Rheumatic Valve Disease causes valve stenosis and leaks. These are quite commonly seen in India. Apart from these there are situations in which valves get infected due to some other severe untreated infections elsewhere in the body. This condition is known as Infective Endocarditis.
Rheumatic Valve Repairs:
In young patients with Rhd, some of the valve tissues are severely damaged and many centers prefer to replace their valves. We believe in repairing most of the valve.
Preoperative assessment using a 3D echocardiogram is done and complete planning for the repair is tried in all patients to check if the valve anatomy is suitable. We use pericardial tissues, Goretex sutures, and prosthetic rings for the repair. In certain situations, even the calcified portions of the valve are removed and reconstruction was done with the pericardium. Even aortic valve reconstruction and repairs are done in young patients using pericardium.
This is a situation in which the valve tissue is damaged and many centers prefer to do valve replacements. We do repairs in such situations by reconstruction with pericardium of even half of the valve. The results of such reconstruction are excellent and patients can lead a near-normal life if the infection is eliminated. If such patients undergo valve replacements they have a very high chance of recurring infections.
Valve Replacements :
In situations where the valves have been severely damaged due to RHD and other alternatives might not work or in case of calcification disease, we go for replacements. We usually use bioprosthetic valves as replacements as they give a better quality of life.
All these valve surgeries are done mostly by minimally invasive techniques called MICS (Minimally Invasive Cardiac Surgery ).