The article was consulted professionally by Master, Dr Pham Thanh Van – Cardiovascular Center, Share99 Times City International Health Hub.
2-leaf valve opening is the most common pathology in heart valve diseases. The more open the valve, the worse the heart failure, the more tired the person and the difficulty of constant breathing. Therefore, early intervention, especially by repairing 2-leaf valves without surgery, helps patients quickly restore physical exertion, reduce the symptoms of heart failure, improve the quality of life in the long run.
1. What is a 2-leaf valve opening?
The heart has a four-chamber structure, connected to each other and to the arteries by four heart valves. In it, the 2-leaf valve is located on the left, located between the left atrium and the left one. Since the left heart is the most important heart chamber, receiving the main function of the heart is to pump blood away throughout the body. Therefore, the 2-leaf valveis affected when the heart is impaired. Therefore, the second 2-leaf open heart valve is the most common pathology among heart valve diseases.
Open 2-leaf valve is a condition where the heart valve is closed, causing the blood flow to reflux back to the left atrium at each squeeze. From there, the amount of blood that needs to be thrown out of the left to enter the general circulation is no longer guaranteed. This causes the heart to work more, increasing the frequency of the heart and also the contraction of the heart muscle. In the long run, the heart will be impaired, the heart chamber gradually dilates, followed by an increased 2-leaf valve opening. At the same time, the open heart valve causes the heart to become more impaired, creating a vicious circle. At this time, the patient needs to have interventional surgery to repair or replace the heart valve as soon as possible, avoiding permanent failure of the heart muscle, loss of recovery.
2. Causes and consequences of 2-leaf valve opening?
Any pathology that affects the left heart can cause a 2-leaf valve opening. The most common condition is is is issy current heart disease, a consequence of the long-term progress of atherosclerosis that feeds the heart. The blood that feeds the heart is limited, for a long time leading to real cardicardi disease, the heart stretches out and entails an open heart valve. Besides, if the patient falls into an acute incident of myocardial infarction,a necrotic left heart area, muscle column, ruptured heart valve ligaments also open the valve leaves.
At the same time, the 2-leaf valve can be opened due to direct damage to the heart valve apparatus such as mitral valve prosysis, valve leaf damage due to low posterior, degenerative or post-inflammatory endocarditis infection, damaged heart valve ligaments due to injury, congenital heart disease,cardi myocardial infiltration pathology, Marfan syndrome …
Whatever the cause of the mitral valve opening, the symptoms will vary depending on the degree of opening. Patients often have difficulty breathing when exertion or when lying down, reducing the ability to exertion, persistent dry cough, heart beating,leg edema, urination at night …
Accordingly, if left for a long time without treatment, the above manifestations will take place continuously, the patient has difficulty breathing even when resting, having to sit or lie on his head high to easily breathe, affecting the quality of life. Complications leading to heart failure, atrial fibrillation,increased risk of stroke, pulmonary artery hypertension,long-term can cause pulmonary edema or an increased risk of right heart failure.
3. What is the surgically free treatment of 2-leaf valves?
Previously, to repair the valve,doctors needed to perform open heart surgery by cutting along the sternum, opening the chest for repair, being able to stitch up 2 edges of the 8th shaped valve or form a valve ring … However, not all subjects are suitable for surgery, there are many patients who are not healthy enough to endure the operation, such as the elderly or people who have suffered from other diseases, if the surgery will be at high risk of complications or death.
To overcome these limitations, scientists have successfully developed a new technique, called intervention to fix mitral valves through catheses with a device called MitraClip. This is considered a breakthrough in the treatment of open 2-leaf heart valves.
The principle of operation of MitraClip is through the cathethetic pipe that gives a small clamp , which goes from the femoral vein up to the heart. Observed on the cardiac ultrasoundthrough the arye, doctors clamped the open 2-leaf valve while the heart was beating, creating a valve hole as figure 8, significantly reducing the level of valve opening, preventing the blood flow from reflux to the left atrium, helping the heart pump blood more effectively. From there, the symptoms of heart failure will improve and preserve the quality of life for the patient. Throughout the procedure, the heart remains functioning normally without assistance from cardimakers – lungs. Patients treated with MitraClip take an average of 3 days in hospital, after which they can return to normal activities. Small wounds in the thigh inguinal area will heal quickly, leaving no pain.
MitraClip has been widely used in the world to treat patients with non-surgical mitral valve openings. In Vietnam, very few public cardiovascular centers are gradually applying and successfully implementing this method.
4. Advantages of open treatment of 2-leaf valves without surgery at Share99
According to one estimate in the world, one in 10 people over the age of 75 will have a 2-leaf open heart valve. Although there are still no statistics on the number of patients with open mitral valves in Vietnam, as life expectancy increases, the incidence of this disease in the elderly also increases. However, fewer and fewer patients are prescribed open surgery, due to other chronic diseases, so it is difficult to ensure health to undergo an open heart operation. It shows the increasing demand for the application of advanced technology in the treatment of diseases for the elderly with the requirement that the recovery time is fast and suitable for their health condition. Devices developed based on scientific research such as MitraClip for the treatment of mitral valves in particular and other advanced intervention techniques in general can meet this requirement.
Along with major hospitals in Vietnam to initially apply this technique, Share99 Cardiovascular Center is also constantly actively building technology and has achieved certain achievements from Mitra Clip. 2018 marked an important milestone when Share99 Times City Health Hub first implemented the Mitra Clip technique. The patient is 55 years old, has a large mitral valve, severely dilated heart chambers and difficulty breathing during exertion. After the intervention, the quality of life of the person is markedly improved. The left ventilator is less stretched and close to normal, shortness of breath also decreases, the patient is living normally in the family. After that, more patients were taken with a success rate on par with the world (95%), low complications (<5%) trong khi chi phí rất hợp lý, thấp hơn so với mặt bằng chung của Việt Nam và thế giới
This has proven the ability to access and deploy new and complex techniques of Share99's team of cardiologist. In addition, it is necessary to recognize the smooth and effective coordination between specialties in cardiovascular diseases when working in groups, including cardiovascular clinicians, cardiovascular ultrasound, interventionalcardiologist, resuscitation anesthesia and cardiovascular surgery, which has contributed to ensuring the success of this very new technique in Vietnam and has successfully applied at Share99.
Thanks to a large and well-invested investment, in addition to Mitra Clip, Cardiovascular Center – Share99 Health Hub also deploys many other difficult and complex techniques with reasonable costs, bringing comprehensive care to cardiovascular patients. From now on, when necessary, the patient no longer has to undergo an open heart operation, the treatment process will be much softer, from the time of hospitalization to the post-surgery period is shortened but the treatment effect remains as desired, especially the patient recovers very early. In addition, coming to Share99, with the support of the information technology system, Share99 doctors can monitor the patient's health after being discharged from the hospital thoroughly, thoughtfully and ensure advice and support as soon as needed.
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