Cardiosurgery: Pulmonary valve insufficiency — Pulmonary valve repair. Treatment
Pulmonary valve insufficiency is a rare heart defect characterized by poor closing of the valve leaflets in the pulmonary artery, resulting in an inverse flow of blood, which increases the venous pressure. The frequency of the pulmonary valve insufficiency (PVI) is less than 1% of all diagnosed defects. This defect is formed either in utero or after birth under the influence of rheumatic and systemic diseases, infectious agents, or atherosclerosis.
Conservative Treatment Principles
Upon asymptomatic PVI, the treatment involves check-ups by a cardiologist and lifestyle adjustment subject to a moderate limitation of physical activity. Slight decompensation is the indication for conservative therapy aimed at maintaining the cardiac activity:
- diuretics reduce the venous stasis;
- ACE inhibitors monitor the blood pressure, and improve the condition of vessels and heart;
- nitrates are used to reduce the pressure in the pulmonary circulation;
- metabolic agents.
Treatment should be comprehensive and include the treatment of the underlying disease causing the heart disease.
Surgical Correction of the Pulmonary Valve Insufficiency
PVI surgical treatment is indicated for hemodynamic instability progression. The feasibility of surgical correction of the defect is determined by a physician taking into account the patient’s complaints and a comprehensive survey findings. There are several methods of PVI surgical treatment.
- Valve plastics is carried out for intact leaflets without calcification and severe deformity. Depending on the nature of the structure violation, the annulus is sutured or reinforced with a synthetic frame.
- Valve prosthetics is used in a situation where the profound changes are detected in its structure. Surgery implies excision of the damaged structures and implantation of the prosthesis. Mechanical prostheses are made of medical alloys; biological prostheses are made of specially treated animal tissues.
- Heart-lung complex transplantation is indicated upon extremely severe disease progress. Traumatism of such an intervention, high requirements for the operating surgeon and the entire team, as well as complexity of choosing a compatible donor are the reasons for an extremely rare performed of such a surgery.
- Correction of a set of heart defects is required for patients combining PVI with other defects.
The correct choice of the pulmonary valve insufficiency treatment and timely measures help increase the life expectancy and improve its quality substantially.Hide