Heart Valve and Heart Valve Disease
What are Heart Valves ? Heart Valves are valves that follow a single direction. This feature allows blood to flow through the chambers of the heart in one direction. The heart valve determines the blood flow depending on the pressure circulating the large blood vessels around the heart (arteries). The heart valves determine the pathway of blood flow with the help of the four valves, mitral valve and tricuspid valve present between the upper and lower chambers of the heart, separating them. While the two upper chambers called right and left atria are responsible for receiving incoming blood flow, the two lower chambers called ventricles are responsible for pumping out blood.
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Types of Heart Valves The mitral valve is present on the left and the tricuspid valve is present on the right heart. The mitral valve is the only valve that has two cusps while the other valves have three. The other two valves called the aortic and pulmonary valves are located between the lower heart chambers and blood vessels that leave the heart. They are responsible for transporting blood to other organs of the body. They do this when the lower right chamber closes. Blood is pumped out from it through the pulmonic valve that transports it to the lungs through the pulmonary artery. When the lower-left chamber closes, blood is pumped out and transferred to the arteries through the aortic valve. The valves consist of flaps called cusps that open to allow blood flow and are sealed close together to prevent backflow of the blood to the atrium and ventricles. www.cardium.in
Why are valves in the heart important ? The heart valves are important because they help blood pump into the heart and other essential organs of the body. The heart valves ensure that blood flows in a single direction and prevent the backflow of blood into the upper and lower chambers of the heart. In the absence of valves, blood flows back to the upper and lower chambers of the heart. Since the maximum amount of blood flows back, very little amount of blood flows to the heart. This puts pressure on the heart to work harder which may stiffen the heart muscles, causing heart failure. In the absence of a valve, there will be a shortage of blood in the lungs and other organs since the pulmonic and aortic valves are responsible for transporting blood to the lungs and other organs. The valve prevents blood leakage from either of the valves and narrowing of valves by transferring blood to the heart and other parts of the body, therefore, ensuring normal functioning of the body. www.cardium.in
What is it like to have an artificial heart valve ? Living with an artificial valve in your heart does not change anything. Artificial valves work just like normal valves. They last more than 20 years. People who have gone through heart failure or either of their valves are not functioning properly, need a valve replacement. Artificial valves are mainly of three types :1. Mechanical valves - which come in various designs like bileaflet, caged-ball, tilting disc, and others 2. Bioprosthetic valves - that are made from animal tissues like bovine(cow) tissue and porcine(pig) tissue 3. Tissue-engineered valves - that are made by cultivating human cells onto a platform. This platform acts as an extracellular matrix, directing tissue development into the right 3D design of the heart valve. Unfortunately, they are not commercially available. www.cardium.in
In case of replacement with a mechanical valve, even though they are more durable than any other artificial valve, they can form blood clots which can cause blockage in blood vessels leading to myocardial infarction (heart attack). Patients with mechanical valves need to take anticoagulants for the rest of their life to prevent such accidents. The scenario is just the opposite concerning bioprosthetic valves. They do not form blood clots but are not durable enough. So the person with this valve has to go through another valve replacement.
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What is the best treatment for heart valve disease ? Treatment of valvular heart disease depends on the condition of the individual. Depending on the person's heart stability, The following two types of treatment are ideal :1. Repairment - For those who can withstand surgery, primary angioplasty, or balloon valvuloplasty(in the case of infants and teenagers) treatment is given to those who have aortic stenosis. This procedure involves widening the coronary artery walls where cholesterol deposits are present. The narrowed areas of the artery walls are widened by using a long, flexible tube (catheter) and placing it in between the plaque deposits. The catheter is inserted into the main blood vessel of the lower arm and passed carefully into the area where an independent blood supply is given to the heart. A balloon is placed at the tip of the tube in such a way that when it is blown, it forces the narrowed areas of the artery to wide blood
open. This clears the passage of the coronary artery walls, allowing to flow to the heart.
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2. Replacement - For those who cannot withstand surgery, transcatheter aortic valve replacement is the only procedure since surgical aortic valve replacement involves the opening of the rib cage. It is a surgical process that many cardiac patients might not be able to withstand. Transcatheter aortic valve replacement is done where a catheter is used to replace the dysfunctional valve. This is a noninvasive technique and is highly consulted to patients who cannot withstand surgical treatments.
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What are the symptoms of heart valve disease ? Some individuals with valvular heart diseases do not show any signs or symptoms but all types of symptoms indicate that blood flow in the body is irregular. The signs and symptoms include :• • • • • •
shortness of breath chest pain irregular heart rhythms fatigue, fainting, and dizziness; lethargy (lightheadedness) cough in some cases, swelling of hands and feet, abdomen
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How is the life of an adult after heart valve replacement ? The quality of life of an adult after heart valve replacement depends on factors like the type of valve used to replace the person had and the type of treatment the person when through. Usually, people after valve replacement or people living with artificial valves lead a normal and healthy life depending on the precautionary measures they are taking. If the person went through surgical valve replacement by using a mechanical valve, for lifelong the person has to take anticoagulants like warfarin since there is a maximum possibility of forming blood clots. If replacement is done by using a bioprosthetic valve, the valve will not last more than 10 years so the person is likely to go through a second replacement process.
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For those who cannot physically go through surgery and cannot take blood thinners, transcatheter aortic valve replacement is the only treatment. Even for such patients, TAVI is the safest method for replacing the damaged valve, some studies show the potential risk of hypertension and myocardial infarction is high among people who have gone through valve replacement. According to the British Journal Of Cardiology, the cohort group containing people who have gone through TAVI has a slightly high risk of hypertension and heart attack. Therefore, the patients should know the repercussions of the treatments before going through the actual procedure.
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