A heart valve allows blood to flow in only one direction through the heart. Tissue heart valves are harvested from pig heart valve or a cow heart sac. These tissues are treated, neutralized, mounted on a frame or stent so the body will not reject them. A tissue valve lifetime is 10-15 years. An advantage in a tissue heart valve replacement is that there are fewer requirements for anticoagulation therapy which reduces an incidence of bleeding. Mechanical heart valves are made out of pyrolytic carbon and last up to 20-25 years. A mechanical heart valve requires warfarin anticoagulation therapy and there is a risk for bleeding (Silberman, 2008).
Due to heart valve replacement surgery being a risk of death, patient life expectancy is a major criterion to be considered. Life expectancy, ability to take anticoagulants, compliance and available facilities for monitoring INR, lifestyle, risk of bleeding, patient preference, and risk of reoperation should all be considered in choosing a valve substitute, although in clinical practice patient age is most often the determining factor. Studies have shown that age between 60-65 years is when the benefits of mechanical valves shift to favor the use of bioprostheses (Silberman, 2008).
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That is why a mechanical heart valve requires anticoagulation therapy due to the risk of bleeding. However, it can last up to 25 years. Bioprosthetic does not require anticoagulation do to the lower thrombotic risk but it does not last as long as the mechanical heart valve
heart. The old valve is pushed to the side and the new valve gets implanted. This procedure
It was established that the patient’s symptoms were due to an aortic regurgitation this was confirmed by echocardiogram. The use of the SOAPIER model is an effective means of providing rationale for a holistic clinical decision making. The findings and treatment options were discussed in a multidisciplinary meeting including Mr Jones and family. The family were informed that surgery was the safest treatment option. Complications that could happen with or without surgery were also explained ensuring that the patient had adequate understanding to make a valid choice about his treatment. Mr Jones agreed that a replacement of the aortic valve with a mechanical valve was necessary, thus it last for more than twenty years or more . Mr Jones
A doctor may also suggest treatment later in a person’s life, if the disease worsens. If a cardiologist suggests medical treatment, two options include: Mitral Valve Repair or Mitral Valve Replacement. “If the patient chooses to have Mitral Valve Replacement, he or she should find a surgeon who satisfies three criteria; the surgeon should have a 90 percent or greater rate of successful repair, should have an extremely low rate of death from surgery (less than 1 percent) and should be proficient in operating with less invasive approaches, if your surgeon cannot provide these sorts of numbers, you need to move to another” (Gillinov 326). By reconnecting valve leaflets a surgeon can perform Mitral Valve Repair (mayoclinic.org). A surgeon can also remove excess tissue from the valve for a repair (mayoclinic.org). “The traditional approach to most aortic valve problems is to open the chest, remove the old valve, and sew in a new one” (Gillinov
There were no early or late postoperative deaths and we achieved 100% follow-up for included patients. No patient had aortic valve replacement after one year. Preoperatively the mean ejection fraction in group S was 62.33±4.39% while in group R was 59.53±6.10%, the width of the regurgitant jet in group S was 34.67±2.72 % and in the group, R was 35.73±1.87 % ( p-value non-significant). Postoperatively after 1 year follow up the width of the regurgitant jet in group S increased significantly to 37.27±4.67% ( p > 0.5) while in group S almost remained unchanged 34.73±4.13% ( p <
Located in between the left atrium and the left ventricle is the bicuspid or better known as the mitral valve. The mitral valve works to prevent the back-flow of blood into the left atrium once it enters the left ventricle. This action may become hindered when the mitral valve prolapses or in other words the valve becomes “floppy” and is no longer strong or tough enough to handle the normal stresses brought upon it. This condition is known as Mitral Valve Prolapse (MVP). It is said to be one of the most common cardiac abnormalities in the general population, effecting 2-3%, approximately 7.8 million people in the United States and over 176 million people worldwide.
An estimated 200,000 aortic valve replacements are done yearly. Surgical valve replacements frequently use BP valves over mechanical valves. 2 All transcatheter valves are bioprosthetic (BP) and have been increasingly used in patients with severe aortic stenosis deemed to be at high surgical risk. 13 TAVR was
This retrospective analysis is on a class III medical device called the Micra Transcatheter Pacing System (TPS). The device is created by Medtronic Incorporated which is a company that focuses primarily on devices for cardio and vascular, restorative therapies, diabetes, and minimally invasive therapies. The target customers are those who have slow or irregular heartbeats that need to be monitored. This pacemaker is useful for patients who could have difficulties with the placement of traditional pacemakers, or would be better off with a single chamber pacemaker. The underlying technology used is a 1in long pacemaker that is placed directly into the right ventricle through the femoral artery using
The ideal prosthetic valve that combines excellent hemodynamic performance and long-term durability without increased thromboembolic risk or the need for long-term anticoagulation does not exist. Choice of operation and the prosthesis used for those patients undergoing valve replacement is important for each individual patient and ideally should be made together by the patient, cardiologist, and surgeon.
Artificial heart valve is a device implanted in the heart of a patient with valvular heart disease. When one of the four heart valves malfunctions, the medical choice may be to replace the natural valve with an artificial valve. This requires open-heart surgery. Valves are integral to the normal physiological functioning of the human heart. Natural heart valves are evolved to forms that perform the functional requirement of inducing unidirectional blood flow through the valve structure from one chamber of the heart to another. Natural heart valves become dysfunctional for a variety of pathological causes. Some pathologies may require complete surgical replacement of the natural heart valve with a heart valve prosthesis [34].The mid twentieth century kick started the
Prosthesis-patient mismatch (PPM) is caused by Effective orifice area provided by prosthetic valve which is small and Incompatible in relation to the body surface area (BSA) of the patient(1,2) . Despite of normal functioning prosthetic mitral valve, due to the small and incompatible EOA of the prosthetic valve, the mean gradient in postoperative period was found to be relatively high which is equivalent to mild-moderate mitral stenosis(2-4). Regression of left atrial pressure and pulmonary artery hypertension is prevented by PPM in the mitral position (5,6) . PHT causes right ventricular dysfunction thereby increases cardiovascular morbidity and mortality. As a result, prime objective of MVR is to restore normal PAP(7-9).
Bioprosthetic or tissue valves commonly used in clinical practice are called heterografts and are usually stented or stentless porcine or bovine tissue valves. An advantage is that tissue valves do not require lifelong warfarin therapy, due to their lower thrombotic risk compared with mechanical grafts. However, tissue grafts have a shorter durability because they only last for 10-15 years. Hence the patients have higher incidences of reoperation as compared to mechanical grafts. (Jaffer and Whitlock,
In their research, Oterhals et al. (2013) reviewed several studies pertaining to heart valve replacement. For instance, they note that Koertke et al. (2003) had argued that heart valve replacement has become an everyday life saving practice for patients with heart valve problems. They also noted that Kvidal et al. (2000) had claimed that patients who had undergone mechanical aortic valve replacement had noticeable and obvious improved qualities of life and their life expectance was no different from those who had no valve replacement. They also reviewed a study by Nugteren and Sandau (2010), that describes how
Since 19th century, scientists have tried to develop a device which could temporary replace heart action (SynCardia n.d). In 1957, at Cleveland Clinic, DR. Kolff and Dr. Tetsuzo Akutsu implanted an artificial heart in animals such as dog which survived for roughly 90 minutes (SynCardia n.d). On December 1982, doctors put a permanent artificial heart in to Dr. Barney Clark , 61 years old dentist, as a result, he lived for 112 days, however, he was suffering due to hard condition after the operation (SynCardia n.d; Lewis 2016). After in 2004, the CardioWest became the first and only total artificial heart which approved by FDA and the name of SynCardia temporary CardioWest™ Total Artificial Heart was given within approval process (SynCardia
It’s not completely understood what the future holds for those who underwent this procedure but so far the research looks excellent. Risks of the procedure include the common risks associated with open heart surgery: stroke, bleeding, infection, organ damage, nerve damage, adverse reaction to anesthesia, requirement of a temporary/permanent pacemaker or possibly death. Also, Suture lines of the lengthy great vessels predispose these patients to postoperative bleeding. Blood loss at this time indicates the need for adequate drainage from the mediastinum to avoid cardiac tamponade while treating the coagulopathy. Based on 99% of all pediatric heart disease surgical procedures, the risk of these complications are less than 5%. In some cases
On the other hand, it might be argued that, artificial heart should not be used for several reasons. Firstly, each device is approximately, $300,000, which is extremely expensive and will only save the lives of few people, while by spending the same amount of money by increasing preventive programs; it is more likely to save more people (Caplan 2014). For instance, if artificial heart was provided for each person with heart disease, it would be billions of dollars for the healthcare budget (Caplan 2014). In addition, Dr Caplan at the Division of Medical Ethics at the NYU Langone Medical Center points out, “Artificial heart is not something you install and forget about; they require maintenance and check-ups” (Caplan 2014, Para 6). Other reason