Valvulopathies: what are heart valve diseases?

“We have four valves in the heart: the mitral valve, the aortic valve, the tricuspid valve and the pulmonary valve. These heart valves are valves that open and close to separate the heart chamber and allow blood to pass. , always in the same direction. They are made of a resistant but very fine fabric, a bit like the canvas of a sail of a boat “ explains Prof. Geneviève Derumeaux, cardiologist at the Henri Mondor Hospital Center (Créteil).

This fabric is flexible enough to allow permanent movement, but it is not foolproof. Sometimes, the valve no longer manages to open sufficiently to allow blood to pass or, conversely, its closure is no longer airtight, which results in blood leaks (or regurgitation). These dysfunctions are called valve disease.

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What are the causes of valve disease?

Heart valve disease can have several causes. Most of these heart valve diseases appear with age, diabetes, obesity or even smoking. Today, they affect 2% of the general population “specifies Professor Geneviève Derumeaux. But due to the aging of the population, it is estimated that 2.8 million people will be affected by 2040.

These valve diseases have also struck a number of patients. who took the pick, a drug originally intended for type 2 diabetic patients but was widely prescribed as an appetite suppressant before it was withdrawn from the market in 2009. The aortic or mitral valves of these patients lost their flexibility and stiffened.

What are the main diseases of the heart valves?

Heart valves can present two main types of dysfunction:

• Valvular insufficiency (or leak): in this case, the valve is no longer tight, which results in a reflux of the blood towards the atrium or the ventricle.
• Valve stenosis (or narrowing): in this case, the opening of the valve is insufficient, which slows down the passage of blood from one cavity to another.

The most common valve disease is aortic stenosis, also called aortic stenosis. Over the years, the stiffening causes a narrowing that hinders the passage of blood and ends up putting life in danger.

What are the symptoms of heart valve disease?

“The first warning sign it’s shortness of breath. Shortness of breath on exertion and then at rest. There may also be great fatigue or palpitations “explains the cardiologist. But since these symptoms are not specific to heart valve disease, it is important to regularly ask your doctor to listen to the heartbeat through a stethoscope.

Sometimes the doctor will detect an abnormal noise called a “murmur”. He then sends the patient to the cardiologist who will confirm the diagnosis. with an ultrasound of the heart.

What are the treatments for heart valve disease?

“If the ultrasound shows that some heart valves are no longer tight, we will quantify the blood leak. If it is minimal, a follow-up by a cardiologist every 3 years is sufficient. If the leak is moderate, we put in place a treatment to help the heart work better. Then, we see if the heart is functioning normally or if the leak is preventing its proper functioning and fatigue “ Geneviève Derumeaux.

But since the diagnosis of valve disease is often late, the treatment is most often surgical. This consists of either repairing the faulty valve or replacing it with a mechanical or biological prosthesis.

• Mechanical prosthesis is made of titanium or carbon. It is in theory indestructible but requires the taking of a anticoagulation treatment for life.
• The biological prosthesis (or bioprosthesis) is made of pig or bovine tissue. As it degrades over time (it begins to deteriorate in the 5th year considers the High Authority for Health), it is sometimes necessary to have the operation again. but it does not require taking anticoagulant therapy.

The choice of one or the other prosthesis is made according to the patient’s profile, the seriousness of his pathology, his lifestyle …

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