Treatment Of Heart Disease - Surgery |
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SurgeryThree sorts of - heart disease may be treated surgically: congenital defects, valve disease and coronary disease. (Rhythm disturbances may also times be treated surgically and this includes the use of pacemakers.) Most heart surgery is carried out with the heart's pumping action stopped and often with the heart opened; this requires the use of an artificial pump and usually artificial lungs as well, a so-called heart-lung machine. This technique is called cardiopulmonary bypass but is often loosely referred to as 'open heart' surgery, and is naturally a major undertaking. A few less severe surgical procedures may be undertaken without the use of cardiopulmonary bypass; this is called 'closed heart' surgery. The repair of congenital heart defects The common congenital heart defects are those of the septum which separates the atria or the ventricles, and ductus artenbsus (when a blood vessel carrying blood from the pulmonary artery to the aorta of an unborn child does not close after birth), and all may be totally cured by surgery. Risks are very small and the surgery is easily carried out in childhood. Small defects may be left unrepaired, but large defects could cause trouble later and may shorten life, even though they may cause no, symptoms early in life.More complex defects such as ventricular septa defect plus pulmonary valve stenosis, and transposition, may also be treated. Frequently, one of the major problems is inadequate blood flow to the lungs. Here, closed heart surgery may be used to divert some of the blood to the lungs from the left heart. 'Total correction' of these defects, in the sense of restoring a normal pattern of blood flow, is often very complex, and requires open heart surgery with its accompanying risks. These operations rarely completely cure the person. Valve repair and replacement Narrowing (stenosis) of the pulmonary and mitral valves can sometimes be dealt with satisfactorily without the need for valve replacement, and the narrowing can be widened by the use of closed heart techniques. Any of the heart valves, but usually the aortic and mitral valves, may be replaced using open heart surgery. Valves may be replaced by man-made (prosthetic) valves or by biological valves taken from cadavers or animals. Each has its own advantages and disadvantages. Prosthetic valve insertion is relatively simple and its valve functions are fairly red, but it is fairly noisy and the use of coagulant drugs is required to prevent blood clots forming on the valve. Biological valves are more cult to insert, but they are silent in operation and usually do not need anticoagulants. All valves are fairly reliable nowadays although, on the whole, biological valves are less likely to fail suddenly. There no rejection problem with these biological valves as they are treated beforehand to make rejection by the body impossible, and man-made valves are made of material that the body will not reject. |
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