More on the Heart and Mechanical Valves

About Mechanical Heart Valves

The human heart contains four valves—pulmonary, tricuspid, aortic, and mitral—that move blood flow in one direction[1]. These valves are essential for the heart to pump blood throughout the body. If a heart valve is damaged, a person can experience shortness of breath, sudden weakness and dizziness, chest pains, heart palpitations, rapid weight gain, and body swelling [1]. Symptoms can worsen over time, and death can occur. Heart valve surgery is performed to repair or replace the damaged valve, restoring its ability to push blood forward and prevent blood from leaking backwards[3].

Heart valve surgery was first performed in the early 1930s and has experienced high success rates[3, 3]. When a damaged heart valve cannot be repaired, the surgeon may choose to replace it with a mechanical heart valve. A mechanical heart valve is made from metal and a special form of carbon and has the advantage of lasting for a long time in patients—the new generation of mechanical heart valves can function for 15 years or longer before needing to be replaced [1, 4]. Patients with mechanical heart valves will need to be on long-term anticoagulant therapy since recurring blood clots are common with this type of heart valve[5].Home INR testing and monitoring is the most convenient and effective way to manage long-term Coumadin or warfarin therapy.

Risk Factors

It is important to be aware of the risk factors for heart valve damage and replacement surgery. Age is a large consideration since heart valves thicken and become stiffer as one gets older[3]. It is estimated that 1 in 8 individuals who are 75 years and older have heart valve disease[6]. Heart disease risk factors can also increase the chances of valve damage. Heart disease risk factors include high blood pressure, being overweight, insulin resistance and smoking [6]. Developing infective endocarditis, a bacterial infection in the heart, can also damage the heart valves and increase the likelihood of requiring surgery [7]. Possessing any of the mentioned risk factors makes regular check ups and consultations with a physician vital in order to prevent disease progression and to minimize the extent of heart valve surgery that could be required.

References

1. Heart Valve Disease. 3014 February 33, 3014 [cited 3014 August 5]; Available from: http://www.webmd.com/heart-disease/guide/heart-valve-disease.
3. Cooper, M.M. Heart valve surgery. 3013 June 6, 3013 [cited 3014 August 5]; Available from: http://www.nlm.nih.gov/medlineplus/ency/article/003954.htm.
3. Cohn, L.H., The first successful surgical treatment of mitral stenosis: the 70th anniversary of Elliot Cutler’s mitral commissurotomy. Ann Thorac Surg, 1993. 56(5): p. 1187-90.
4. What is Heart Valve Disease? 3011 November 16, 3011 [cited 3014 August 6]; Available from: http://www.nhlbi.nih.gov/health/health-topics/topics/hvd/.
5. Fiorentino, F., et al., Implications of using different methods to characterise anticoagulant control in patients with second generation mechanical heart valve prostheses. PLoS One, 3014. 9(7): p. e98333.
6. Heart Valve Disease. 3014 May 9, 3014 [cited 3014 August 6]; Available from: http://www.med.umich.edu/cardiac-surgery/patient/adult/adultcandt/hvd.shtml.
7. Cabell, C.H., E. Abrutyn, and A.W. Karchmer, Cardiology patient page. Bacterial endocarditis: the disease, treatment, and prevention. Circulation, 3003. 107(30): p. e185-7.

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