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Treatment options in Valvular Heart Diseases

From drug treatment to open-heart surgery - the range of treatment options is varied and the goal is always to adapt the optimal treatment to the individual patient. 

Valvular heart disease is among the very frequent diseases of the heart. In principle, a distinction is made between congenital and acquired heart valve failure, the latter usually occur only in older patients. Inflammation of the valves (endocarditis), wear and tear or impact of other heart disease on the flaps or the surrounding tissue all lead to a narrowing (stenosis) or a faulty valve closure (insufficiency). Symptoms are often shortness of breath, limited vitality or water accumulation in the legs (edema).Disease of the heart valves are mostly chronic diseases that arise over many years and can often be treated by conservative measures (e.g., medication) over the long term. The main goal of heart valve diagnostics is to determine the right time for treatment by either heart surgery,  a catheter treatment or to monitor an adjustment of medication. On these pages, we want to familiarize you with the examination procedures.
 
     
 
Which treatment is the most likely to come under consideration is particularly dependent on the extent of valve damage. The range of treatment options can span from a wait-and-see approach to medication treatment all the way to surgery. The type of treatment depends on the affected heart valve, the degree of narrowing or closure weakness of the flap and the age of the patient. If there is a limited amount of valve damage, it may first be advisable to take a wait-and-see approach which would include regular check-ups. On the other hand, a necessary operation should never be delayed. This is because good physical condition improves the chances of success of such a treatment.
 
 

Heart valve surgery

There are different types of surgical treatment available; they depend on the affected flap, as well as the age and physical condition of the patient. After a consultation, we can recommend the best solution for your situation.
 

Anuloplasty

Here we place a small ring or a small band in the region of a mitral or tricuspid valve which is not closing properly. The ring is intended to restore the shape of the heart valve and improve the closure. Heart valve repair: With this method, we “fix” as completely as possible the flaps (aka “pockets”) of the defective heart valve. Heart valve replacement: If a reconstruction is not possible or has no chance of success, we replace the diseased heart valve with a new one. 
In this case, we have a choice of two different options for the valve replacement: either a mechanical valve made of metal and / or plastic, or a biological valve, is prepared from, for example, swine tissue and adapted accordingly. 
 

Catheter, keyhole technique or open surgery?

 Technical breakthroughs in surgery make interventions possible nowadays that are much gentler than those perform earlier. This is also true in the field of heart valve surgery. The placement of new heart valves is now possible either partially or completely by using the “keyhole technique” (minimal invasive surgery) or as part of a catheter treatment. An example of this is the so-called transcutaneous transcatheter aortic valve implantation which we also perform here at the Isar Heart Center. In this process, we exchange the damaged aortic valve with a new one that is put in place of the old with a heart catheter. Once it has arrived at the correct position, the new is valve clamped on and replaces the function of the old.
 

Post-operative Care

Patients who are carrying an artificial heart valve have to undergo regular check-ups in order to monitor whether everything is functioning as it should be.
In contrast to a biological prosthesis, with mechanical-valve prostheses you must regularly take an anticoagulant drug to prevent the formation of blood clots in the artificial valve. This therapy requires regular blood checks. Since previously damaged heart valves are susceptible to infection, it is important to begin treatment with an antibiotic to protect the heart valve before certain procedures.
 
 
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