Rheumatic heart disease is the sequela of rheumatic fever, and it is a heart disease left over from carditis caused by acute rheumatic fever, mainly caused by valve lesions. Heart valve diseases are structural damage, fibrosis, adhesion, shortening, myxomatoid degeneration, ischemic necrosis, calcinosis or congenital malformation caused by the inflammation of heart valves (including valve leaflets, chordae tendineae and papillary muscles), thus causing acute and chronic stenosis and/or dysfunction of one or more valves. Traditional treatment methods include valvuloplasty, biological valve replacement or mechanical valve replacement. Our department adopts small incision or thoracoscopic valvuloplasty, biological valve or mechanical valve replacement. This treatment method is minimally invasive, beautiful after operation and quick to take effect.
Valvular heart disease is a very common heart disease. There are about one million patients with valvular heart disease in China. In all cardiac operations, valvular heart disease accounts for nearly 1/3. In the early stage of valvular disease, patients often feel short of breath, flustered and cough when their activity increases; Advanced patients will also feel dyspnea, palpitation, edema and so on. When resting, it seriously affects the activity ability and quality of life of patients. If valvular heart disease is not treated in time, it will lead to heart failure and circulatory failure, which directly threatens the life of patients and even leads to death in severe cases. Rheumatic valvular heart disease is common in China. Other diseases such as congenital valvular dysplasia and senile valvular degeneration can cause valvular heart disease.
At present, the surgical treatment of valvular heart disease is mainly divided into two methods:
1) valvuloplasty, that is, repairing damaged valves;
2) Valve replacement, using artificial mechanical valve or biological valve for replacement.
Valvuloplasty is usually used for mild mitral or tricuspid valve diseases, but for severe heart valve diseases, especially rheumatic heart valve diseases, valve replacement is often chosen. The main methods of valvuloplasty include Key plasty, DeVega plasty and C-ring plasty. Valve replacement is to replace human heart valves with artificial valves, such as mechanical valves and biological valves. Mechanical valve has a long life, but it needs lifelong anticoagulation, which is easy to cause complications, while biological valve does not need lifelong anticoagulation, but its life is short. There are also tissue engineered valves developed by bioengineering technology, which have not been applied to clinic at present.
Replacement of valve disease in children
First of all, heart valve replacement is possible in children with valvular diseases. However, it is necessary to comprehensively analyze the condition, weigh the pros and cons, and choose the most beneficial plan for the children.
Children with valve disease may be congenital or acquired. If it is caused by rheumatic heart disease, the heart valve will be stuck, narrowed, thickened and curled. , it will lead to the "valve" in the heart can not be opened or closed tightly, thus affecting heart function and systemic blood circulation.
The treatment principle of valvular disease in children is plastic repair as much as possible, and valve replacement surgery should be considered only when the valve injury can not be repaired. If children need to replace valves, most of them choose mechanical valves. Generally, children can only install artificial heart valves after 7-8 years old. The biggest problem after installing a heart valve on a child is that with the growth and development of the child, the effective caliber of the artificial valve is not large enough and needs to be replaced again. At the same time, lifelong anticoagulation will also bring a lot of inconvenience, such as easy to miss taking anticoagulants.
At present, the same biological valve is being studied and selected at home and abroad. This valve has a long service life and is easy to use, and does not need to take anticoagulant drugs for life, especially for children.