General information
The four heart valves (aortic, mitral, tricuspid and pulmonary) perform a valve function and thereby allow the forward flow of blood in the heart. This valve function can be disturbed by the heart valve becoming narrowed (stenosed) or leaky (regurgitating). The affected valve can now be reconstructed or replaced as part of a heart valve operation.
In a heart valve reconstruction, the patient’s own valve is preserved. This procedure is mainly carried out in the case of an existing inability of the heart valve to close (valve regurgitation). Valve regurgitation is caused, for example, by inflammation or calcification, which shrinks the leaflets of the heart valves, or by the increase in size of the heart, which leads to a widening of the valve ring. This leaves small gaps between the leaflets when the valve is closed, allowing blood to flow back into the ventricle. In a heart valve reconstruction, the diseased leaking valve is repaired by special suturing techniques or by implanting valve rings. This restores the tightness of the valve. Most often, this surgical procedure is chosen for leakage of the mitral valve and less frequently for leakage of the aortic valve.
If a heart valve cannot be preserved (reconstructed), a heart valve replacement is performed. This is often the case when there is a narrowing of the heart valves (stenosis). A heart valve replacement involves removing the patient’s valve that is not working and replacing it with a new valve.
Mechanical and biological valves
Two different types of valves, mechanical and biological, are available for valveValve. replacement. Mechanical valves have the advantage that they have an unlimited shelf life. The disadvantage of this valve is the fact that blood clots can form more frequently on these artificial surfaces. For this reason, the patient must permanently take blood-thinning medicationAdministration and dosage of a medicine. (Marcumar). Biological valves are usually made from material from pigs or cattle. As these valves have natural surfaces, the risk of clot formation is not increased. Permanent blood thinning is therefore not usually necessary. The disadvantage of these biological valves is their limited durability, because like all biological material, these valves are also subject to an ageing process. This means that after a certain period of time, a valve dysfunctionMalfunction, impaired function. can develop again, which may require a new valve replacement. Your heart surgeon will discuss whether a mechanical or a biological valve is more suitable for you in detail during the consultation before the operation.
In addition to conventional surgical heart valve replacementReplacement of the patient’s own diseased heart valve with an artificially produced biological valve of animal (pig or cow) or human origin (from deceased persons, also called homograft) with a mechanical valve (metal, plastic, carbon fibres)., in selected cases there is the possibility of using interventional, catheter-based procedures to treat heart valveIn the inflow and outflow area of the heart chambers there are valves which prevent the blood from flowing back in the wrong direction. Each heart half has a sail valve and a pocket valve: 1. Tricuspid valve (between the right atrium and right ventricle) 2. Pulmonary valve (between the right ventricle and pulmonary artery) 3. Mitral valve (between the left atrium and left ventricle) 4. Aortic valve (between the left ventricle and the aorta). diseases. This procedure is mainly performed in cases of highly symptomatic aortic valve stenosisAcquired valvular heart defect. The aortic valve narrows so much due to inflammation and/or calcification that when blood leaves the (left) ventricle, it can only enter the aorta by overcoming a high resistance. This narrowing leads to an increased load on the left ventricle. as part of catheter-assisted aortic valveHeart valve between the left ventricle and the aorta. It prevents the blood from flowing back into the left ventricle during the relaxation phase. implantation (TAVI).
