心脏健康

关于主动脉瓣疾病你需要知道的

作者：滕C. 李,医学博士
专业: 心胸外科手术

According to data from the Alliance for Aging Research, as many as 5.800万美国人 have aortic valve disease – making it an incredibly common form 心脏病的风险，尤其是老年人.

那么，主动脉瓣疾病到底是什么?

Your heart is made up of four chambers – two atria and two ventricles. Oxygenated blood passes from the left ventricle into the aorta, your main 动脉，然后循环到身体的其他部位. 当你的心脏挤压， the aortic valve opens to allow blood to pass through to the aorta. 当 it relaxes, that valve closes to prevent blood from flowing from the aorta 回到心中.
As you’ve probably guessed, Aortic Valve Disease happens when this 结构不能正常运行. 这叫做主动脉反流 when the valve doesn’t close all the way and blood leaks back into 心脏. Or when the valve doesn’t fully open which reduces blood 血流，叫做主动脉狭窄. 因为它们都是机械的 issues of the aortic valve – meaning something isn’t working quite right – they may be managed to a certain extent with medication, 但只能通过手术治疗.

它如何影响我的身体?

当 your aortic valve isn’t functioning properly, your heart has 更努力地将血液输送到心脏. 随着时间的推移， increased effort can result in enlargement of 心脏, which actually reduces its ability to effectively and efficiently circulate blood.

当 left untreated, some common complications caused by this condition include:

心脏衰竭
心律失常（心律失常）
死亡

我有患主动脉瓣疾病的风险吗?

While some aortic valve defects may be congenital, it can also be caused by infection, injury, or, most commonly, the aging process. 事实上，多达八分之一的人 over the age of 75 show signs of moderate-to-severe aortic stenosis.

主动脉瓣疾病的危险因素包括：

超过60岁的
Heart conditions present at birth, like bicuspid aortic valve disease
A history of infections of 心脏, including rheumatic fever and endocarditis
主动脉瓣损伤或损坏
高血压（高血压）

我应该什么时候去看医生?

Because the complications associated with aortic valve disease increase in severity the longer this condition is left untreated, it’s important to see your primary care provider if you’re experiencing any of 出现以下症状：

胸痛或胸闷
感到头晕或昏倒
呼吸急促（气促）
运动后疲劳增加
不正常的心跳
脚和脚踝肿胀

Your doctor will typically listen for an abnormal heart murmur (the sound of blood passing through your valves) using a stethoscope, then refer 你去找心脏病专家做一个明确的诊断.

我的治疗方案是什么?

Aortic valve disease is an issue with your heart mechanics that, while it can be managed with medication and lifestyle modification, requires 手术干预最终固定. 同时打开主动脉瓣置换 or repair surgeries have long been the gold standard in treatment, transcatheter aortic valve 更换 (TAVR) procedure is a promising recent development.

主动脉瓣开放手术是一种心脏直视手术. 尽管它是 certain risks, such as bleeding, arrhythmia, infection, stroke and death, and has a longer recovery time, it’s still the most common form 治疗的最佳长期效果. 事实上，这是一个过程这是我们在买球网站医院经常做的.

In comparison, transcatheter aortic valve 更换 is a minimally invasive procedure in which a catheter is inserted into an artery via a small incision 在胸部或腹股沟. 导管携带一个可折叠的瓣膜通过 the artery to the valve site; once expanded, the new valve pushes the 发生故障的阀瓣分离并接管. 因为它没有 cause as much bodily trauma as open-heart surgery, patients usually feel noticeably better upon waking and are able to leave the hospital within 三天.

However, because the TAVR procedure has only been commercially available in the United States since 2011, 在那里’s not a lot of data on its 长期耐用性. 有一些数据表明，这种需求 for a pacemaker is more common after TAVR than after open aortic valve 更换. Washington Hospital is currently developing a TAVR program, but through the affiliation with UCSF Health, TAVR is now offered by my 我和加州大学旧金山分校的同事.

The decision on valve repair or 更换, as well as which therapy is right for you depends on a number of factors including the severity of your condition, your age and general health, and whether you require surgical intervention to treat related conditions (aortic valve disease is sometimes found alongside coronary artery disease, which requires bypass surgery).

While the idea of surgery may sound scary, not treating your aortic valve 疾病是致命的. A skilled team, like the one we have here at Washington Hospital, can effectively treat your condition through surgical intervention, so you can live a longer, healthier and higher-quality life. 学习 more about Washington Hospital’s Heart and Vascular Program, visit the 买球网站医院网站.

发布于2019年2月

关于腾C. 李,医学博士
腾C. 李,医学博士, FACS, joined UCSF as an Associate Professor of Surgery 在成人心胸外科工作. 他之前是 Co-Director of the Aorta Center at University of Florida. 在此之前， he founded the Center for Aortic Disease at University of Maryland and also started the highly successful Transcatheter Aortic Valve (TAVR) program 在那里. Originally from Singapore, he graduated from Washington University 圣路易斯医学院毕业的. 然后他去做了一个普通手术 residency at Case Western Reserve University in Cleveland where he was 也是Dudley P. Allen Scholar before finishing his cardiothoracic surgery 杜克大学实习医师. He also completed a fellowship in Endovascular/Interventional Radiology at Skåne University Hospital (Lund University) in Malmö, Sweden where he trained under the world-renowned Krassi Ivancev, M.D., Ph.D. and another fellowship in advanced aortic surgery, heart transplantation, 以及杜克大学的机械循环支持系统. Dr. 李是一个 of only a handful of "hybrid" specialists fully cross-trained in both interventional and open surgical techniques for the treatment 复杂的胸主动脉疾病.