Valvular insufficiency not only surgery cannot but

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Anatomy of heart valve function as we need every day out of doors in daily life, when the door open not open, not closed or strict situation


Anatomy of heart valve function as we need every day out of doors in daily life, when the door open not open, not closed or strict situation, certainly is a big problem in the home, must be repaired or replaced, in order to restore the function of the door. Also, no matter what reason as long as the cause of valvular dysfunction such as the emergence of mechanical valvular stenosis or insufficiency, and not due to the expansion of the heart function caused by the insufficiency, the mechanical valve stenosis and regurgitation is not through drug treatment to restore the original structure and function. Although some drugs can adjust the heart rhythm, increase or decrease the cardiac contractile function and regulation of peripheral vascular resistance, make the body to balance an optimal hemodynamics in pathological conditions, the symptoms relieved or disappeared, but not a drug to treat valvular disease itself, can not make the narrow opening valve, also can make the insufficiency of valve closing function recovery. On the other hand, the lesions of the valve will continue to develop, after a period of time or because of force, or because of emotional excitement, there will be a new imbalance and clinical symptoms appear again. When severe valvular heart disease to a certain extent, must undergo surgical treatment, in order to restore the function of the prosthetic valve, only when the valve function was restored, the heart function can be restored, patients can restore health and vitality. The recovery of cardiac valve function by surgery has become a common method for the treatment of valvular disease.

Heart valve regurgitation can be divided into two types: mitral regurgitation and aortic regurgitation. Mitral valve insufficiency is common cause of rheumatic mitral valve prolapse chordae significantly expand coronary heart disease congenital malformations of aortic insufficiency in flap myxoid degeneration of rheumatic heart disease, congenital malformations of aortic endocarditis traumatic aortic dissection of prosthetic valve rupture, ankylosing spondylitis two of the disease have common characteristics of infective endocarditis left ventricular rupture of mitral annular ring and calcification of infection, cardiac function is compensatory period, patients have no obvious symptoms for a long time, patients with early symptoms can also alleviate the symptoms through medication in the short term, these are often caused by patients that their disease is light, can continue to conservative treatment. Clinical statistics, currently more than 40% patients because the influence of the traditional concept of medical treatment, that heart disease operation cost is high and the operation effect is not good, the mortality rate is high, so it is a kind of fear of heart disease operation, often missed the best timing of surgery, and serious consequences, quite a few people so sudden death.

The author has recently encountered such a case of a 60 year old woman with 1 years ago had mild chest tightness, fatigue symptoms, echocardiography showed moderate mitral regurgitation, left ventricular thickening, left atrial enlargement, decreased left ventricular ejection fraction, the doctor suggested mitral valve replacement surgery, but patients taking strong heart, diuretic drugs after symptoms significantly reduced, coupled with the traditional concept of the impact of medical fear heart surgery, and chose to conservative treatment. 1 years after the symptoms increase, and atrial fibrillation, thrombosis caused by cerebral infarction side hemiplegia, echocardiography showed that left ventricular was also enlarged, left ventricular ejection fraction decreased significantly, has left the doctor several hospitals do not dare to do. He said to me, I am now very determined, even if it is possible to die on the operating table, I have to do. The problem is, only the determination is not to solve the problem. This surgery in two years ago, about 50 thousand yuan is enough, due to the increased difficulty of surgery, it is estimated to be down to $200 thousand to $150 thousand, the doctor did not dare to do. Now we are conditioning his physical condition to see if there is a chance of getting surgery.

At present, in line with the surgery cases, patients with early elective surgery success rate is 99%, and 3-6 months after the operation, most of the cardiac function of the patients can recover after surgery before surgery can do can do a lot of things, get a good quality of life. If the heart disease into decompensation, surgical success rate of only 50-80%, even through the operation safety, postoperative recovery also need quite a long time, and even some patients cannot fully recover normal heart function. I hope people will be able to establish a disease to early detection, early diagnosis, early treatment, the concept of giving their own opportunities, but also to the doctor.

Here are the indications for valve regurgitation:

Mitral valve regurgitation surgical indications: 1 asymptomatic patients with moderate mitral regurgitation, with one of the following circumstances shall: (1) surgical heart function decline, EF< 0.55; (2) left ventricular enlargement, LVESD> 50mm, LVEDD> 70mm; (3) activity limitation after the activity of pulmonary wedge pressure abnormal increased; (4) resting pulmonary hypertension; (5) atrial fibrillation. 2 symptoms appear, whether normal or abnormal cardiac function, should be surgery. When EF< 0.3, whether surgery should be treated as individual patient specific circumstances. 3 asymptomatic, counter flow in patients with moderate severe, cardiac cavity size LVESD<, 50mm, LVEDD<, 70mm, EF, FS normal, should be followed up every 6 months, once the abnormal situation, should be treated with surgery.

Indications of aortic valve insufficiency: (1) symptoms, dyspnea, fatigue, angina, chest pain and other symptoms, is an absolute indication of surgery. (2) no symptoms, the following indexes: the LVESD operation should be close to 55mm; LVPSWS< 80.0kpa; LVPSWS< (600mmHg) 30.1kpa (235mmHg); the FS is close to 25%; the EF is close to 50% (ultrasound); the activity of shortness of breath. (3) asymptomatic, check up to the above indicators, every six months to follow up once, such as the size of the left ventricle or left ventricular dysfunction, should be operated immediately.

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