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More than 1500 bypass surgeries were performed.
Rheumatic heart disease is very common in India affecting females more than males and prevalent in low socioeconomic conditions affecting heart in age group 15-40 years. It affects predominantly mitral and aortic valve.
It causes valvular stenosis and/or regurgitation lesions. Patients presents with breathlessness, fatigue, tiredness while doing routine activities, sometimes chest pain, syncope can be there.
Along with the clinical presentation, diagnosis is confirmed with echocardiography (2 D Echo). The mainstay of treatment is either valve repair or replacement surgery.
1. Mitral valve disease
In this condition, the size of the orifice of the mitral valve is reduced or has a regurgitant lesion or both. In the early stages of mitral stenosis, it can be opened angiographically by a procedure called ‘Balloon Mitral Volvotomy’. (BMV) In moderate to severe cases, we need to repair or replace the valve by performing open-heart surgery.
In mitral valve repair surgery, we repair the patient’s own valve with an annuloplasty ring and the patient can be medication-free post-surgery.
2. Aortic Valve Disease
This is the second most commonly affected valve. Aortic stenosis and aortic regurgitation are common lesions. In the older age group, it is mostly seen as a degenerative disease. Valve replacement is the treatment of choice in aortic valve disease In valve replacement surgery, the patient’s original diseased valve is removed and an artificial valve is placed. There are two types of artificial valves,
This is a long-lasting valve usually put in the younger age group. The only disadvantage being patient needs to be on blood thinners life-long.
b) Tissue valve-
This is made up of either bovine or porcine tissue. It usually lasts for 10-15 years and needs to be replaced after that. Patients do not need to be on blood thinners. This valve is preferred in the older age group.