Replacement of the aortic valve: surgery, possible complications, reviews

The life of a person depends on the work of the heart muscle. But normal blood circulation can be provided only if the heart valves function correctly. The greatest burden falls on the aortic valve, which after some of the diseases can stop functioning normally. This is how the heart disease develops, which leads to serious disorders in the circulation, and therefore, in the work of the whole organism.

Replacement of the aortic valve is currently possible. In the article we will consider what indications for this exist, how the operation is conducted and what its consequences are.

The causes of problems in the operation of the valve

This valve is located between the left ventricle and the aorta, which will carry blood enriched throughout the body with oxygen. During the process of filling the blood of the heart muscle, this valve should be in a closed state. When the ventricle contracts, it opens and lets the blood flow into the aorta.

Replacement of the aortic valve of the heart is necessary when it can not function properly, which leads to a violation of blood circulation. Sometimes deformity of the aortic valve is observed from the very birth - this is a congenital defect. But there are cases when he worked for many years normally, and then begins to not fully open and close, then talk about the acquired pathology of the aortic valve. This can happen due to wear with age, as a result of build-up of calcium salts on the valve, which disrupts its work.

To the violation of the valve can lead to some diseases, such as:

• Complications after the transferred diseases, for example, streptococcal infection may well have a negative effect on the operation of the valve.
• Endocarditis, when the infection affects the heart and its valves.
• Aneurysm of the aorta.
• Hemorrhage in the wall of the aorta.
• Stenosis of the aortic valve, in which it is so tight that even blood under pressure is unable to fully open it.
• The condition when the valve is unable to close completely after the release of blood, and part of it returns to the ventricle.

All these diseases and pathologies can lead to the need for an operation to replace the aortic valve.

Features of the operation to replace the valve

This type of surgical intervention is considered the most difficult. Not every surgeon can perform an operation on an open heart. To carry out such an intervention, modern equipment and high qualification of doctors are required.

Currently, in our country there are not enough clinics equipped with the latest technology, so there is no way to help in a timely manner to all those in need of such operations. Replacement of the aortic valve of the heart is for many the only way to save life, but, unfortunately, not everyone is waiting for their turn.

But there are also foreign cardiological centers that are ready to receive foreign patients and provide them with the necessary help, thereby saving lives.

Variety of valves

Even the possibilities of modern science and technology still do not allow the creation of an ideal valve. Those varieties that are used now have their pros and cons. To replace surgeons use several types of prostheses:

• Mechanical valves. They are made of modern high-strength alloys. Plus they are their perpetual functioning, but the patient will have to take anticoagulants throughout life to prevent the formation of blood clots.
• Biological prostheses are made from animal valves. After their installation, taking medications that dilute the blood is not required, but the life of the prosthesis is only 10-15 years, and then a second operation is needed.
• Donor valves receive from a deceased person. Such valves also can not last forever.

When a replacement of the aortic valve is required, the choice of the variety depends on several factors:

• Age group of patients.
• General health.
• For what reason does the valve need to be replaced.
• Presence of other chronic diseases.
• Does the patient have the opportunity to take anticoagulants for life?

After the valve type is selected, there is a complicated operation to replace it.

Types of surgical intervention

Until recently, the operation to replace the aortic valve at the heart necessarily required stopping the heart muscle and opening the chest. These are so-called open operations. During the surgical intervention, the patient's life is maintained with the help of an artificial circulation device.

But at present, in some clinics, aortic valve replacement is possible without opening the chest. These are minimally invasive operations, in which cardiac arrest is not required, as are large incisions.

Of course, I must say that carrying out such surgical interventions requires the surgeon to be truly skilled. For example, the clinics of Israel are famous for their cardiac surgeons, so many patients, if the funds permit, go to this country for such an operation.

Preparing for an operation

Replacement of the aortic valve requires careful preparation of the patient. After contacting the doctor, the patient is assigned a series of studies:

• The first thing is done by a doctor.
• Blood tests are done.
• An echocardiogram is performed, in which the movement of the heart and its valves is determined.
• An electrocardiogram is performed to follow the heart rhythm.
• Do a catheterization of the heart - this is the introduction of a thin tube through which the contrast agent is injected and then a snapshot is taken, which allows to determine the presence of problems with the functioning of the aortic valve.

A few days before surgery, the patient should follow the following recommendations:

• Stop taking anti-inflammatory drugs and aspirin.
• Do not take anticoagulants.
• The day before surgery, only light foods should be included in the diet.
• On the day of surgery, you can not eat at all.
• Clothes should be prepared without embarrassing movements.

Only after all necessary preparations for surgery, the doctor prescribes the time of surgery and the aortic valve will be replaced.

Operation

When the patient is on the operating table, he is given a general anesthesia, and he falls asleep. If the operation is performed with a thoracic opening, in the middle the surgeon makes a cut and spreads the thorax so that one can get to the heart.

Cardiac arrest is required to allow for a replacement, so the patient is connected to an artificial circulation device. The doctor in the aorta makes a cut, removes the worn or damaged valve and in its place sets a new one. After that, the aorta is sutured, the heart muscle is triggered, the thorax is connected and sewn.

After the operation to replace the aortic valve

Once the operation is completed, the patient is sent to the intensive care unit. Here he is taken out of anesthesia and carries out control over vital functions:

• The heart rate is determined.
• Breath and blood pressure are monitored.
• The oxygen content of the blood is checked.
• The tube is inserted into the mouth and lungs to provide additional ventilation.
• Drainage is installed to drain fluid from the chest.
• The patient is put a catheter into the bladder to drain the urine.
• Anesthetic drugs, fluids and electrolytes are injected directly into the vein.

After aortic valve replacement, the patient usually spends 5-7 days in the hospital, if there are no complications.

Complications during the operation

Surgery to the heart is always a big risk. When aortic valve replacement is planned, complications are possible as follows:

• Infection of the infection.
• Possible bleeding during surgery.
• Appearance of clots, if there was a stroke or there are problems with the kidneys.
• Complications of anesthesia.

There are also factors that increase the risk of complications in the process of surgical intervention:

• Presence of heart diseases.
• Diseases of the lungs.
• Hypertension.
• Diabetes.
• Obesity.
• Smoking.
• Presence of infections in the body.

Complications after surgery

For any surgeon is important not only the process of the operation and its outcome, but also the recovery period, which can also be accompanied by serious complications:

1. Sprouting of scar tissue. There are cases when, after surgery, a fibrous scar tissue grows rapidly at the site of the valve replacement. This process does not even depend on the variety of the valve and can lead to thrombosis. But thanks to modern methods of conducting an operation, this complication is rare.
2. Bleeding against the background of taking anticoagulants. And it can occur not only in the valve area, but also in any organ, for example, in the stomach.
3. Thromboembolism. You can recognize it by the following manifestations:

• The patient has shortness of breath.
• Confusion of consciousness.
• Losing sight and hearing.
• Numbness and weakness in the body.
• Dizziness.

4. Infection of the delivered valve. Even the most sterile valve, getting inside, can be infected. That is why, if suddenly the body temperature rises, respiratory problems appear, then it is necessary to inform the doctor immediately to perform the tests and to exclude the infection of the valve.

5. Hemolytic anemia. It causes damage to a large number of erythrocytes during contact with the valve material. There is a strong weakness, fatigue, which does not go away after rest.

As a rule, in the presence of heart disease, the patient has this or that group of disabilities. All this is determined by a special commission of doctors. If aortic valve replacement is made, disability can be withdrawn if the doctor's consultation finds that you are healthy and you do not need special payments from the state. In some cases, leave 3 groups.

Postoperative period

For several days, the patient after the valve replacement surgery is injected with anesthetic medications to reduce pain. But after a while they cancel. In addition, the patient may face the following problems:

• Edema of the extremities.
• Pain sensations in the region of the incision.
• Inflammatory process in the place where the incision was made.
• Nausea.
• Accession of infection.

If all these manifestations last too long, it is worthwhile to tell the doctor. Operations to replace the aortic valve (the patients' reviews say this) bring noticeable improvements after a couple of weeks. Significant positive shifts come in a few months.

After the operation, doctors recommend to observe the regime of work and rest and strictly dose the physical load.

It is best if the patient does not spend the recovery period at home, but in a specialized institution, for example, in a sanatorium or in a cardiac rehabilitation center.

There, under the supervision of doctors, there is a recovery of the body, each individual program is selected . Rehabilitation can take a different length of time. Everything depends on the general condition of the patient, the complexity of the operation and the recovery abilities of the body.

In obligatory order, the doctor prescribes medicines after the operative intervention. Their reception must be carried out strictly according to the scheme and can not be canceled independently.

If different physiotherapeutic procedures are required, medical interventions, then it is necessary to inform that there is an artificial aortic valve.

If there are concomitant diseases of the heart, the replacement of the valve does not cure them, so it is necessary to visit the cardiologist and conduct appropriate therapy.

Restorative therapy at home

If the patient does not have the opportunity to go to the sanatorium for recovery after surgery, then strictly follow all the recommendations of the doctor at home.

1. If a mechanical valve is installed, it is mandatory to take anticoagulants, and this will have to be done all my life.
2. If there is a dental intervention or other surgical operations, then it is necessary to take antibacterial drugs before them in order to prevent inflammation in the valve area.
3. It is necessary to monitor the balance of fluid in the body.
4. Do special exercises on the recommendation of a doctor, which will help normalize the respiratory function.
5. Conduct hardware prevention of pneumonia.

Only compliance with all the recommendations of the doctor will help make life after the replacement of the aortic valve normal and full.

Lifestyle change

Any surgical intervention on the cardiac muscle requires a cardinal revision of one's lifestyle. Replacement of the aortic valve (the reviews only confirm it) - is no exception. Patients have after surgery:

1. Exclude from his life all bad habits, if, of course, life is expensive. Smoking, drinking alcohol and consuming large amounts of caffeine is not compatible with the artificial valve, and in general with the pathologies of the heart.
2. It is necessary to practically exclude fat food from your diet.
3. Minimize salt intake, per day no more than 6 grams.
4. The food should be balanced and contain more fresh fruits and vegetables.
5. To consume a sufficient amount of pure water, but without gas.
6. Gradually introduce the load, which will help strengthen the heart muscle.
7. Every day in any weather, take walks in the fresh air.
8. Exclude from their lives psycho-emotional overload, stress.
9. Compose with the doctor the daily routine and stick to it.
10. Use vitamin preparations to maintain the mineral balance.

If you review the reviews of patients who have undergone the operation to replace the valve, you can be sure that most of them could return to a normal lifestyle. Disappeared unpleasant symptoms, which did not give rest, normalized the work of the heart.

Replacing the aortic valve (reviews confirm this) is not an obstacle to future pregnancy. Many women suffering from heart disease, even did not expect to become mummies, and such an operation gives them such an opportunity.

In this situation, the most important thing is to find a competent specialist, then you can be sure of a positive outcome of the operation. Modern science and medicine allow not to put on your life a cross, even if there are serious pathologies in the heart, so do not give up. You must always hope for the best, and a miracle will come true - your heart will work long and reliably. Take care of yourself and be well.