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Mitral stenosis- Diagnosis, Treatment
Mitral stenosis- Diagnosis, Treatment
Mitral stenosis - a narrowing of the left atrioventricular orifice. Mitral valve is located between the left atrium and left ventricle. It opens in diastole and in predsedno-ventricular opening into the left ventricle through the mitral valve is free to the arterial blood enters the right atrium. In systole the valve closes when the blood pressure reduction of the left ventricle and prevents backflow of blood from the left ventricle into the left atrium. The valve consists of two wings. In mitral stenosis valve thicken, coalesce with each other, the size of the atrio-ventricular opening is reduced.
The cause of mitral valve stenosis, as well as the majority of acquired heart diseases, rheumatism, is previously transferred in 80% of cases. In the remaining 20% comes from other infectious diseases of the heart, atherosclerosis, cardiac trauma, syphilis, etc. The narrowing of the entrance of the left atrium into the left ventricle causes an increase in left atrial pressure, blood from the pulmonary circulation did not have time to pump the increased pressure in the vessels of the lungs . Due to the increased pressure in the pulmonary vascular spasm arises, and all this leads to increased pressure in the pulmonary artery, which leaves the right ventricle and carries blood to the lungs. Hypertrophied right ventricle of the heart due to increased load. Gradually, his compensatory reserve is exhausted, it expands, the contractile ability of the heart muscle of the right ventricle is reduced. The right ventricle can not pump all the blood from the systemic circulation. Heart failure occurs. The appearance of a patient with mitral stenosis, a long time has not changed. Gradually, there is shortness of breath, palpitations. The patient does not tolerate physical activity. Over time, with an increase of stenosis in a patient appears the so-called "mitral flush" - a bluish-pink color lips and cheeks. If you put a hand to the chest in the heart of the patient, can feel the tremor, the so-called "cat's purring."
Mitral stenosis - Diagnosis
When listening to the heart is determined by the diastolic murmur. The noise occurs when the blood in diastole through the narrowed mitral orifice flows into the ventricle. The noise is enhanced after exercise. On the electrocardiogram are increasing left atrium and right ventricle. Radiologically determined changes in the lungs. On the echocardiogram can see thickening of the mitral valve, the violation of their movement, reducing the size of atrio-ventricular opening, the deposition of calcium salts on the wings of the valve. Sometimes, in an enlarged right atrial thrombus found.
Mitral stenosis - Treatment
Surgical treatment of mitral stenosis. Surgery for the treatment of mitral stenosis were among the first heart surgery. Closed mitral commissurotomy was performed. Fused mitral valve burst or ripped. This is done now. Only in modern conditions it is produced in the so-called "dry" in the heart lung machine. This allows us examine in detail the mitral valve, to assess its condition. If necessary, can be made of plastic valve.
If the valve is damaged significantly, and can not fix it, make this valve prosthesis with an artificial mechanical heart valve. Young patients, especially women, she may be sparing surgery. This is a closed mitral commissurotomy (cutting sutures) or balloon dilation (expansion) stenosed atriventrikulyarnogo holes. The operation is performed through the subclavian artery or the other. Do not open the chest, heart-lung machine is not used.
Mortality in the surgical treatment of stenosis of the mitral valve does not exceed 0.5%. A quarter of patients may experience restenosis (re-stenosis). In this case, producing mitral valve replacement. Mortality for mitral valve replacement is 3-5%. Results of surgical treatment are good.
