Prognosis of valvular heart disease
There is currently no pharmacological treatment to halt the progression of valvular heart disease and the deterioration this causes in heart function. Most medications are intended to treat symptoms and prevent the emergence of other complications like endocarditis and embolisms. Only surgery and other invasive procedures that act directly on the function of the heart valves, modify this progression and have the ability to make the heart function normally again. This is why early diagnosis and follow-up of patients with heart valve disorders is so important, so that they can be operated on at the optimum time. Timely surgery avoids irreversible damage and serious complications, and can be performed with the lowest risk of complications for the patient.
Acute complications
After a surgical or percutaneous operation on the heart valves, as in any medical procedure, there is the risk of an adverse event. Most of these are minor complications with no consequences. Complications depend largely on the specific procedure performed and the patient’s state of health.
Cardiac arrhythmia. This is one of the most frequent complications after a valve operation, with atrial fibrillation and cardiac blocks being the most common. They are usually transitory and resolved with pharmacological treatment, although they may increase the length of the hospital stay and, in some cases, require further invasive procedures, such as the implantation of a pacemaker.
Serious complications or post-operative mortality. The risk of serious complications or death after surgery is generally very low and there are tools available to measure this risk prior to surgery as well as use this information when making decisions and selecting the best treatment for patients.
Chronic complications
In the long term, after valve surgery, complications and new situations may arise that require treatment. These are predictable and are detected during the routine follow-up that all patients receive.
Complications from the disease itself. With time, rheumatic valve disease may affect other heart valves that were working properly at the time of the first surgery.
Complications from the treatment. This includes the degeneration of biological prostheses that, some years after being implanted, may require further surgery due to their progressive dysfunction.
Infective endocarditis. This is a serious infection of the heart valves that all patients with valvular disorders or valve implants have a higher risk of contracting. For this reason, it is essential that patients are careful about maintaining their oral health and undergo adequate antibiotic prophylaxis before any dental.
Thromboembolic complications. Many valvular heart diseases increase the risk of thromboembolic complications for various reasons, including the alteration of the diseased valve itself, the appearance of atrial fibrillation (the most frequent arrhythmia in these patients), and the presence of valve prostheses, mainly mechanical. For these reasons, many patients are treated with oral anticoagulants (Sintrom® is the most commonly used), which reduce the risk of experiencing these types of complications.
Substantiated information by:
Published: 23 January 2020
Updated: 23 January 2020
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