Valvular and Ischaemic heart disease- therapy Flashcards
(13 cards)
What are the main surgical techniques for ischaemic heart disease (IHD)?
CABG: A new path is made around blocked heart arteries using another blood vessel.
Off-pump CABG: Same as above but done without stopping the heart.
MIDCAB: A smaller version of CABG done through a smaller chest cut.
Laser treatment (TMR): Creates small holes in the heart to improve blood flow.
What problems can happen after heart artery surgery?
Heart attack
Stroke
Bleeding
Irregular heartbeats
Infection in the chest
Kidney issues
Graft (bypass) can get blocked again
What surgeries fix those problems if they happen?
Surgery again if there’s bleeding
Another bypass if the graft blocks
Pacemaker if the heart beats too slow
Special pump (IABP) if the heart can’t pump well
Drain fluid if pressure builds up around the heart
Which heart valve problems can be treated with surgery?
Aortic stenosis (narrow valve)
Aortic regurgitation (leaky valve)
Mitral regurgitation
Mitral stenosis (less common, sometimes treated with a balloon instead)
When do doctors decide to replace a heart valve?
When symptoms like shortness of breath or chest pain start
If the heart muscle gets weak
If the heart is getting bigger
If there are clots or infection on the valve
If the valve is stiff or very leaky
What kinds of new valves can be used?
Mechanical valves: Made from metal or plastic
Bioprosthetic valves: Made from animal or human tissue
What’s good and bad about mechanical valves?
✅ Last a long time (over 20 years)
❌ Need blood thinners forever (like warfarin)
❌ Can cause clots if not careful
What’s good and bad about tissue (bioprosthetic) valves?
✅ No need for long-term blood thinners
✅ Good for older or high-risk patients
❌ Don’t last as long (10–15 years)
What can go wrong after valve surgery?
Bleeding, stroke, irregular heartbeats, infection
Later problems (months or years):
Valve wear-out (esp. tissue valves)
Infection of the new valve
Clots
Blood cell damage
Valve leak
How do doctors treat infective endocarditis (infection of the heart valve)?
Strong IV antibiotics for weeks
Blood tests to find the right antibiotic
Check for signs the infection is spreading
When do you need surgery for infective endocarditis?
If the valve is badly damaged and causes heart failure
If infection won’t go away with antibiotics
If infection spreads or causes strokes
If it’s caused by a fungus
If there are large infected clumps (vegetations)
Why are blood thinners used after valve surgery?
Mechanical valves: Always need them for life
Tissue valves: Sometimes just for the first few months
Goal: To stop dangerous blood clots
