How to treat rheumatic heart disease, surgical treatment is effective

Rheumatic heart disease, which we usually call rheumatic heart disease, is a heart disease caused by rheumatic fever activity. Generally, there are no obvious symptoms in the early stage, but in the later stage, there will be symptoms of fatigue, palpitations, shortness of breath, lower limb edema, and cough. It can be treated surgically.

1. Surgical treatment

1. Indications for surgery

It should be pointed out that most patients with valvular disease and severe hemodynamics should receive surgical treatment even if they have no clinical symptoms, unless they have contraindications to surgery. With the advancement of myocardial protection technology and cardiac surgery technology, the treatment effect of rheumatic heart valvular disease has steadily improved, with the surgical success rate reaching 98% and a satisfactory long-term survival rate. It mainly includes valvuloplasty and valve replacement.

2. Valvuloplasty

It includes the use of artificial valve ring plasty alone or in combination, stripping of thickened fibrous tissue of the valve leaflets, resection of calcified foci of the valve leaflets and patch repair, as well as correction of thickened and fused chordae tendineae.

3. Valve replacement

With the development of cardiovascular surgery technology and the improvement of people's demand for quality of life, mitral valve replacement has gradually replaced closed mitral valve commissurotomy, percutaneous mitral valvuloplasty, and direct mitral valvuloplasty, becoming the main method for treating rheumatic heart valvular disease.

4. Valve selection

Currently, there are two main types of artificial valves: biological valves and mechanical valves. Each valve has its own characteristics, and the surgical costs of the two valves are not much different. Patients can choose according to their own situation. First of all, biological valves can be chosen for elderly patients over the age of 65. After bioprosthetic valve surgery, there is no need to take anticoagulants for life, which avoids the related complications caused by daily use of anticoagulants. Therefore, it is also a good choice for young women, especially those with pregnancy and childbearing needs. However, the average adaptive life of biological valves is about 10 years, which means that after bioprosthetic valve surgery, the valve may need to be replaced again due to valve failure.

Mechanical valves are characterized by long service life and resistance to wear and tear. There is no need to worry about the valve itself aging. However, due to the destructive effect of mechanical valves on the blood, they have a tendency to form blood clots, and require long-term and strict warfarin anticoagulation after surgery. The anticoagulation intensity needs to be checked regularly to adjust the dosage to avoid excessive anticoagulation bleeding or insufficient anticoagulation leading to embolism. Therefore, the choice of valve should fully consider comprehensive factors such as the patient's age, the presence or absence of atrial fibrillation, economic conditions, etc.

2. Nursing of rheumatic heart disease

1. Patients with rheumatic heart disease after surgery can also take some drugs to maintain heart function, such as cardiotonic and diuretic drugs. Because some patients have very poor heart function before they come to the doctor, their heart function is at level three or even level four. These patients suffer from myocardial strain for a long time. Even after valve replacement, it only solves the valve problem but cannot alleviate myocardial disease, myocardial strain, etc. Moreover, some foods also affect the anticoagulant effect. For example, foods containing vitamin K can affect the anticoagulant effect and weaken it. Therefore, you cannot be picky about food and the food combinations should be reasonable.

2. Follow-up after rheumatic heart disease surgery: Patients who take anticoagulants after valve replacement surgery are advised to go to the hospital for a blood test once a month to adjust the anticoagulant dosage. The incision after surgery should heal as quickly as possible to avoid wound infection. You should also prevent colds, upper respiratory tract infections, etc.