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Heart Valve Surgeries

How are heart valve diseases treated with surgery?

The recommended treatment method for heart valve surgeries is to try to repair the problematic valve by preserving the patient's own valve tissue as much as possible (heart valve repair surgery). Thanks to the preservation of its own valve tissue, the patient's need for long-term blood-thinning treatment is eliminated.

Thus, the patient is protected from possible complications of blood-thinning treatment. If it is not possible to repair the problem on the patient's valve during the surgery, the diseased valve tissue is removed by cutting and a prosthetic valve is sutured in its place (heart valve replacement surgery).

What are heart valve prostheses, what is the difference between them?

Today, there are two types of prosthetic heart valves (mechanical and biological). Both types of prosthetic heart valves have advantages and disadvantages against each other. The long-term durability of the valve and its thrombogenic (clotting) properties are two important problems of prosthetic heart valves.
Mechanical heart valves are highly durable but have high clot-causing properties.

If a patient with a mechanical valve does not hold the infection valve in any part of his/her body, if a clot does not develop that prevents the valve from working, or if the patient's own tissues do not disrupt the operation of the valve by advancing towards the valve, there is no need for re-operation.

However, these patients have to use anticoagulant drugs for the rest of their lives. Patients using anticoagulant drugs are closely monitored to ensure that the blood is fluid at the desired level. There is a risk of drug-induced bleeding or clot development on the prosthetic valve, especially in elderly patients and patients who are not compatible with the use of drugs.

Bioprosthetic valves are usually obtained from the pericardial tissue of cattle or pig heart valves. The use of valves from human donors is extremely rare. The main advantages of bioprosthetic heart valves are that the risk of developing a clot in the valve tissue is much lower. Prolonged use of anticoagulant drugs is usually not necessary in these patients, but endurance is a serious problem in bioprosthetic heart valves. Structural deterioration of the bioprosthetic heart valves occurs within 10-15 years. Patients may need to have surgery again in the future.

When replacement of the cover is required, how is it decided what type of prosthetic cover to install?
Before the planned surgery, the patient and his/her relatives are informed in detail and it is jointly decided on the right type of prosthetic valve selection. In general, bioprosthetic caps are preferred as much as possible in patients who are inconvenient to use anticoagulant drugs following surgery or in patients over 70 years of age. In young patients, mechanical prosthetic caps are considered more in the foreground.

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