The four heart valves regulate the flow of blood through the atria and ventricles. Each ventricle is made up of thin layers of tissue. It opens like a swinging door. But only in one direction.
A basic distinction is made between the tricuspid valve (pulmonary valve in the right ventricle) and the mitral valve (aortic valve in the left ventricle).
The four heart valves are like well-oiled valves that steer our blood in the right direction with every heartbeat @ elvira gerecht / AdobeStock
The reasons for a heart valve replacement can be congenital or acquired. In this context, we speak of congenital or acquired heart valve defects (dysfunctions).
The older a person is, the more likely they are to have thickened aortic and mitral valves. This makes the aorta less elastic and increases blood pressure.
The aortic valve is under greater strain and requires additional oxygen. This results in the following defects in the heart valves:
- The heart valves are "leaky" (heart valve insufficiency or failure)
- The heart valves do not open properly, which partially blocks the blood flow.
In both cases, the heart can no longer provide the full pumping capacity. This is referred to as defective cardiac output. In most cases, heart murmurs and abnormal heart sounds occur, which are detected using ultrasound (echocardiography).
Cardiac ultrasound examination in an elderly man @ Peakstock / AdobeStock
The heart valves can be damaged by inflammation, e.g. a bacterial infection of the inner lining of the heart (endocarditis).
Rheumatic fever, which can occur after a streptococcal infection, can also lead to heart valve disease.
Congenital adhesions or constrictions are also possible. Valves with malformations tend to calcify.
There are various options for treating diseased heart valves:
For example, the doctor can prescribe medication such as beta-blockers or ACE inhibitors.
- Transcatheter aortic valve implantation (TAVI)
There are also numerous minimally invasive procedures to correct functional disorders or defects in the heart valves. One well-known minimally invasive procedure, for example, is transcatheter aortic valve implantation (TAVI).
TAVI is particularly suitable for narrowing of the heart valve. This method inserts a new valve through the aorta. The "new" heart valve is located in a foldable metal frame. Using a catheter, the doctors push the new valve towards the heart, starting in the groin. The new valve then unfolds mechanically and takes over the functions of the old valve.
- Transcatheter mitral valve reconstruction (mitral clip)
Another minimally invasive procedure is the Mitra-Clip procedure, which is now a proven standard therapy . Mitra clip treatment is suitable for severely leaking mitral valves.
Doctors insert a mitral clip into the patient using a catheter. This plastic clip stitches together the "old" heart valve that is not closing properly. This allows the blood to continue flowing in the appropriate direction.
No general anesthesia is required for this procedure. The patient can leave the hospital after a few days. This treatment can significantly improve symptoms of heart failure.
- Surgical heart valve replacement
Surgical heart valve replacement is also possible. The operation is performed on the open heart and under general anesthesia.
The heart must be at a standstill during this procedure. For this reason, the doctors connect the patient to a heart-lung machine during the operation. The heart-lung machine takes over the heart and lung function during the operation.
The surgeon then removes the defective heart valve and replaces it with an artificial one. Mechanical or biological heart valves are available.
If the patient receives a mechanical heart valve, they must takeanticoagulants on a permanent basis. Mechanical heart valves generally last a lifetime.
A biological heart valve only lasts 10 to 15 years before it has to be replaced. However, it is not necessary to take anticoagulants.
Various mechanical heart valve prostheses @ pirke / AdobeStock
How long recovery takes after heart valve replacement surgery or a minimally invasive procedure varies from patient to patient. Patients usually receive clear instructions from their cardiologist on how they should behave afterwards.
Some patients are given a special diet plan, drug therapy and special exercises. Cardiac rehabilitation is also advisable.
Patients should avoidphysical exertion during the healing phase. Sporting activities are usually possible again after around two to three months.
As with other medical procedures, heart valve replacement can cause difficulties.
The following problems can occur with all operations:
- Blood clots
- secondary bleeding
- Nerve injuries or
- infections
- pericarditis
- Cardiac arrhythmia
- Infections of the inner lining of the heart
If a heart valve defect is present, the prognosis depends primarily on which valve is impaired and whether the heart function is affected.
A severe heart valve defect should be treated immediately, otherwise heart failure will develop. If heart valve defects are detected and treated in good time, the therapies already mentioned will significantly improve the patient's quality of life.
Specialists from various medical fields are usually involved in the diagnosis and treatment of heart valve defects:
The family doctor is the first point of contact as close to home as possible. He or she should be familiar with yourindividual medical history, living conditions and lifestyle habits. He or she collects the results of individual examinations by specialists and clinics and should use this information to decide which medication and other treatments to recommend. Many family doctors are general practitioners or internists.
The specialist in internal medicine (internist) has specialized knowledge that is important for the treatment of heart patients. They are particularly familiar with all diseases of the internal organs, including the blood vessels and the heart, and are particularly skilled in treating them with medication.
The cardiologist is a specialist in internal medicine and also a specialist in cardiology, which means that he has further knowledge in the treatment of heart disease.
