Treatment of Heart Valve disease
Prosthetic heart valves are artificial surgically implanted replacements used as a treatment for diseased or damaged heart valves.
There are several types currently in use. They fall into two main categories:
Mechanical devices
These valves are usually made of metal or synthetic parts. More than 80 different types have been in use since the procedure was introduced in the 1950s.
Natural Tissue
These may be obtained from deceased human donors (Homograft) or from other animals. They are modified artificially to allow insertion into the human heart.
Valves from natural tissue use either a valve itself or tissue from the heart lining of the animal. This is sterilised and treated with preservatives before being attached to a synthetic ring to be sewn into the heart aperture. They are commonly derived from porcine (pig) heart tissue. Grafts of the original valves taken from human donors (homografts) are used less commonly.
Prosthetic valves are more often used for young people. Because of the tendency for clots to form on the valve, anticoagulants must be taken for life, whereas this is not needed for biological valves. The patient should be well recovered 2 - 3 months after the operation.
- Any heart valve may be stenosed or incompetent.
- Those with known valvular heart disease should always be treated with antibiotics for procedures such as dental work because of the risk of infection of the valves ('endocarditis').
- Those with mitral valve disease with atrial fibrillation should be treated with anticoagulants to prevent emboli (and subsequent stroke).
- A patient with an artificial or prosthetic valve should also be treated with anticoagulants.
- Aortic stenosis - valve replacement is usually necessary.
- Aortic incompetence (regurgitation) - ACE inhibitors may be all that is needed for moderately affected patients. Valve replacement is done if there are symptoms of L heart failure.
- Mitral Stenosis - mitral valve replacement or repair is the usual treatment used.
- Mitral Incompetence (regurgitation) - Mild mitral incompetence may require no treatment. If there are signs of heart failure and marked symptoms, mitral valve replacement or repair is the treatment of choice.
- Tricuspid and Pulmonary valve disease - Are uncommon. Medical treatment such as diuretics are used when necessary – surgery is usually avoided.
