Surgery Notes

Posts Tagged ‘Valvular Surgery’

If at the time of surgery is found that the mitral valve can not be repaired or attempted repair after the result is not satisfactory, perform valve replacement with an artificial prosthesis may be of biological origin, pigs, cattle or horses, or mechanical calls are ceramic components with metal supports, mainly titanium.

The aortic valve is mainly affected by degenerative processes are accelerated when present a birth defect.

The aortic valve normally has three leaflets, but it is quite common to find aortic valves with two leaflets (bicuspid valve) or three veils in which there is a merger between two of them (pseudobicúspides valves). These anomalies, in principle, do not cause problems over the years can be the cause of accelerated degeneration of the valve.

Degeneration or wear of the valve tends to cause calcification and malfunction. Surgery on the aortic valve is very common in older people.

At the time of aortic valve surgery, the intervention is most often performed valve replacement. Valve options available to the surgeon are the same as in the case of mitral valve (mechanical and biological prostheses) with some additional possibilities (homografts, bioprostheses unsupported Ross operation, etc).

Tricuspid valve abnormality usually appears as the most frequent failure or leak. The most common cause of this failure is functional, ie it is secondary to problems found in other valves.

Very rarely have to change and is usually performed tricuspid annuloplasty using a ring, band or just a few stitches.

Involvement of the pulmonary valve is almost exclusively a congenital problem and is usually diagnosed and treated during childhood. The most commonly affected valve stenosis, ie a fusion of the components of the valve is an obstruction to blood flow through the valve. Interventions to correct this problem can be made by an inflated balloon to get the full opening of the valve or by an operation under direct vision able to separate the merging parties to obtain a full opening.

In the case of surgery on the valves, to lie within the heart, the only way to have a direct view of the valve is open heart surgery that requires mandatory pump or heart-lung machine. In rare cases, concrete is still used the original technique of closed mitral commissurotomy involves opening the mitral valve without opening the heart.

In the same way that the median sternotomy can reach any point of the heart, you can use other cuts of very specific approach to operations only when it is necessary to have access to a limited area. This has allowed the development of cardiac surgical techniques require incisions that can be considered minimal. The ministernotomy for surgery on the aortic valve and technique for surgery Heart Port on the mitral valve, the tricuspid valve and atrial defects.

The mitral valve is most affected by rheumatic fever. The injury will require surgical intervention can be both a poor opening of the valve, mitral stenosis, for a bad end to escape, mitral regurgitation, or a combination of both, double mitral lesion.

Although the valve functioning as such, it is possible that the muscles that support it are affected when there is a lack of blood to the heart, in which case you may see a leak, ischemic mitral regurgitation.

Whenever possible, try to repair the mitral valve. The options are manifold. Open the valve orifice when it is restricted, mitral commissurotomy, enhance support hole through rings, mitral annuloplasty, inserts, patch, resection of excess material and multiple combinations of techniques mitral valvuloplasty.

The result of the repairs is monitored by intraoperative transesophageal echocardiography, ie in the same operating room is assessed by ultrasound introduced into the esophagus if the repair was successful.