Valve diseases

One or other of the one-way valves in the heart may become diseased so that it does not fully open (stenosis) or does not fully close (regurgitation or incompetence). The heart has to pump harder to eject blood trough a stenosed valve, or it has to pump twice as much blood out if half of it leaks back. Ultimately if the extra work gets too great, the heart may not be able to cope and heart failure results. Valves may become disease by scarring from a long-forgotten attack of rheumatic fever or because of a congenital abnormality of a valve which may not cause problems until late in life. Rheumatic fever has recently increased in Mediterranean countries, especially  in Northern Africa ones.

            The development of open-heart surgery has dramatically changed the outlook for those whose valves have been scarred or deformed.

Vlves may be biological or mechanical. If biological they may be made from bovine or porcine pericardium, or aortic valves (xenograft). The mechanical valves consist of an orifice surrounded by a sewing ring and filled with an occluder. The occluder may be a ball, a tilting disc or two leaflets.


Main models of artificial valve


Autograft (pulmonary to aortic switch

Homograft (human cadaver aortic valve)

Xenograft porcine, such as Carpentier-Edwards, Hancock intact

Unstended porcine, such as Carpentier-Edwards, Hancock. Intact

Unstented porcine, such as Edwards Prima, St Jude Totonto

Bovine pericardial, for exampleMitral Medical, Baxter 


Caged ball, for example, Starr-Edwards

Caged disk (withdraun), for example, Beall

Caged disc (withdrawn), for example Beall

Tlting disc, for axample, Bjork-Shiley, Medtronic Hall, Omnicarbon, Omniscience, Sorin monostrut

Bleaflet, i.e: St. Jude Medical, Carbomedics, Jyros


Anyone with an abnormality of a heart valve should take antibiotics shortly before surgery or any kind of endoscopy. Antibiotics need also before dental treatment because bacteria introduced into the blood can settle on a weal valve. Infection of a heart valve is called endocarditis

Echocardiography assesses the following aspects of an artificial valve:

q       Imaging

q       Forward flow

q       Regurgitation

q       Complications (thrombus, endocarditis, valve abscess)

q       The rest of the heart

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