0
