Heart valve replacement surgery is an important medical breakthrough in the treatment of heart disease and dysfunction. Within the framework of advanced healthcare in Iran, particularly in the city of Shiraz, outstanding efforts are being made in the field of performing this delicate surgery. This article aims to review the significant role played by heart valve replacement surgery in improving the quality of life of patients, and to highlight the experiences and developments that characterize Iran, and Shiraz in particular, in this vital field of medicine.
Article contents
- Introduction.
- What is the reason for heart valve replacement?
- How is a heart valve replacement performed?
- What is minimally invasive heart valve replacement or the catheter method?
- After the operation, replace the heart valve.
- How do you recover for a heart valve replacement?
- Pre-operative instructions and recommendations.
- The duration of the operation is heart valve replacement.
- What are the risks of heart valve replacement surgery?
- Sources.
Introduction
The heart is a muscular pump with 4 chambers that distributes blood, oxygen and nutrients throughout the body with its constant activity. The two upper and lower two chambers of the heart are called the atrium and ventricle, respectively. In the heart there are also structures called valves, which are as follows:
Tricuspid valve: located between the ventricle and the right atrium.
Mitral valve or bivalve: It is located between the left ventricle and the left atrium.
Aortic valve: located between the left ventricle and the aorta.
Pulmonary valve: located between the pulmonary artery and the right ventricle.
By their function, these valves help in one-way blood flow and transit through the heart. The above valves, like other parts of the body, may be diseased and require treatment. In this article, we will explain the heart valve replacement procedure and examine its various aspects in Iran.
What is the reason for heart valve replacement?
Valves lose their proper function when injured or sick and must be repaired or replaced. Stenosis, leakage, and hereditary defects of the valve, including diseases that cause defective heart valve diseases. When one or more valves become stiff or narrow, the heart must work harder to maintain proper blood circulation. Depending on the symptoms and general condition of the patient, the doctor suggests heart valve repair or replacement.
How is a heart valve replacement performed?
Traditionally, open heart surgery is used to repair or replace heart valves. This means that a large incision is made in the chest and the heart stops working while the surgeon replaces the valves. During this time, the job of pumping blood will be the responsibility of the machine. Today, less invasive and more modern methods of replacing or repairing heart valves have been introduced into the field of treatment. In these methods, the incisions will be smaller, the pain will be less and the hospital stay will be shorter. Depending on the opinion of the doctor and the patient, two types of artificial and natural valves can be used in valve replacement:
- Natural valve: These valves are obtained from the tissues of the animal’s body and last for 10 years. People using these valves, unlike the mechanical type, will not have blood clots and will not need to take blood thinners.
- Mechanical valve: This valve is usually made of metal or plastic and is more durable. However, a mechanical valve increases the chance of a blood clot forming and the person must use blood thinners such as aspirin for life.
What is minimally invasive heart valve replacement or the catheter method?
When replacing the valve with the catheter method, unlike the traditional method, there is no need to make a large incision in the chest and only a few small incisions are made. In this method, an intravenous line is first taken from the patient and then anesthetics, blood thinners and infection prevention drugs are given. The surgeon selects a blood vessel in the groin or chest area and inserts a catheter into it. A catheter is a thin plastic tube that is inserted into a blood vessel.
Next, the doctor uses x-rays or transfacial imaging methods to properly guide the catheter to the heart and position the valve in its proper place. The new valve is attached to a balloon in the catheter and is inflated when the balloon reaches the correct spot. When said balloon is inflated, the new valve is put in place and the balloon is pulled out of the body after deflation. During this process, the treatment team carefully monitors the patient’s vital signs, including blood pressure, heart rate, heart rhythm, and breathing.
After the operation, replace the heart valve
The patient spent one night in the intensive care unit (ICU) for follow-up. The length of the patient’s stay in the hospital depends on various factors, but some people can be discharged home the day after the operation. Before discharge from the hospital, the treatment team teaches the patient and companions how to care for the scars and to watch for signs and symptoms of infection. Warning signs of infection include fever, increasing pain, redness, swelling, and discharge from the catheter insertion site.
Medications are also prescribed to the patient, and the following are examples of them:
- Blood thinners: Blood thinners are prescribed to prevent blood clots from forming. The doctor will determine the required period of use of these medicines for the patient. People should always take their medications as recommended.
- Antibiotics: Artificial heart valves can become infected with bacteria. Most of the bacteria that cause this type of infection originate from oral bacteria. Oral and dental health can help prevent the above infections. Before some dental procedures, some antibiotics are prescribed.
To ensure proper functioning of the new valve, the doctor will prescribe periodic imaging tests. If you develop new symptoms or worsen previous symptoms, you should discuss this with your doctor. Among these symptoms are:
- Confusion.
- Chest Pain
- Signs or symptoms of infection.
- Extreme tiredness with activity.
- Respiratory problems
- Heart beat.
- Edema or swelling of the abdomen, legs and wrists.
- Sudden weight gain due to fluid retention
If you see the following, you should see a doctor immediately:
- Feeling of pain, tightness or pressure in the chest.
- Sudden severe shortness of breath.
- Fainting
How do you prepare for a heart valve replacement?
During the pre-operative consultation, the doctor will explain the procedure to the patient and answer their questions and concerns. Next, the patient is asked to fill out and sign a consent form to allow the surgeon to operate. This form should be read carefully and any unclear items should be requested.
Guidelines and recommendations for preoperative heart valve replacement
In order to assess the health status of the person, in addition to examining the patient’s family and personal health history, the surgeon may also prescribe some tests such as blood tests. The treatment team will make the following recommendations to the patient prior to the procedure:
Avoid eating and drinking for at least 8 hours before the procedure.
If you are pregnant or think you may be pregnant, tell your doctor about this.
Inform the physician of any allergy to any drug or device, including glue, iodine, anesthetics, or local anesthetics.
If you have a history of bleeding disorders or take any blood thinners such as aspirin, inform the treatment team. The doctor can stop taking these medications before the procedure.
Before the surgery, the treatment team will take a blood sample to check the patient’s blood clotting time.
If you have a pacemaker or any device implanted in the heart, discuss this with your doctor.
If you smoke, stop as soon as possible. Smoking cessation increases the likelihood of successful surgery and has countless health benefits.
Depending on the individual’s health conditions, the physician may make other recommendations to the patient.
Duration of heart valve replacement surgery in Iran
While valve replacement with the catheter method takes about 90 minutes, this process takes 4 to 6 hours with the traditional method. In angioplasty, patients experience faster recovery and are often given sedatives instead of general anesthesia.
What are the risks of heart valve replacement surgery?
Heart valve replacement surgery, like any other surgery or medical procedure, has some side effects. Among these cases, the following examples can be cited:
- Bleeding during or after surgery.
- Bleeding during or after surgery.
- Infection.
- Respiratory infection (pneumonia).
- kidney disease.Vascular problems.
- Irregular heartbeat (arrhythmia).Replace or repair valve failure.
- Death
Depending on a person’s health condition, other risks may also threaten a person’s life. People should consult their doctor about all of these risks before undergoing the procedure.
Sources:
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