Chapter 2138： 【2138】Decide by yourself

Chapter 2138 [2138] It is up to you to decide

In view of this, it is impossible to say that the preoperative factor that the doctor did not take into account the patient's own physical needs cannot exist.

The first surgeon gave this patient a mechanical valve for only one reason: there was no other choice.

Bioprosthetic valve is more expensive, and patients can afford it, but unfortunately the patient may not be able to accept it. It's like buying an expensive piece of clothing, if it doesn't suit you, it doesn't suit you, no matter how expensive it is. Once again, it shows that the disease treats people regardless of whether the patient is poor or rich.

The compatibility of biological valves is much better than that of mechanical valves, and the postoperative anticoagulant drug is only required to be taken for half a year, which has advantages over mechanical valves in this respect. Friendly to women who want to get pregnant. The problem is that the production process of biological valves is subject to physical limitations such as material science, and the finished products are often not as good as mechanical valves, resulting in limited use conditions.

The simplest example, when the aortic root of the patient in front of him is too thin to less than 19 mm in diameter, to fit such a small-diameter valve, only a mechanical valve can do it perfectly. If the bioprosthesis can achieve the same size of less than 19 mm in diameter, there will be fewer manufacturers with such a manufacturing process, and the range of patients and doctors who want to carefully select the best products will become smaller. Not only that, even if the size of less than 19 mm can be placed in the original caliber of the mitral valve, the effective valve area of ​​the biological valve is much smaller than that of the mechanical valve.

What a valve really plays a key role in the human heart is the effective use area of ​​the valve rather than others. Specifically, it refers to the leaflet area of ​​the valve except for the opening and closing joints.

What are the advantages of having a large effective area of ​​the valve? The valve leaflets work every day to withstand the impact of blood flow from the heart and large blood vessels.

When the valve leaflets are closed, the large-area valve leaflets are closed tightly, and can withstand the huge blood flow impact like a solid large-volume dam.

The hemodynamics when the valve leaflets are opened is more important. At this moment, the blood flow is rushing out of the heart to nourish other organs of the whole body. The best effect should be the opening of the dam to release the flood. The effective area of ​​the valve leaflet is large, and the gate is opened wide enough, the blood flow in the heart like stored in a reservoir can be expelled for a thousand miles, avoiding the residual in the heart and increasing the burden on the heart, and at the same time, it will not cause insufficient blood flow and nutrition in other organs of the body.

What if the effective area of ​​the valve is not enough? From the above principles, it can be inferred that in clinical practice, valve insufficiency and valve stenosis lead to various symptoms of the body.

The human heart has a total of four valves.

Among them, the mitral valve and the aortic valve are on the left atrium and left ventricle, and they bear the hemodynamic pressure of the systemic circulation. some.

Compared with the aortic valve, the mitral valve is more important and prone to failure, because it is located between the left atrium and the left ventricle, at the root of the aorta. The large diameter of the site results in less room for valve models to choose from.

Right now, what the chief surgeon said is not very good. Combined with what Zhang said, it should be that the doctor opened the patient's heart and looked at it during the operation: Oh, this patient's physical structure is not good, and it is estimated that the only way to replace the mechanical valve is to replace it.

(end of this chapter)