Cardiosurgery: Aortic valve insufficiency (avi) — Aortic valve replacement. Treatment
Aortic valve insufficiency (AVI) is one of the most frequent heart diseases characterized by insufficient closing of the aortic valve leaflets, which results in the blood outflow from aorta into the left side of the heart. In 60% patients, the failure is combines with stenosis.
The most common cause of AVI is a rheumatic heart disease. Less frequently, this defect is formed in utero or after birth under the influence of infectious agents, atherosclerosis, and systemic diseases affecting the connective tissue.
Conservative Treatment of Aortic Insufficiency
In some cases, AVI is identified by accident during examination. These patients do not report any complaint and do not require special treatment. In this case, the regular check-ups by a cardiologist and lifestyle with moderate limitation of physical activity is recommended.
For mild symptoms of decompensation, the treatment regimen, moderate exercises and drug therapy aimed at maintaining the cardiac activity is prescribed, namely:
- cardiac glycosides;
- metabolic drugs;
- ACE inhibitors;
- antitromoboticheskie funds;
Surgeries for Aortic Insufficiency
The surgical defect correction is indicated for symptomatic severe aortic insufficiency. After a comprehensive examination and determination of the degree of hemodynamic disorders, the cardiac surgeon selects the optimum method of surgery, taking into account the minimal trauma and the best expected outcome.
- Ross surgery is performed by open access to replace the aortic valve with the pulmonary one. The surgery requires a high qualifications and vast experience of a surgeon, as well as accuracy and coherence of the surgical team.
- Valve plastics implies access via sternotomy and the use of cardiopulmonary bypass. This surgery is possible subject to sufficient preservation of valve structures. The insufficiency is eliminated by suturing, strengthening of annulus with supporting structures or creation of suspending compounds.
- Traditional prosthetics means implantation of a biological or mechanical prosthetic valve and is conducted using the cardiopulmonary bypass.
- Minimally invasive prosthetics can significantly reduce the risk and the rehabilitation period. The prosthesis is installed through a small incision in the apex of the heart or through the femoral artery catheterization.
The good long-term results are shown by more than 80% patients operated for aortic insufficiency in the modernly equipped cardiology centers.Hide
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