The aortic valve is located between the left ventricle and the aorta, the largest artery of the human heart. It controls the blood flow. Its main function is to hinder backflow of the blood to the ventricle once it is pumped out by the heart. The aortic valve may become dysfunctional due to stenosis or insufficiency. In these cases, the treatment options are the aortic valve repair or replacement.
Aortic Valve Stenosis and Insufficiency
Aort kapak darlığı, doğuştan gelen bir hastalıkta olabilir, sonradan da kazanılabilir. En sık görülen doğumsal neden 3 parçalı olması gerekirken iki parçalı olmasıdır. İlerleyen safhada kan akışının sürebilmesi için kalbin sol karıncığının daha fazla çalışarak kas dokusunun kalınlaşmasına sebep olur. Bu durum kalp yetmezliğine zemin hazırlar. Aort kapak yetersizliği genellikle uzun süre belirti vermeden gelişen bir hastalıktır. İleride nefes darlığı, kısa sürede yorulma, göğüs ağrısı ve bayılma aort kapak yetmezliği belirtileridir. Bu belirtiler hastalığın ileri seviyede seyrettiğini gösterir. En riskli durum ise aort kapak yetmezliğinin ani ölümlere sebep olabilmesidir. Aort kapak hastalığı cerrahi ile tedavi edilebilen bir hastalıktır. Aort kapak yetersizliği, aortaya pompalanan kanın bir miktarının sol ventriküle (karıncık) geri dönmesi ve buna bağlı olarak karıncığın iş yükünün artmasıdır. Hastalarda nefes darlığı en erken görülen belirtidir. İlerleyen aşamalarda göğüs ağrısı da hastaların belirgin şikayetlerindendir.
Ciddi aort yetmezliği olan hastalar mümkün olan en kısa sürede ameliyat edilmelidir.
Aortic valve stenosis can be either congenital or acquired later. The most common abnormality occurs when the aortic valve has only two leaflets, instead of three. Due to the abnormality, the left ventricle works harder to sustain the blood flow; which leads to thickening of the muscle. In the long run, this thickening may create cardiac insufficiency. Aortic valve insufficiency usually develops without showing symptoms for a long while. In the advanced stages, symptoms like breath shortness, fatigue/exhaustion, chest pain and fainting. These symptoms show that the disease is in the advanced stage. Rarely, the aortic valve insufficiency may be the cause of sudden deaths. It is a disease that can be treated surgically. The aortic valve insufficiency occurs when some of the blood pumped to the aorta flows back to the left ventricle, increasing the workload of the ventricle. Breath shortness is the earliest symptom of the disease. In the advanced stages, chest pain is the most common and evident complaint of the patients.
Patients with severe aortic insufficiency must be operated as quickly as possible.
Aortic Valve Repair or Replacement
n aortic valve insufficiency, the surgery technique to be employed must be selected according to the medical state of the patient. In patients with relatively lower risks, the classical aortic valve surgery is preferred. In this technique, the surgery can be performed through a small incision, again depending on the state of the patient. In older patients, whose aortic valve is severely calcified, the sutureless AVR (as an alternative to TAVI) is employed, in order to shorten the operation duration and accelerate the healing process for the patient. Generally, in this method, small incisions are made on the chest and under the clavicle (collar bone). As the operation duration is shorter and the incision is small, the patient recovers more quickly.
Patient Care at Home Following an Open-Heart Surgery
After the discharge your doctor will prescribe oral medication. The prescription may include any or some of the medication listed below, depending on their need for the continued treatment.
- Blood-thinner: Aspirin, Warfarin (Coumadin etc.). Blood-thinners help decrease the embolism risk.
- Cardiac medication: These agents will strengthen your heart and regulate the pace.
- Stool softeners: These medications eliminate constipation by facilitating the normalization of bowel movements.
- Diuretics: Enabling you discharge more liquids, diuretics eliminate edema and excessive liquid accumulation.
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