Anything is original good
This is the first instinct of many people
But if something goes wrong with the aortic valve of the heart
In the past, only prosthetic valves could be replaced
Right now
Department of Cardiac and Macrovascular Surgery, First Affiliated Hospital of Zhejiang University School of Medicine
There may be another possibility: to retain the original valve
Uncle Lu (pseudonym), a 68-year-old in Zhejiang, tasted the sweetness
Always dizzy but diagnosed with heart disease?
Uncle Lu lives in a small mountain village in Zhejiang, has been a farmer for a lifetime, is tall and athletic, and has never had a serious illness. But some time ago, Uncle Lu inexplicably appeared dizzy.
"Because I happened to have a cold at that time, I coughed very badly, so I thought it was caused by coughing too much." Uncle Lu said, but soon found that the situation was not as imagined, after the cold and cough, he still continued to dizzy, and each time the amount of activity was slightly larger, it would be particularly dizzy, and it would take more than an hour of meditation to ease up.
This situation lasted for more than three weeks and still did not see any improvement, and Uncle Lu, who had never bothered his children, could not hold back and called his son. The son heard that the old father was unwell, hurried back to his hometown, and took him to the local hospital overnight. "After we got to the emergency room, we did a lot of tests and finally said my dad might have a heart problem." Uncle Lu's son said that the local doctor suggested going to a higher hospital for treatment.
"Obviously it was dizzy, but I didn't expect it to be a heart problem." In the cognition of Uncle Lu's family, the heart disease is already a very serious and dangerous situation, because the son usually works in Hangzhou, so there is no hesitation, and immediately decided to take the old father to the first hospital of Zhejiang University in Hangzhou to see a doctor.
Prosthetic valve replacement is difficult to complete
Stubborn old people refuse treatment
"When the patient came, the overall situation was OK, and there were no other serious symptoms except for dizziness." Luo Wenzong, deputy chief physician of the Department of Cardiac and Macrovascular Surgery of the First Hospital of Zhejiang University, introduced that after improving various examinations, Uncle Lu was diagnosed with aortic valve insufficiency.
Schematic diagram of aortic valve insufficiency, courtesy of the department
If the heart is understood as a "water pump", the aorta is understood as a "water pipe", then the aortic valve is a one-way valve that controls the flow of water between the pump and the water pipe, the aortic valve is incomplete to close the valve can not be closed, the blood will regurgitate to the heart, if not properly treated in time, it will affect normal heart function, trigger heart failure, and cause patients with chest tightness, syncope and other related ischemic symptoms.
Treatment of aortic valve insufficiency, surgery is the best way, although there is a solution, but Uncle Lu is still full of sadness.
Originally, unlike the repair techniques used for mitral valve insufficiency, the current treatment of aortic valve disease is still based on the replacement of artificial valves. "Because the aortic valve itself is in a high-pressure area, the valve repair is easy to deform, and the operation is difficult, risky, and easy to bleed, so surgeons have always been very cautious about the repair of the aortic valve." Luo Wenzong, deputy chief physician, explained that in the past, the industry has also tried some simple aortic valve repair techniques, but the repaired valves are easy to deform under the impact of high pressure, and the effect is difficult to last, so valve replacement is the most common method.
However, at present, the artificial valves on the market (mainly mechanical valves and biological valves) are always non-"original", no matter which valve can not achieve "perfect": although the mechanical valve is used for a long time, but patients need to take anticoagulant drugs for a long time, there is a risk of concurrency; although the risk of complication is small, but the use of the life is not long, it may need to be replaced for more than ten years.
This kind of operation that is difficult to do both makes Uncle Lu have the idea of conservative treatment and negative treatment.
The new technology successfully preserves the aortic valve
In the face of Uncle Lu's hesitation, the doctor gave a new surgical plan - aortic root reconstruction surgery to retain the aortic valve - which avoided the concurrent risk of anticoagulant drugs and did not have the problem of service life.
"By retaining the autologous valve, the aortic valve can obtain the same hemodynamic parameters and resistance to foreign bacteria as normal people, which are incomparable to the replacement of artificial valves." Luo Wenzong said that the operation includes David surgery to eliminate the aortic sinus and Yacoub surgery to retain the aortic sinus, and both have a very ideal long-term effect, but due to the difficulty of operation and high technical requirements, there are only a few heart centers in China, and david surgery is mainly carried out alone, and the Department of Cardiac and Large Vessel Surgery of The First Hospital of Zhejiang University can skillfully carry out these two operations at the same time, and the technology and strength are leading in China.
Left: Schematic diagram of David's surgery, Right: Schematic diagram of Yacoub surgery
, courtesy of the department
And this also made Uncle Lu take a reassuring pill and decide to undergo surgery. A few days ago, Luo Wenzong, deputy chief physician, underwent surgery for him and cured the problem of aortic valve insufficiency. "You look at your heart and valves, just like a normal person." Looking at the CT reconstructed blood vessel image pointed out by the doctor, Uncle Lu also smiled happily.
Postoperative reconstruction of the three positions, completely normal, the department provided the picture
"In the past, Professor Ni Yiming led us to be the first group in the field of heart valve replacement in China, and now we are at the forefront of the country in the field of valve repair." Chief Physician Ma Liang, director of the Department of Cardiac and Large Vascular Surgery of the First Hospital of Zhejiang University, said that the department can not only mature the minimally invasive repair technology of the mitral valve, but also be in a leading position in the repair technology of the aortic valve, and last year retained the original valve for more than 20 patients with incomplete aortic valve.
Aortic valve repair is suitable for aortic sinus tumor-like dilation, aortic valve dipole malformation, etc. caused by aortic regurgitation insufficiency, Marfan syndrome, infectious endocarditis, aortic dissection and other diseases, and the doctor will make a comprehensive judgment according to the specific situation.
Experts remind that although the aortic valve insufficiency has palpitations, precordial discomfort, dyspnea, fatigue and fatigue, angina, cough and cough pink foam sputum and other clinical symptoms, but the early stage is usually not easy to detect, patients may accidentally find through physical examination, if ultrasound diagnosed aortic valve insufficiency, should be timely medical treatment, so as not to delay the best time for treatment.