Artificial valves

Artificial Valves

Artificial valves, also known as prosthetic heart valves, are devices implanted in the heart to replace damaged or diseased natural heart valves. These devices are crucial in the treatment of various heart valve diseases, such as aortic stenosis, mitral regurgitation, and other valvular heart diseases. Artificial valves are designed to mimic the function of natural heart valves, ensuring unidirectional blood flow through the heart and preventing backflow.

Types of Artificial Valves

There are two main types of artificial heart valves:

Mechanical Valves

Mechanical valves are made from durable materials such as titanium, carbon, and other synthetic materials. They are designed to last a lifetime and are often chosen for younger patients due to their longevity. However, patients with mechanical valves require lifelong anticoagulation therapy to prevent blood clots.

• Ball-and-cage valves: An early design where a ball moves within a cage to open and close the valve.
• Tilting-disc valves: These have a single disc that tilts to open and close, allowing blood flow.
• Bileaflet valves: These have two semicircular leaflets that open and close, providing a more natural blood flow pattern.

Biological Valves

Biological valves, also known as tissue valves, are made from animal tissues (usually porcine or bovine) or human donor tissue. These valves are treated to prevent rejection and calcification. Biological valves do not require long-term anticoagulation therapy, but they tend to have a shorter lifespan than mechanical valves.

• Xenografts: Valves made from animal tissue, typically porcine or bovine.
• Allografts: Valves harvested from human donors.
• Autografts: Valves transplanted from one position to another within the same individual, such as the Ross procedure.

Indications for Valve Replacement

Artificial valves are indicated in patients with severe valvular heart disease that cannot be managed with medication alone. Common indications include:

• Severe aortic stenosis
• Severe mitral regurgitation
• Congenital heart defects affecting the valves
• Infective endocarditis leading to valve destruction

Surgical Techniques

Valve replacement surgery can be performed using traditional open-heart surgery or minimally invasive techniques. The choice of technique depends on the patient's condition, the type of valve being replaced, and the surgeon's expertise.

• Open-heart surgery: The chest is opened, and the heart is stopped to replace the valve.
• Minimally invasive surgery: Smaller incisions are used, and the heart may not need to be stopped.
• Transcatheter aortic valve replacement (TAVR): A catheter-based approach for aortic valve replacement, often used in high-risk patients.

Complications

While artificial valves are life-saving, they can be associated with complications such as:

• Thrombosis and embolism
• Valve degeneration (more common in biological valves)
• Infection (prosthetic valve endocarditis)
• Paravalvular leak

Follow-up and Management

Patients with artificial valves require regular follow-up to monitor valve function and manage anticoagulation therapy if necessary. Echocardiography is commonly used to assess valve performance.

Also see

• Heart valve disease
• Cardiac surgery
• Anticoagulation therapy
• Echocardiography

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