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Transcript
VALVE SURGERY Your doctor has determined that you need to have valve surgery. This pamphlet you explains how the heart functions and the main steps in the surgery. Many problems with heart valves can require heart VALVE SURGERY surgery. YOUR HEART The heart is a muscle located in the center of the chest between the lungs. It works like a pump, circulating blood in order to provide the body with oxygen and nutrients. The parts of the heart are the atria, ventricles, valves, and coronary arteries. Valves One or more heart valves do not open completely. When one or more heart valves do not open completely, blood cannot circulate freely. As a result, the heart must work harder to push blood from one chamber to the next. The medical terminology for this condition is valvular stenosis. Atrium One or more heart valves do not close completely. Ventricle Blood circulates in four chambers referred to as atria and ventricles. The upper two chambers are the atria; the lower two are the ventricles. The heart has four valves that are flap-like tissue structures that open and close with each heartbeat. The valves allow blood to pass through the atria and ventricles, ensuring that blood flows in the right direction. The coronary arteries are located on the surface of the heart, providing it with blood and oxygen. When one or more valves do not close completely, blood can flow backward into the chamber it came from. This is referred to as valvular insufficiency. These two abnormalities can cause various symptoms, including: Dizziness and fainting Shortness of breath Chest pain Swelling of the ankles or abdomen or a weight gain To restore valve function and relieve your symptoms, the doctor may recommend that the valve be surgically repair or replaced. Valvuloplasty (valve repair) consists in repairing the diseased valve by narrowing or widening it. This operation can be performed if the valve tissue is intact. Valve Repair Once the surgeon has access to your heart, he or she will repair the defective valve. Valve Replacement The surgeon will remove the diseased valve and then install a new valve (biological or mechanical). If the diseased valve cannot be repaired, it will be replaced with a biological or mechanical valve. The surgeon will recommend the one that is the most appropriate for you. Biological valves are made of tissues from animals or human donors. While they make no sound, their duration is variable. Mechanical valves are made of synthetic materials. Their main advantage is their long durability. They do, however, make a clicking sound. Moreover, mechanical valves require that the recipient take anticoagulants (Coumadin®) for life. MAIN STEPS OF THE SURGERY General Anesthesia Before putting you under, the care team will connect you to a cardiac monitor (which measures arterial pressure), a saturometer (which measures blood oxygen level), and an IV drip. Then, you will be anesthetized (put to sleep). Once you have been put to sleep, a tube will be installed to help you breathe as well as a urinary catheter and venous-access lines. An anesthetist will monitor you during the procedure. Opening the Sternum (Sternotomy) Usually, the surgeon will perform a sternotomy. This technique consists in sawing your sternum in half vertically and in separating the two sides. This approach gives the surgeon access to your heart. Temporarily Stopping the Heart (extracorporeal circulation) Your heart will be temporarily stopped and connected to a cardiopulmonary bypass pump. This device is often referred to as a heart–lung machine because it takes over their functions. Once the valve has been repaired or replaced, your heart will be restarted. Closing the Sternum At the end of the operation, your sternum will be put back into its normal position and attached with steel wires. IMPORTANT If you have to cancel or postpone your admission. If you have a cold, the flu, a fever, or an infection the day before your surgery. Promptly call the admissions office at 819-3461110, extension 13058. Authors Cardiopulmonary-Care Patient Program Surgical Patient Program Revision and Layout Direction des communications et des affaires publiques © Centre hospitalier universitaire de Sherbrooke (CHUS) chus.qc.ca January 2015 – 1-6-71911