Features of surgery for heart defects and indications for interventions

0
2017.06.26
735
Heart diseases

Heart disease is a life-threatening violation of the anatomical structure of the heart. The reasons for the emergence of this pathology are different and they act even before the birth of a person or after. However, always a vice leads to a disruption in the process of pumping blood. In the future, this causes a stagnation of blood in the vessels and hypoxia. Due to the fact that it is impossible to treat cardiac damage of a structural nature medically, the operation becomes the most effective solution.

Content

  • The need for heart surgery
  • Complications of refusal of surgery
  • Types of heart interventions
    • Types of operations with AMS
  • Postoperative period
  • Recovery
  • Cost of operation

The need for heart surgery

If you do not get rid of the lesion, the walls of the heart chambers, valves and vessels will suffer. Therefore, surgical operation is necessary, because heart disease is not a disease that can be treated carelessly. And if an adult rejects a heart problem, then this is his conscious choice, which will inevitably lead to death.

A completely different picture with newborn children. Their problems are of an innate nature. Congenital heart diseases (CHD) in 60% of cases are detected in children no older than 14 years. And if in the first year of life the operation is not performed, 70% of these children die.

Surgical surgery is what requires congenital heart disease immediately, immediately after detection. This will avoid the development of the disease and further complications.

The postponement of the intervention is justified if the patient does not have enough strength to cope with its consequences. In this case, it is decided to wait until the child grows up to the point where his body can fight for his life.

.

In cardiosurgery, the phases of primary adaptation and compensation are identified. The child in this state is stable and therefore this period becomes an appropriate moment for performing the surgical intervention.

.

Complexity of heart defects is very clearly manifested in the phase of decompensation. In this condition, the person begins irreversible changes, serious complications arise, the degeneration of internal organs and heart develops.

Child after heart surgery

Complications of refusal of surgery

If a sick person does not undergo surgery, this will cause huge complications in the future. People who abandoned surgery suffer from a lack of blood supply to the lungs and the brain and their consequences.

Heart problems:

  • heart failure is periodically exacerbated;
  • the conduction and rhythm of the heart is disturbed;
  • there is a septic endocarditis, chronic rheumatic carditis.

Problems with breathing:

  • vulnerability to colds;
  • complications in the form of chronic bronchitis and pneumonia;
  • pulmonary edema.

Problems with the central nervous system:

  • abscesses in the brain tissue;
  • hypoxia
  • hemorrhages in the cerebral cortex;
  • risk of thromboembolism.

That's how many health problems can there be if you do not go for surgery. Therefore, it is especially important to remove severe heart defects in infancy.

Heart surgery

Types of heart interventions

For each specific damage, you select your type of intervention. The choice is made by a cardiac surgeon, and it depends on several factors:

  • a type of damage;
  • the degree of defects of blood vessels and heart chambers.

Today special cardiosurgical and vascular centers operate in the country. In them, with the help of high-tech equipment, operations are performed on the unbreakable heart. The patient undergoes hypothermia and is connected to the apparatus of artificial circulation. As a result, the intervention is carried out accurately and quickly, risks are minimized.

Each intervention is carried out in different ways:

  1. The doctor bandages, and then crosses the unnecessary vessel. Thus, the open arterial duct is eliminated.
  2. Elimination of damage to the interatrial or interventricular septum. To do this, you will first need to sew the septum, and then hold the plastic tissue and apply a patch.
  3. Stenosis of the aortic orifice is removed as follows. With the help of stents dilate the narrowed vessels or the narrow portion of the vessel is removed.
  4. If the positions of the diverting arteries are violated, the vessels move, correcting the localization.
  5. Problems with valves are solved by replacing them. For this, homotransplants or artificial analogs are used.
  6. In the case where stenosis of valves and atrioventicular apertures is noted, commisurotomy is indicated. To prevent re-splicing, install an expansion ring.

There are two types of prosthetic heart valves:

  1. Mechanical. They are made of metal or synthetic materials. There are two- and one-leaf. The term of their service is 50 years, but constant reception of anticoagulants for prophylaxis of thromboses is required.
  2. Biological. This type is made of human or porcine fabrics. After about 12 years they need to be replaced because of the loss of elasticity. It is recommended to use for the elderly, and those who are unable for some reason to take anticoagulants.
.

With artificial valves, it becomes necessary to constantly take medications that dilute the blood. Gomotransplants require the use of cytostatics, which will not allow the body to reject tissues.

.

If the vice turned out to be combined and complicated, it may require a second heart operation. But the time after the primary operation should be at least several months, perhaps a year.

Types of operations with AMS

Surgical actions are divided into three types:

  1. Open. The surgeon opens the heart cavity and performs the necessary manipulations. Such work is carried out under general anesthesia. Pulmonary and cardiac activity stops, and the patient is connected to the apparatus of artificial circulation.
  2. Closed. The heart cavity remains closed. All manipulations go beyond the heart zone and do not touch the heart itself. Using the eye of the left atrium, placing a seam on it, the doctor enters the heart area. The main thing before beginning is to make sure there are no thrombi.
  3. X-ray surgical. A new highly successful method that is gaining popularity. The doctor with a thin catheter, at the ends of which fixed special mechanisms resembling umbrellas or cans, gets through the vessels into the heart cavity. There they expand, closing the lumen of the septum or opening the heart valve damaged by stenosis. This is an effective and low-traumatic method for performing heart surgery. In addition, it is successfully used in combination with others.

Each of the three ways best deals with certain types of violations. However, the ability to combine the two methods together with the new X-ray surgical method opens the way to a new and better quality type of surgery.

Conditions for heart surgery

Postoperative period

After the intervention, the patient should be monitored. Therefore, he is placed in the intensive care unit, where he is monitored by hemodynamics. For this patient connect to a continuous monitor. This allows you to monitor the frequency of heartbeat, breathing, blood pressure.

To prevent the patient from experiencing pain after the operation, analgesics are administered to him. Breathing is facilitated with the help of an oxygen mask. Nutrient solution, vitamins, antibacterial drugs that prevent postoperative pneumonia, are injected into the patient with a subclavian catheter.

Depending on the patient's condition, the doctor assigns him a certain regimen. He determines how and under what conditions rehabilitation should take place.

In the usual situation, the stitches are removed after 10 days. To respiratory gymnastics begin after 3 days. If a mechanical valve was installed in the heart, anticoagulants of indirect action are prescribed.

.

People who are discharged from the hospital need to check prothrombin at least once a month. In order not to increase the coagulability of blood, you need to exclude from your diet products containing vitamin K.

.

Such products include:

  • green tea;
  • coffee;
  • spinach;
  • beans;
  • leaf salad;
  • cheese;
  • cabbage.

Avoiding these products will speed recovery.

Operation

Recovery

How quickly will a man recover? Time for this in each case requires different. On average, both adults and children require 3 to 6 months to restore the heart.

In the first 3 months it is strictly forbidden to lift weights, drive a car, jostle and the like. In these months, the bone tissue of the sternum fuses, and any heavy load can seriously harm this.

Ordinary work on the house is allowed to begin after this period. Completely health will be restored in about six months. This is provided that all the prescriptions of the doctor were carried out rigorously.

Cost of operation

The person who required such a procedure, sooner or later, wonders how much it will cost him? How much money does it take and what does the price depend on?

The cost of surgical intervention depends on several factors:

  • workload;
  • name and fame of the doctor, clinic;
  • patient status.

With this in mind, approximate price tags for certain operations for eliminating heart disease have been developed:

  1. About a quarter of a million dollars will be needed for a heart transplant. An alternative may be a free transfer, which takes place in the order of the queue. Because these queues are rather big, there is a risk not to live up to the right moment.
  2. From 500 to 3 thousand dollars will be required to eliminate defects in the partitions of the heart. Replacement and plastic valves is included in this category. The price of heart surgery varies because of the factors listed above.
  3. A low-invasive intervention has a relatively low cost, which depends on the same factors.

Based on all of the above, you can draw an approximate picture of what is happening in the market of medical services in this area. The picture is not very bright, not everyone can cope with such rates for the operation. The only way out is to collect the necessary documents and get the state quota.

.

Especially the price bites, if the heart disease is serious, and the intervention of a well-known doctor working in a prestigious clinic is required. In this case, the price can grow twice, or even more.

.

Do not be careless in relation to health. Such negligence combined with serious heart disease is the direct way to death. In the best case, it will be quick and relatively painless. In the worst person expect strong pain for a long time. To avoid such a fate, it is enough not to be lazy and go to the hospital if you feel unwell.

.. .