Valvuloplasty Health Dictionary

Open-heart surgery permits the treatment of many previously inoperable conditions that were potentially fatal, or which made the patient chronically disabled. CORONARY ARTERY VEIN BYPASS GRAFTING (CAVBG), used to remedy obstruction of the arteries supplying the heart muscle, was ?rst carried out in the mid1960s and is now widely practised. Constricted heart valves today are routinely dilated by techniques of MINIMALLY INVASIVE SURGERY (MIS), such as ANGIOPLASTY and laser treatment, and faulty valves can be replaced with mechanical alternatives (see VALVULOPLASTY).

Heart transplant Replacement of a person’s unhealthy heart with a normal heart from a healthy donor. The donor’s heart needs to be removed immediately after death and kept chilled in saline before rapid transport to the recipient. Heart transplants are technically demanding operations used to treat patients with progressive untreatable heart disease but whose other body systems are in good shape. They usually have advanced coronary artery disease and damaged heart muscle (CARDIOMYOPATHY). Apart from the technical diffculties of the operation, preventing rejection of the transplanted heart by the recipient’s immune system requires complex drug treatment. But once the patient has passed the immediate postoperative phase, the chances of ?ve-year survival is as high as 80 per cent in some cardiac centres. A key di?culty in doing heart transplants is a serious shortage of donor organs.... heart surgery

An operation that is performed to correct a narrowed heart valve.

Cuts are made, or pressure is applied, to separate the flaps of the valve where they have joined, thereby reducing the degree of narrowing.

Valvotomy is performed either by opening the heart up (see heart-valve surgery) or by balloon valvuloplasty.... valvotomy

A diagnostic test in which a fine, sterile catheter is introduced into the heart via a blood vessel. It is used to diagnose and assess the extent of congenital heart disease (see heart disease, congenital) and coronary artery disease, and to diagnose and treat some disorders of the heart valves (see valvuloplasty). During the procedure, the pressure within the heart’s chambers can be measured, samples of blood and tissue can be taken, and a radiopaque substance can be injected to allow the heart’s cavities to be X-rayed.... catheterization, cardiac

Any abnormality of the heart present from birth. Defects may affect the heart chambers, valves, or main blood vessels. Major abnormalities are septal defects, coarctation of the aorta, transposition of the great vessels, patent ductus arteriosus, tetralogy of Fallot, hypoplastic left heart syndrome, pulmonary stenosis, and aortic stenosis.

Developmental errors leading to defects arise early in the life of the embryo. In most cases, there is no known cause. Rubella in the mother is the most common known cause.

The onset and severity of symptoms depend on the defect. Some anomalies cause cyanosis and breathlessness but others may go undetected. Possible complications of an untreated heart defect include impaired growth, pneumonia as a result of mild respiratory infections, rapid tiring during exercise, and Eisenmenger complex.

Antenatal diagnosis, using specialized ultrasound scanning, is possible for most defects. After birth, any suspected defect is investigated using chest Xrays, ECG, or echocardiography.

Oxygen and various drug treatments may improve the symptoms of heart block. Some conditions, such as small septal defects or patent ductus arteriosus, may get smaller or disappear of their own accord. Other defects will require surgical correction. Narrowed heart valves can often be treated by balloon valvuloplasty. In other cases, open heart surgery or a heart transplant may be required.

Children with heart defects are at an increased risk of bacterial endocarditis; to prevent this, they are given antibiotic drugs before all surgical procedures including dental treatments.... heart disease, congenital

An operation to correct a heart valve defect or to remove a diseased or damaged valve. A heart valve may have to be repaired, widened, or replaced because it is either incompetent (leaky) or stenotic (narrowed). Widening of a valve may involve valvotomy or valvuloplasty. A damaged valve can be replaced by a mechanical one (fashioned from metal and plastic), a valve constructed from human tissue, a pig valve, or a valve taken from a human donor after death. A heart–lung machine is used during replacement.After heart-valve surgery, symptoms such as breathlessness may take weeks to improve and require medication to be continued. Some people need longterm treatment with anticoagulant drugs to prevent the formation of blood clots around the new valve.... heart-valve surgery

see mitral stenosis; valvuloplasty.... inoue balloon

a subspecialty of cardiology concerned with the treatment of heart conditions using cardiac *catheterization techniques under local anaesthetic and X-ray control, including *percutaneous coronary intervention and percutaneous balloon mitral *valvuloplasty.... interventional cardiology

narrowing of the opening of the mitral valve: a result of chronic scarring that follows rheumatic fever. It may be seen alone or combined with *mitral regurgitation. The symptoms are similar to those of mitral regurgitation except that the patient has a diastolic *murmur. Mild cases need no treatment, but severe cases are treated by reopening the stenosis with an Inoue balloon passed to the heart through the venous system under X-ray control (percutaneous balloon mitral valvuloplasty) or surgically by inserting an artificial valve (mitral prosthesis).... mitral stenosis

a procedure in which, under X-ray guidance, a sharp-tipped catheter positioned in the heart is used to create a small hole in the partition (septum) separating the atria. This allows other catheters to be passed from the right to the left atrium for the purposes of pressure measurement, *ablation, or *valvuloplasty.... transseptal puncture

Failure of the mitral valve of the heart to close properly, allowing blood to leak back into the left atrium (upper chamber) when pumped out of the left ventricle (lower chamber). The disorder, which is also known as mitral regurgitation, may occur in conjunction with mitral stenosis.

Symptoms include increasing breathlessness and fatigue, sometimes with palpitations. Later, the ankles may swell.

Diagnosis may be made by hearing a characteristic heart murmur, and from chest X-rays, ECG, and echocardiography. Cardiac catheterization may also be performed. Treatment may include diuretic drugs, vasodilator drugs, and anticoagulant drugs. If symptoms are disabling, heart-valve surgery may be considered.

Before dental or other surgery, patients with mitral incompetence are given antibiotic drugs to prevent endocarditis. mitral stenosis Narrowing of the opening of the mitral valve in the heart. The left atrium (upper chamber) has to work harder to force blood through the narrowed valve. Mitral stenosis is more common in women and may be accompanied by mitral incompetence. Stenosis is usually due to damage to the valve caused by rheumatic fever.

The main symptom is breathlessness on exertion. As mitral stenosis worsens, breathing difficulty eventually occurs when at rest. Other signs include palpitations, atrial fibrillation, and flushed cheeks. There may also be coughing up of blood and fatigue. Possible complications are as for mitral incompetence.

A diagnosis is made from the patient’s history, listening to heart sounds, and by investigations such as an ECG, chest X-rays, echocardiography, and cardiac catheterization.

Drug treatment is broadly the same as for mitral incompetence.

If symptoms persist, balloon valvuloplasty may be carried out to stretch the valve.

Alternatively, heart-valve surgery may be performed to replace the valve.... mitral incompetence

n. see valvuloplasty.... valvoplasty