Our heart is located in our chest cavity and is a pump made of special muscles known as myocardium. Our heart is divided into four chambers; two upper chambers known as auricles (atria) and two lower chambers are known as ventricles. They are interconnected by a passage and the opening and closing is controlled by valves. The blood flows in unidirectional from atria to ventricles; the right side of the heart contains deoxygenated (oxygen deficient) blood and the left side contains Oxygen reach blood. The blood flow is unidirectional and maintained by the valves between each of the chambers that pump the blood from one chamber to the next.
There are four valves as under:
Tricuspid valve. Located between the right atrium and the right ventricle
Pulmonary (or pulmonic) valve. Located between the right ventricle and the pulmonary artery
Mitral valve. Located between the left atrium and the left ventricle
Aortic valve. Located between the left ventricle and the aorta
If the heart valve is damaged or diseased its function is impaired. This leads to impairment in functioning of the heart. There are many reasons why the heart valves can be impaired. One of the main causes include infection (such as rheumatic fever or staphylococcus infections), congenital (present at birth) valve abnormalities, and aging. The stiffening of the heart valve is known as are valvular stenosis and valvular insufficiency (regurgitation). In the vulvular insufficiency, the valves do not close properly leading to the backflow that mixes blood from one chamber to the other.
Steps taken :
Once it is diagnosed that heart valves are stenosed or blocked making them stiff, surgery may not be advocated. In these situations, the blockages are plasticised and the blockages are cleared. Such procedures are known as valvuloplasty. In short Valvuloplasty is the widening of a stenosed valve using a balloon catheter. Valvuloplasty is mainly performed for stenosed aortic valve known as Aortic valvuloplasty that repairs the blocked aortic valve so that the heart can pump the blood well from the left ventricle to the aorta, the major artery arising from the chamber of the heart. The other common Valvuloplasty procedure is the mitral valve repair (left side of the heart). Valvuloplasty procedures involve use of balloon catheter inside the valve. The inflated balloon plasticises the blockages, removes valve stiffness and increases the opening size of the valve improving blood flow.
The symptoms of the valvular heart disease includes symptoms such as Dizziness, fainting episodes, breathlessness palpitation, swelling of the feet, ankle, abdomen, rapid weight gain, feeling of uneasiness, high fatigability etc. Valvuloplasty are critical procedures and there could be episodes of bleeding at the catheter insertion site, blood clot, damage to the blood vessels, infection, cardiac arrhythmias due to damage to the pacemaker cells in the heart during the procedure, stroke worsening of the valuvular diseases such as leakage being increased, rupturing of the valve etc. Patient needs to be hospitalised to undergo this procedure. Patient should be stable prior to undetkaing the procedure.
Recent improvements in both balloon technology and procedural technique have made Valvuloplasty the procedure of choice in fragile patients, elderly patients a choice of interventional procedures than the open heart surgeries to repair the valve diseases.
Valvuloplasty is generally safe and uneventful. However, due to intervention at the valve sites there could be some temporary and permanent health risks. Patient must follow all the advice given by the doctor and be in a stable physical and mental form to undergo the procedure. The entire concomitant, comorbid conditions must be under control. Patients with diabetes mellitus and hypertension should follow the entire necessary step to keep blood sugar and blood pressure within the normal limits to avoid any risk to the health.
How safe and effective are the Valvuloplasty
These procedures are reasonably safe and have good success rate.
Who will perform these procedures?
Interventional cardiologists shall perform Valvuloplasty procedures in the special operating room called as Cath-Labs.
What are the side effects of Valvuloplasty?
The Valvuloplasty procedures involve repair of the heart valves and also interfering with the very delicate and intricate part of the heart with a catheter, balloon etc. During the procedure, some important nodal centres also get the pressure of the balloon inflations and may get temporarily affected. This can lead to increased heart arte, fibrillation, arrhythmias etc. The cardiologists manage these situations with medications and they resolve with time.
Can this procedure be performed during pregnancy?
Usually no surgical intervention of such high critically is recommended during pregnancy. There is risk for the mother as well as for the foetus.
Can a patient return to normal activities soon after the procedure?
A successful procedure leads to quick recovery to normal life. However, doctors’ advice is utmost important and one must all the necessary precautions and medication support.
What is minimal invasive cardiac surgery (MICAS)?
Angioplasty is a specialised procedure performed in a Cath lab (cardiac catheterisation laboratory). Since the patients are awake and alert through the procedure, they are given medication before and during angioplasty procedure to help relax
Coronary angiography is an imaging technique or a radiological test that helps visualize the insides of the coronary arteries. It shows the exact location and severity of any plaque formation and consequent narrowing of the coronary arteries. This helps the doctor to decide on what treatment is needed.
Arteries, veins and lymphatic vessels form the vascular system of our body and vascular surgery is a specialty dealing with diseases affecting the vascular system The diseases affecting our vascular system involve the obstruction in the blood flow due to blockages (aneurysms) in the vessels.
Heart valve surgery is used to repair or replace diseased heart valves. Blood flows between different chambers of the heart must flow through a heart valve. Human heart has four valves namely Tricuspid, Pulmonary, Mitral and Aortic Valves. If a valve is not working correctly, blood flow is impaired either by leakage or by back flow.
The rhythmicity of the heart beat is based on the electric impulses. These impulses are initiated by the contraction of the cardiac muscles also known as myocardium.
Electrophysiology is a branch of cardiology that deals with the diagnosis and treatment of heart rhythm disorders. Electrophysiologists are the cardiologists with special training in heart rhythms disorders and its management.
Heart Surgery may be required to fix the problem with the functioning of the heart. Closed heart surgery does not require patients to be supported by a heart-lung bypass machine and the heart chambers are opened during the procedure. Some repairs are best performed using closed heart surgery.
Heart surgery in children are indicated to repair heart defects a child is born with CHD (congenital heart defects) and heart diseases a child gets after birth. The surgery is needed for the child's wellbeing. There are many kinds of heart defects ranging from minor to serious.
Coronary artery bypass grafting (CABG) is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). Symptoms of coronary artery disease include chest pain, fatigue, palpitations, abnormal heart rhythms and shortness of breath.
Pacemaker implantation is a surgical procedure where a small electrical device called a pacemaker is implanted on the chest or abdomen. The pacemaker sends regular electrical pulses that help keep your heart beating regularly.
Heart valve surgery fixes a damaged or faulty heart valve. There are two main types of heart valve surgeries: valve repair and valve replacement. Double valve surgery is a surgery where two valves are involved. Sometimes a faulty valve can be repaired by cutting away excess tissue in the cusps of the valve and sewing the edges together.
A ventricular septal defect (VSD) is an opening or hole in the wall that separates the two lower chambers of the heart. This wall is the ventricular septum. The hole causes oxygen-rich blood to leak from the left side of the heart to the right side.
The upper chambers of the heart are divided a wall called “interatrial septum”. The defect in this wall is known as Atrial septal defect (ASD). It is a form of a congenital heart defect, the defect the baby is born with.