تعريف

This is surgery to replace a damaged heart valve. The heart’s four valves open and tightly close. The tricuspid and mitral valves allow blood to flow from one chamber to another. The pulmonary and aortic valves allow blood to flow to the large blood vessels. The valves make it so that blood can only flow forward when the heart squeezes. Usually, only one valve is replaced at a time. But, at times, one or more valves may need to be replaced. The new heart valves can be:

  • Mechanical, made of metal and plastic, such as a St. Jude valve
  • Made of tissue—most commonly from a pig or a cow, but they may also be supplied by a human donor or even made from your own tissue

استبدال صمام القلب

أسباب هذا الإجراء

This procedure is done to repair a valve that is not functioning properly due to:

  • العيوب الخلقية
  • Narrowed, stiff valves that obstruct the free flow of blood
  • Loose, leaky valves that allow blood to flow the wrong way through the heart
  • Infected heart valves

المضاعفات المحتملة

If you are planning to have heart valve replacement, your doctor will review a list of possible complications, which may include:

  • العدوى
  • Blood clots forming around the valve, which can cause a stroke,, myocardial infarction, kidney damage, or damage to the extremities
  • New valve does not work properly
  • نزيف
  • المشاكل المتعلقة بالتخدير
  • موت

بعض العوامل التي قد تزيد من خطر المضاعفات تشمل:

  • التدخين
  • Pre-existing heart or lung condition
  • زيادة العمر
  • Recent or long-term illness
  • Recent infection

ما يمكن توقعه

قبل الإجراء

قد يقوم طبيبك بما يلي:

  • اختبار بدني
  • Echocardiogram —a test that uses sound waves to visualize functioning of the heart, including the valves
  • X-ray —a test that uses radiation to take a picture of structures inside the body
  • Electrocardiogram (ECG, EKG)—a test that records the heart’s activity by measuring electrical currents through the heart muscle
  • Cardiac catheterization —the insertion of a tube-like instrument into the heart through an artery to detect problems with the heart and its blood supply. It can also accurately define the valve problem.

المؤدية إلى الإجراء الخاص بك:

  • If you had to stop medicines before the procedure, ask your doctor when you can start again. Medicines often stopped include:
    • الأدوية المضادة للالتهابات
    • مميعات الدم
  • رتب لتوصيلة من وإلى المستشفى.
  • رتبي للحصول على المساعدة في المنزل بعد الجراحة.
  • تناول وجبة خفيفة في الليلة السابقة للجراحة. لا تأكل أو تشرب أي شيء بعد منتصف الليل.

التخدير

General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV.

وصف الإجراء

The doctor will cut through the skin and breastbone. The chest cavity will be opened. Next, your heart will be connected to a heart-lung machine. This machine will take over the functions of the heart and lungs during the surgery. Next, the heart will be stopped. An incision will be made and the damaged valve will be removed. The new valve will be stitched into place. The doctor will check to make sure the valve opens and closes properly. The incision in the heart will be closed, and the heart will be restarted. After the heart is working fine, you will be removed from the heart-lung machine. The chest will be closed with wires. Lastly, the skin will be closed with sutures.

مباشرة بعد الإجراء

You will be closely monitored in the intensive care unit (ICU) with the help of the following devices:

  • A heart monitor
  • A breathing tube—until you can breathe on your own
  • Chest tubes—to drain accumulated fluids from the chest
  • A line into an artery in your arm or leg—to measure pressure
  • A tube through your nose and into the stomach—to keep the stomach drained of accumulated fluids and gas
  • An IV to deliver fluids and medications
  • A bladder catheter

كم من الوقت سيستغرق ؟

3-5 hours—depending on how many valves need to be replaced

كم هو مؤلم ؟

You will have pain while recovering. Your doctor will give you pain medicine.

متوسط ​​الإقامة في المستشفى

This procedure is done in a hospital setting. The usual length of stay is 2-5 days. The first day is spent in ICU. Your doctor may choose to keep you longer if complications occur.

رعاية ما بعد العملية

في المستشفى

While you are recovering at the hospital, you may be instructed to:

  • Breathe deeply and cough 10-20 times every hour to help keep your lungs working well.
  • Walk with assistance. You may be encouraged to walk 2-3 days after surgery.
  • Take blood thinners to prevent blood clots from forming around the valve. If you have a tissue valve, you will not need a blood thinner. If you have a mechanical valve, you will have to take the medicine for the rest of your life.

في البيت

عندما انت العودة إلى المنزل، قم بما يلي للمساعدة في ضمان التعافي السلس:

  • Gradually resume your regular diet.
  • Work with a physical therapist.
  • اسأل طبيبك حول, عندما هي آمنة للاستحمام, السباحة, أو نقع في الماء.
  • تأكد من اتباع تعليمات طبيبك.

The surgical site in your breastbone will heal in 4-6 weeks. After the recovery process, you should be able to return to normal activities.

استدعاء الطبيب

بعد مغادرة المستشفى، اتصل بطبيبك في حالة حدوث أي مما يلي:

  • علامات الإصابة, بما في ذلك حمى وقشعريرة
  • احمرار أو تورم أو ألم متزايد أو نزيف مفرط أو إفرازات من موقع الشق
  • الغثيان و / أو القيء الذي لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك بعد الجراحة ، أو التي تستمر لأكثر من يومين بعد الخروج من المستشفى
  • ألم لا يمكنك السيطرة عليه بالأدوية التي أعطيت لك
  • السعال، ضيق التنفس، أو ألم في الصدر
  • سعال الدم
  • سرعة دقات القلب
  • Sudden headache or feeling faint
  • Problems with vision or speaking
  • Numbness or weakness on one side of your body
  • Inability to urinate
  • ألم أو حرقة أو إلحاح أو كثرة التبول أو نزيف مستمر في البول
  • ألم و/أو تورم في قدميك، أو ساقيك، أو ساقيك

في حالة الطوارئ ، اتصل على المساعدة الطبية على الفور.

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