Heart Valve Diseases: A Case Study

The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right

When the left ventricle is full, the bicuspid valve closes and the aortic valve opens. This allows the blood into the aorta and once the blood passes the aortic valve closes. Finally, the blood then has access through the rest of the body by systematic capillaries  veins  back to the right atrium.

Disease, endocarditis or a congenital defect can result in heart valve problems. When the valves don't open or close properly during each heartbeat, the heart muscle has to pump harder to keep blood moving.

The mitral valve is located on the left side of the heart between the left atrium and left ventricle. The purpose of the mitral valve is to form a seal between these two chambers of the heart to prevent the back flow of blood. When blood enters the left side of the heart, it is oxygenated and enters through the pulmonary veins. The blood then travels through the left atrium; the bicuspid (mitral) valve then opens to let the blood flow down to the left ventricle. The left ventricle contracts, causing the mitral valve to close (preventing the backflow of blood).When the left ventricle contracts it is pumping the blood out to the remainder of the body. (Jenkins, 2007)

People, who receive artificial hearts, fall into two categories being “bridge” or “destination.” The “bridge” group, are those people who would most likely die waiting for a suitable donor heart. The “destination” group are those patients who’s body would not suit a donor heart transplant but would benefit in additional years lived from an artificial heart.

That is why a mechanical heart valve requires anticoagulation therapy due to the risk of bleeding. However, it can last up to 25 years. Bioprosthetic does not require anticoagulation do to the lower thrombotic risk but it does not last as long as the mechanical heart valve

Transcatheter aortic valve implantation is a very important and difficult surgery for aortic valve and this surgery happened instead of aortic valve replacement. TAVI is an invasive procedure to aortic valve. In this invasive surgery a new valve that is made from biological materials of cows, is inserted through a catheter to the heart.

The ideal prosthetic valve that combines excellent hemodynamic performance and long-term durability without increased thromboembolic risk or the need for long-term anticoagulation does not exist. Choice of operation and the prosthesis used for those patients undergoing valve replacement is important for each individual patient and ideally should be made together by the patient, cardiologist, and surgeon.

In October of that same year, the company had their first artificial heart valve made of pyrolytic carbon which prevents blood from clotting transplanted into a patient. Many surgeons throughout began using St. Jude Medical's new heart valve product due to Mr. Villafana excellent marketing techniques'. According to encyclopedia.com, the company was criticized for the emphasis it had on sales in what was apparently a clinical trial program.

An estimated 200,000 aortic valve replacements are done yearly. Surgical valve replacements frequently use BP valves over mechanical valves. 2 All transcatheter valves are bioprosthetic (BP) and have been increasingly used in patients with severe aortic stenosis deemed to be at high surgical risk. 13 TAVR was

_____(Central) aortic valve replacement for aortic valve stenosis, it is almost like subvalvular membranous tunnel-like stenosis.

This technology incorporates a Collapsible valve which can be coiled over the catheter and hence delivered by a 18-25 French delivery systems following Balloon Valvuloplasty through the Axillary, femoral, subclavian or apical

It’s not completely understood what the future holds for those who underwent this procedure but so far the research looks excellent. Risks of the procedure include the common risks associated with open heart surgery: stroke, bleeding, infection, organ damage, nerve damage, adverse reaction to anesthesia, requirement of a temporary/permanent pacemaker or possibly death. Also, Suture lines of the lengthy great vessels predispose these patients to postoperative bleeding. Blood loss at this time indicates the need for adequate drainage from the mediastinum to avoid cardiac tamponade while treating the coagulopathy. Based on 99% of all pediatric heart disease surgical procedures, the risk of these complications are less than 5%. In some cases

Biological (tissue) valves are taken from pig, cow, or human donors and therefore patients with these valve replacements do not need to take anticoagulants for the rest of their lives. Biological valves, on the other hand, don't last as long as mechanical valves (usc.edu).

The ECM is considered to be the main responsible for the durability of heart valve and its principal components are collagens type I and type III, elastin, glycosaminoglycans (GAGs), and proteoglycans (PGs). Collagen is fundamental for valve´s biomechanical functions, providing stiffness and elasticity; moreover, they have a strong influence on cell adhesion and migration. 5 The glycosaminoglycan (GAG) side-chains of proteoglycan molecules tend to form a gel-like ground substance in which other matrix molecules interact to form permanent cross-links and on which other components are deposited. 6