{"id":265,"date":"2020-07-22T18:34:48","date_gmt":"2020-07-22T17:34:48","guid":{"rendered":"https:\/\/www.kardiohirurgija.rs\/hirurgija-aortnog-zalistka\/"},"modified":"2020-08-19T23:03:26","modified_gmt":"2020-08-19T22:03:26","slug":"aortic-valve-surgery","status":"publish","type":"page","link":"https:\/\/www.kardiohirurgija.rs\/en\/aortic-valve-surgery\/","title":{"rendered":"Aortic Valve Surgery"},"content":{"rendered":"

[vc_row full_width=”stretch_row” type=”vc_default” css=”.vc_custom_1588624603642{padding-bottom: 50px !important;}”][vc_column][vc_column_text]The aortic valve is a tree-leaflet fibrous tissue structure between the left ventricle and the aorta. The aortic valve opens during the heart contraction, and closes during the relaxation phase, providing unidirectional aortic blood flow.[\/vc_column_text][vc_single_image image=”626″ img_size=”full”][\/vc_column][\/vc_row][vc_row full_width=”stretch_row” type=”vc_default” css=”.vc_custom_1589109156911{padding-bottom: 50px !important;}”][vc_column]

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AORTIC STENOSIS<\/h2><\/div><\/div>[\/vc_column][vc_column width=”1\/2″ css=”.vc_custom_1590678248120{padding-top: 16px !important;}”]

Aortic stenosis is the most common disease of the aortic valve. Tissue degeneration during the years is reducing the valve leaflets’ mobility and therefore leads to stenosis. The myocardium is getting hypertrophic while pumping the blood through a smaller valve orifice. That is why patients are experiencing the long asymptomatic period despite the significant stenosis. Meanwhile, the heart is getting tired end eventually starts to fail. At the time of the symptom\u2019s onset, some degree of the myocardial dysfunction already exists. Presence of the systolic heart murmur on the second left intercostal space and the following symptoms are clinical signs of the aortic stenosis:<\/p>\n

    \n
  • Syncope – sudden loss of consciousness<\/li>\n
  • Chest angina<\/li>\n
  • Heart insufficiency \u2013 effort dyspnea or orthopnea<\/li>\n<\/ul>\n<\/div>[\/vc_column][vc_column width=”1\/2″][vc_single_image image=”590″ img_size=”full” alignment=”center” onclick=”link_image”][\/vc_column][vc_column][vc_column_text]These symptoms are clear signs of advanced aortic valve disease. If not treated, the life expectancy at that point is up to five years, or even less in the presence of heart failure.[\/vc_column_text][\/vc_column][vc_column][vc_row_inner][vc_column_inner]
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    AORTIC VALVE REGURGITATION - INSUFFICIENCY<\/h2><\/div><\/div>[\/vc_column_inner][vc_column_inner width=”1\/2″][vc_column_text]Aortic valve insufficiency or regurgitation is a valve inability to close properly. \u00a0Blood regurgitate from the aorta back into the heart, resulting in left ventricle overload, dilatation, and eventually failure. The aortic regurgitation could be isolated or present altogether with the ascending aorta dilatation or aneurism. Surgery is a treatment of chaise and gold standard as well. A faulty valve could be replaced or even better repaired if possible.[\/vc_column_text][\/vc_column_inner][vc_column_inner width=”1\/2″][vc_column_text]The new onset of the aortic insufficiency accompanied by a fever is highly suspicious of valve infection.\u00a0 That is bacterial endocarditis, \u00a0a severe condition that requires hospitalization, antibiotics, and valve replacement eventually. Acute aortic regurgitation accompanied by severe chest pain, the patient probably has an aortic dissection. That is a medical emergency that requires immediate surgery to prevent the fatal aortic rupture.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row full_width=”stretch_row” type=”vc_default” css=”.vc_custom_1588627120952{padding-bottom: 50px !important;}”][vc_column][vc_raw_html]JTNDc3BhbiUyMGlkJTNEJTIyemFtZW5hJTIyJTIwc3R5bGUlM0QlMjJwb3NpdGlvbiUzQSUyMHJlbGF0aXZlJTNCJTIwdG9wJTNBJTIwLTEwMHB4JTNCJTIyJTNFJTNDJTJGc3BhbiUzRQ==[\/vc_raw_html]
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    AORTIC VALVE REPLACEMENT<\/h2><\/div><\/div>[\/vc_column][vc_column width=”1\/2″][vc_column_text]Heart valve diseases are the real mechanical problem, and therefore the surgery is the only option. Valve could be replaced with either mechanical or biological prosthesis. Mechanical ones have unlimited durability but demand lifetime anticoagulation therapy. The biological prosthesis is tissue valves and, therefore, less durable, but lifetime anticoagulation therapy is unnecessary. Medical treatment is only symptomatic and could not affect the condition itself.<\/p>\n

    The most reasonable and practical surgical option in aortic valve disease is the reconstructive surgery, if possible. It is almost impossible to repair aortic valve stenosis. Reconstructive surgery, therefore, is performed mainly for the aortic insufficiency.[\/vc_column_text][\/vc_column][vc_column width=”1\/2″][vc_single_image image=”359″ img_size=”500×345″ alignment=”center”][\/vc_column][vc_column][vc_column_text css=”.vc_custom_1589131925328{margin-top: 20px !important;}”]Visoko rizi\u010dni bolesici sa obolelim aortnim zalistkom \u010desto imaju neprihvatljiv operativni rizik. Terapijska opcija za ove bolesnike je interventna procedura ugradnje aortnog zalistka. To je ugradnja zalistka putem posebnog sistema \u017eica i katetera koja uglavnom ne zahteva ve\u0107u hirur\u0161ku intervenciju, TAVI procedura. Mana ove procedure je visoka smrtnost i visok nivo komplikacija. U na\u0161oj zemlji ova procedura se jo\u0161 uvek ne primenjuje.[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column]

    <\/div>

    TAVI<\/h2><\/div><\/div>[\/vc_column][vc_column width=”7\/12″][vc_column_text]TAVI\u00a0 or transcatheter Aortic Valve Implantation is a procedure of transcatheter aortic valve replacement. Catheters are placed through the femoral artery and introduced into the heart. We have to dilate the valve with a balloon first and, after that to introduce and implant new tissue prosthesis. \u00a0\u00a0TAVI is a treatment of choice for older and high-risk patients with aortic stenosis. Good results in this high-risk group encourage TAVI in intermediate-risk patients.[\/vc_column_text][\/vc_column][vc_column width=”5\/12″][vc_video link=”https:\/\/www.youtube.com\/watch?v=9Bwotibp5QM”][\/vc_column][\/vc_row]<\/p>\n","protected":false},"excerpt":{"rendered":"

    [vc_row full_width=”stretch_row” type=”vc_default” css=”.vc_custom_1588624603642{padding-bottom: 50px !important;}”][vc_column][vc_column_text]The aortic valve is a tree-leaflet fibrous tissue structure between the left ventricle and the aorta. 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