Mitral stenosis Treatment
Medication and care for mitral stenosis: appropriate to avoid excessive manual labor and strenuous exercise, the protection of cardiac function; of rheumatic heart disease in patients with streptococcal infection prevention should be actively and rheumatism as well as infective endocarditis.
When clinical symptoms appear, they are advised of oral diuretics and restricted sodium intake. Obvious right heart failure or rapid atrial fibrillation, the use of digitalis preparations can relieve symptoms and control of ventricular rate. Persistent atrial fibrillation for less than one year, and should consider drug treatment or electrical cardioversion. Heart failure with atrial fibrillation on long-term anticoagulant therapy are available to prevent thrombosis and the occurrence of arterial embolization.
The crux of treatment for mitral stenosis include relieved mitral stenosis and reduce inter-valve pressure gradient. Often use surgical treatment are follow:
1. Percutaneous mitral balloon dissection. This is an interventional treatment of cardiac catheterization, the indications for simple mitral stenosis. This method can expand mitral valve area to more than 2.0cm2, significantly reduced cross-mitral valve pressure gradient and left atrial pressure, cardiac index to increase, effective in improving clinical symptoms. Separation of percutaneous balloon mitral valve surgery does not damage the structure, and do not have to thoracotomy, more safety, injury in patients with small, fast recovery, short-term effect has been positive.
2. Mitral dissection. There are two types include closed and open style. Closed is that the application of left ventricular access to the use of expansion methods, the best effect on the membrane type. Indications for surgery in patients with no more than 55 years of age, cardiac function in the 2 to 3, nearly half of the year the activities of non-rheumatoid or infective endocarditis, atrial preoperative examination without thrombosis, without or only mild b mitral valve insufficiency or aortic valve disease and left ventricular not. With pregnancy and surgery are advised to take during pregnancy to less than in June. Of moderate or severe mitral regurgitation; suspected heart room thrombosis; severe valve calcification or tendons significantly reduced in patients with fusion, should be held in open-type separation surgery.
3. Artificial valve replacement. Indications as follows: cardiac function in the 3 ~ 4, with mitral insufficiency and obvious (or aortic valve disease and increased left ventricular; severely calcified valve repair could not be separated; calcified atherosclerotic stenosis caused by tumor. Common mechanical valve or a biological valve. mechanical valve durability, calcification, or infection are not subject to life-long anticoagulant therapy; avoid to use with ulcer disease or bleeding disorders. Biological valve have no use for anticoagulant therapy, but can be failure due to infection of heart valve endocarditis, or calcification of valve or mechanical injury.