Cardiovascular Surgery

What ıs atrıal septal defect (asd)?

Atrial septal defect, or ASD for short, is a hole in the heart, inside the heart and between the atria. It is one of the congenital heart diseases. A normal heart does not have such a hole. The width of this hole may shrink over time, close on its own or remain the same for years without any change.

What are the causes of atrıal septal defect?

Congenital heart defects usually have no clear cause. Although it is known that these diseases are caused by defects in the early stages of the heart’s development, some genetic and environmental factors may also play a role in the formation of these defects. Approximately 10 percent of congenital heart problems are caused by specific genetic/familial defects.

What are the symptoms of atrıal septal defect?

Many babies born with atrial septal defects may have no signs or symptoms. On examination, abnormal heart sounds called murmurs can be heard in some babies. In some patients, symptoms and signs related to advanced disease may begin in adulthood. While some patients are diagnosed when the right side of the heart is seen to be larger than normal on a chest x-ray taken as a result of another complaint, some patients are diagnosed incidentally on echocardiography performed for other reasons.

Atrial septal defect complaints and examination findings that can be seen in patients are as follows:

• Rapid fatigue, tiredness, feeling of exhaustion
• Shortness of breath, especially when exercising
• Palpitations
• Swelling in the legs, feet or abdomen
• Fainting
• Headache, migraine attacks
• Paralysis, loss of strength in arms and legs, speech and vision problems
• Heart murmur (murmur), a buzzing sound that can be heard through a stethoscope

How ıs atrıal septal defect (ASD) diagnosed?

Hearing a heart murmur during a follow-up examination raises suspicion of the presence of an atrial septal defect or another heart defect. Some tests can be performed to identify the suspected heart defect. These tests are as follows:

Echocardiography (Heart Ultrasound)

It was the most commonly used test for the diagnosis of atrial septal defect. An image of the heart is created with sound waves. The chambers of the heart are visualized and checked for holes, the heart valves are visualized and their function is checked and the pumping power of the heart is measured. It gives detailed information about the heart. Sometimes a heart ultrasound (TEE) can be performed with a device swallowed through the esophagus to get more information about the hole.

This procedure does not harm the patient and can be performed easily.

Electrocardiogram (ECG)

This test records the electrical activity of the heart. It reveals whether the heart chambers are enlarged or whether there are heart rhythm problems.

Chest X-ray (chest X-ray)

Chest X-rays allow the enlargement of the heart and the condition of the lungs to be assessed. It contributes to the detection of lung diseases that may cause similar complaints.

How ıs atrıal septal defect treatment performed?

Most atrial septal defects can close on their own during childhood. Some small atrial septal defects that do not close may not usually require treatment. However, permanent and large atrial septal defects need to be treated. The aim of this treatment is to close the hole in the heart. There are two main methods for closing an atrial septal defect.

The first one is to close the hole in the heart with the help of devices through angiography-like procedures. This procedure is not an operation. It is a procedure performed in the angio room by entering the patient’s groin. The patient usually stays in hospital for one day and the risk of the procedure is very low. Reopening of the hole after this procedure is very rare.

The second option is to close the hole with surgery. In cases where it is not appropriate to close the hole with angiography (such as a very large hole, a hole in the neighborhood of large vessels, multiple holes), the hole is sutured or closed with a patch. This operation is performed under general anesthesia and with a heart-lung machine. In recent years, it can also be performed through very small incisions. The risk of the operation is low. Reopening of the hole is rare.

Frequently asked questıons about atrıal septal defect (ASD)

What are the types of ASD (atrial septal defect)?

There are roughly two main types of atrial septal defect: primum and secundum.

Primum ASD:

This defect occurs in the lower part of the atrial septum and may be accompanied by other congenital heart problems. It is more rare and difficult to treat. It is usually not suitable for angioplasty and must be closed surgically.

Secundum ASD:

This is the most common type of ASD and often occurs in the middle of the wall between the atria (atrial septum). Most secundum ASDs are suitable for angioplasty. Those that are not are treated with surgery

What are the risk factors for atrial septal defect?

There are no established risk factors for ASD. Hereditary or environmental causes (such as drug use, rubella infection during pregnancy, drug, tobacco and alcohol use, exposure to chemicals, diabetes and lupus) are thought to increase the risk of the disease. Sometimes it can also be associated with other genetic problems such as Down syndrome or other congenital heart diseases.

Who is most likely to have atrial septal defect and at what age?

Atrial septal defect is not acquired, but is present from birth. The age at which the disease is diagnosed varies. Many patients continue their lives for many years without any problems and the condition is detected by chance. Some patients are diagnosed in the newborn period after examination and other examinations.

How does ASD (atrial septal defect) affect the heart and circulatory system?

With this hole, which should not be between the atria of the heart, blood passes to the other side of the heart, causing increased blood flow to the lungs. As the hole gets bigger, the amount of blood passing through increases. Over the years, increased blood flow can lead to an increase in lung pressure and cause irreversible damage to the lung. The increased pressure in the lung can lead to heart failure. In cases where the hole is small, patients can live for many years without any problems with very little increase in pulmonary blood flow.

What is the incidence of atrial septal defect?

The prevalence of atrial septal defect in the general population is approximately 1 in 1500-2000 births.

What is a small secundum atrial septal defect?

Sometimes the hole is small and the blood flow through the hole does not strain the heart and lungs too much. Some of these holes can be followed without closure. Others need to be closed and most of these can be closed by angioplasty.

What are the disadvantages of atrial septal defect treatment?

There are two main treatment options for atrial septal defect. Angioplasty and surgical closure. During angioplasty, the vessels in the groin are entered and the heart is accessed. Damage to the vessels in the groin may occur during the procedure. The materials and wires used during this procedure can damage the heart. The device used to close the hole may not fit properly. It may slip out of place and move to other areas. These problems are quite rare.

In the surgical closure process, similar problems that can be encountered in other heart surgeries may occur. A heart and lung machine is used for the operation. Patients may experience problems such as infection, bleeding, varying degrees of paralysis and difficulty waking up after surgery. The incidence of these problems is very low (usually less than one percent).

Is atrial septal defect dangerous?

Atrial septal defect (ASD) can be dangerous in some cases.

Long-term untreated atrial septal defects, especially large ones, can cause damage to the lungs and heart failure due to lung damage.

-If there is a clot in the leg veins and this clot breaks, the clot can pass through the hole instead of the lungs and reach the brain, internal organs, arms and legs. The patient may have a stroke. Vascular blockages can occur in the arms and legs. Damage to internal organs can occur.

-In pregnant women, lung damage may occur earlier or more severely if there is a large hole during pregnancy. Conditions similar to heart failure may occur. However, most pregnant women do not have significant problems during pregnancy.

-In pulmonary patients, lung damage may occur earlier and more in the presence of a large hole. Heart failure may start earlier in these patients

-In some patients, small holes may cause headaches and migraine attacks. This is still controversial and studies are ongoing.

When does the ASD close?

The ASD is open in every baby in the womb. After birth, the hole is no longer needed and closes spontaneously within a few weeks or months.

What can people with a hole in the heart not do?

In the case of a small hole, there is usually no need for significant exercise restrictions. Only heavy exercise may need to be avoided. If lung damage has developed, lung pressure has started to rise and heart failure has occurred, it is recommended that these patients exercise cautiously and avoid heavy exercise. In addition, people with ASD are advised to avoid underwater diving sports because of the high risk of being struck.

Mountaineering is also not recommended, especially high altitude mountaineering.

Does atrial septal defect occur in newborns?

Yes, some newborns (babies in their first 1 month) have ASDs. Most of these holes close spontaneously within weeks or months as the baby grows. It may take up to a year for 20 percent of these holes to close.

Can atrial septal defect cause death?

The hole itself does not cause death. However, in untreated patients, if the hole has caused lung damage, increased pulmonary pressure and heart failure, deaths related to these diseases may occur. In these cases, rhythm disturbances can rarely lead to death. Sudden death can also occur if clots pass through this hole.

What are the consequences of untreated atrial septal defect?

Untreated atrial septal defect can lead to the following consequences;

-After many years, it can lead to lung damage, increased pulmonary pressure and eventually heart failure due to too much blood flow to the lungs.

-Can cause arrhythmia

-Can cause enlargement of the heart

-After lung damage, lung infections may become easier to contract, respiratory failure may occur

Can atrial septal defect (ASD) be treated with medication?

No, it cannot be treated with medication. Medication does not shrink or close the hole. However, medication may be recommended to reduce some of the signs and symptoms that may accompany ASD. If there are rhythm problems, increased lung pressure or lung damage, they may need medication for these conditions. They may need to take some routine medicines before and after an angio or surgery procedure.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

What ıs bradycardıa?

Bradycardia refers to a low (slow) heart rate. The normal heart rate of an adult sitting still should be 60-100 beats per minute. In the presence of bradycardia, the pulse rate is below 60. In some people, bradycardia does not cause any problems or complaints. Sometimes it can have serious consequences. It is important to consult a specialist as a low pulse may be caused by a problem in the electrical systems in the heart.

What are the symptoms of bradycardıa?

A heart rate that is too slow can cause insufficient blood supply to the brain, and symptoms are often associated with this. Symptoms of bradycardia are listed as follows:

– Fatigue or weakness

– Dizziness or darkening of the eyes

– Unconsciousness, confusion

– Attacks of fainting (or feeling like fainting)

– Shortness of breath

– Decreased exercise capacity, fatigue with exercise

– Cardiac arrest

What causes bradycardıa? What are the rısk factors?

Problems that can cause bradycardia are listed as follows:

– Problems with the sinoatrial (SA) node, the heart’s natural pacemaker,

– Problems in the heart’s conduction pathways that do not allow electrical impulses to travel properly

– Metabolic problems such as hypothyroidism (low thyroid hormone)

– Due to structural heart disease or heart attack

– Some heart medicines that can cause bradycardia as a side effect

– Damage to conduction pathways due to aging

– Some congenital heart conditions

– Inflammation of the heart muscle (myocarditis)

– Complications that sometimes occur after heart surgery

– Imbalance of electrolytes in the blood, such as potassium or calcium

– Recurrent respiratory arrests during sleep (obstructive sleep apnea syndrome)

– Inflammatory diseases such as rheumatic fever or lupus

– Tranquilizers, medicines for heart rhythm disorders, medicines for high blood pressure and certain medicines used in psychiatric treatment

How ıs bradycardıa dıagnosed?

Bradycardia is a slow heart rate. The resting adult heart usually beats 60 to 100 times per minute. A heart rate of less than 60 beats per minute is called bradycardia. A slow heart rate can be detected by pulse counting, resting the heart, electronic blood pressure monitors, pulse-oximetry or electrocardiography.

 There are some exceptional cases where the heart rate is low but normal. For example, during deep sleep the heart rate may drop below 60 per minute, or physically active adults (and athletes) often have a slower heart rate.

How ıs bradycardıa treated?

Borderline or occasional bradycardia may not require treatment. In more severe or prolonged bradycardia, if there is an underlying cause, that condition is first addressed. For example, if a direct pulse-lowering medication is being used or if there is a medication whose side effects cause a slow heart rate, the medication dose may be adjusted or discontinued first.

It is important to take medications that reduce heart rate as prescribed by the doctor, to monitor the pulse rate while increasing the dose of medication, and to be careful when using more than one medication with pulse-lowering effects together to prevent bradycardia.

Regular check-ups and consulting a cardiologist in cases suggestive of low pulse rate are also extremely important in preventing adverse events.

A pacemaker may be required in cases where there is a very low heart rate or a complaint that is not related to medication or another temporary condition. A pacemaker regulates the rhythm of the heart and speeds up the heart rate as it should be.

Frequently asked questıons

Can bradycardia lead to death?

The possible and most serious complications of bradycardia include frequent fainting, the heart not pumping enough blood (heart failure) or sudden cardiac arrest or sudden death. Other complications include chest pain (angina pectoris), low blood pressure (hypotension) or high blood pressure (hypertension).

What happens if the heart rate slows down?

A slow heart rate can prevent adequate blood supply to the brain and other organs, preventing them from receiving enough oxygen and impairing their oxygenation. This can lead to complaints such as chest pain, memory problems, dizziness, feeling faint, getting tired quickly during physical activity, fainting (syncope) and shortness of breath.

What happens if the heart rate drops below 50?

Bradycardia is a heart rate below 60, but symptoms usually occur when the heart rate is below 50. If this rate falls below 40, or if it causes symptoms when it is below 60, it is dangerous and should be intervened. Pulse rates below this value can be seen in athletes, in sleep, and in regular exercisers at rest without any complaints.

What is the bradycardia intervention limit?

The treatment of bradycardia is based on treating the underlying cause. If there are conditions such as underactive thyroid gland, sleep apnea, electrolyte disorders, these are treated first; if bradycardia is due to medications, the doses of the medications should be changed. If there is a dangerous slowdown, a pacemaker may be necessary. Generally, intervention is required for low heart rates below 40 or below 60 beats per minute that cause complaints. In addition to heart rate, the shape of the rhythm on electrocardiography is effective in determining the severity of the problem in the conduction pathways and in the decision to intervene.

What causes bradycardia in young people?

A slow heart rate does not always mean there is a problem. For example, a heart rate between 40 and 60 per minute at rest is quite common during sleep and in some people, especially healthy young adults and trained athletes. The most common cause in children and adolescents is sinus bradycardia. This means that the sinus node, which is the source of the stimulus, emits a low-speed electrical current. Sinus bradycardia is usually a normal physiologic response. However, if there are complaints suggestive of bradycardia, even in young patients, if there is a history of structural heart disease or medication use, if the pulse rate is below physiologically accepted values, further examination is required.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

 What ıs buerger’s dısease?

Buerger’s disease is a vascular occlusion disease that occurs when the veins in the arms and legs become inflamed or swollen as a result of tobacco use.

Buerger’s disease is a disease with an unknown cause in medium and small diameter veins, which is characterized by healing and relapse, and is more common in young people. Research has shown that this disease is an immunologic vascular inflammation due to abnormalities in the immune system. In medicine, thromboangiitis obliterans is popularly known as ‘spontaneous amputation’ disease. In 1908, it was described in detail by Leo Buerger.

What causes buerger’s dısease?

Tobacco use clearly plays a role in the development of Buerger’s disease. Chemicals in tobacco are thought to irritate the lining of blood vessels, causing them to swell. In Buerger’s disease, also called thromboangiitis obliterans, blood vessels become inflamed, swollen and can become blocked by blood clots (thrombi). The exact cause of Buerger’s disease is unknown. It is also suspected that some people may have a genetic predisposition to the disease.

What are the symptoms of buerger’s dısease?

– When the disease is active, the affected vascular area is tender and painful.

– The patient has a general malaise, weakness, fatigue and fever. There may also be foot sweating, which disappears as the first symptom. The fingers become cold and numb.

– Sometimes the first symptom is numbness in the feet with walking instead of loss of sweating. Most of the time, a decrease in the fullness of the veins may be noticeable.

– Over time, limping in walking may develop. Pain in the calf area is often a distinctive feature.

– As the disease progresses, bruising of the feet begins. Afterwards, wounds appear on the toes with increasing rest pain at night.

– In the absence of intervention, gangrene develops and the person loses a limb, starting with the fingers and progressing upwards.

Who gets buerger’s dısease?

It is most common among young men between the ages of 25-40 who smoke. Buerger’s disease accounts for 7-10% of the vascular disease group in Turkey. The probability of occurrence in women is about 2% of cases.

The most important cause is the hypersensitivity of the body against the vascular wall triggered by the nicotine metabolite cotinine (the substance that nicotine turns into after it enters the body) in smokers. The increase in free oxygen radicals due to elevated homocysteine also sensitizes the vascular walls and can initiate the reaction. In addition, frequent exposure to cold, low socioeconomic status, malnutrition, hepatitis B jaundice, elevated fibrinogen, and a tendency to clot are among the causes.

How ıs buerger’s dısease dıagnosed?

Clinically, 5 main criteria (shionaya) are essential. Smoking, age below 50, involvement below the knee, absence of atherosclerosis risk factors and the presence of 4 of the 4 upper extremity involvement criteria are sufficient for diagnosis. The diagnosis is usually made according to the above criteria during arterial examination upon the patient’s complaints. After the examination, ultrasonographic and doppler studies should be performed to determine the location and degree of obstruction. Tomographic angiography is required for the involvement of the arterial tree. This determines the location of the blockage, the amount and length of the blockage, the blood flow to the fingers and, most importantly, the presence of collateral blood vessels. This is very important in treatment. In some cases, classical angiography is required for both diagnostic and therapeutic purposes.

How ıs buerger’s dısease treated?

First of all, smoking should definitely be stopped. Since Buerger’s disease is considered to be an allergy to smoking, quitting smoking is the first and indispensable part of the treatment. Because if the allergen is eliminated, the disease will also disappear. Approximately 90% of patients diagnosed with Buerger’s disease who quit smoking recover, even if they have a foot wound. A sustainable and regular exercise program is essential. Cold temperatures and cold trauma should be avoided to the maximum extent possible. Medication includes painkillers, vasodilators, clot dissolvers and anticoagulants. These medications must be used continuously and uninterruptedly, they can never be stopped. If there is a wound; in addition to local treatment, ozone, high pressure oxygen, PRP and stem cell applications can be performed. Unfortunately, painkillers in daily use are often ineffective, although they partially reduce pain. In this case, the specialist may prescribe narcotic painkillers or epidural anesthesia, i.e. partial anesthesia, may be deemed necessary.

If there is no response to these treatments, it is aimed to open the vessel angiographically. If no results are obtained, open reconstructive vascular surgeries are performed with sympathetic nerves that narrow the vessels supplying the affected limb. If there is no response to these, unfortunately, the decision is made to amputate the affected area. The disease progresses with healing and re-occurrence of the disease, and the process continues by cutting over the previously cut area. However, in the vast majority of patients who change and improve their habits in the direction of vascular health, use their medications properly and do not interrupt their controls, clinical stagnation occurs and the person can get rid of bad pictures.

Frequently asked questıons about buerger’s dısease

How does Buerger’s disease occur?

It mainly affects all layers of small and medium arteries (panarteritis) and veins (panphlebitis). There are intact areas in between the affected areas. The disease progresses in recovery and relapses. During each attack, intact areas of the vessel wall are affected, the disease spreads and the vessel becomes fibrotic like a rope.

At the time of the attack, there is widespread swelling in and around the affected vessel wall and fresh clots form in it. In a way, microscopic pus accumulation, i.e. microabscess formation, is observed in the vessel. Over time, while the clot persists in the vessel, the edema in the wall decreases and is replaced by thickening of the vessel wall. The active phase of the disease is then terminated by occlusion of the affected area of the vessel. In some attacks, the arteries and veins as well as the surrounding nerves are affected and the affected area hardens.

How does Buerger’s disease start?

It starts with an abnormally exaggerated reaction of the immune system against its own vessel wall. It is most commonly manifested by blockages in the arteries of the feet. The veins of the hands and abdomen are rarely affected. In advanced stages of the disease, the veins of the hips, groin and arms can also be affected. In Buerger’s disease, immune system antibodies C4, antielastin and anticholigin antibodies, HLA1, HLA3 antigens and organ-specific IgM, IgG, IGA and C3 antibodies are increased.

Is Buerger’s disease related to other diseases?

It can be seen together with other diseases. It can be associated with many connective tissue and rheumatic diseases. Factors belonging to other diseases may be present in the background of the disease. However, Buerger’s disease is a clinical picture with its own specific criteria. It is completely different from atherosclerosis, which clogs the arteries with lime. This distinction should be made well. In Buerger’s disease, obstruction occurs due to thickening and coarsening of the vessel wall. There are never plaques containing calcium deposits. It can be associated with Raynaud’s phenomenon, a functional narrowing and opening of the arteries, or it can be considered as an organic form of it.

Is there a herbal treatment for Buerger’s disease?

Herbal cures that dilute the blood and dilate the vessels that cause clot dissolution can be tried. Herbal products that reduce mental tension and support the immune system may be useful. It should not be forgotten that the aim of the treatment is to transport blood to the anemic area. This criterion should be the main and most important solution in treatment.

What is good for Buerger’s disease?

Living in a warm climate is very good for this problem. You should definitely quit smoking and take regular walks. Walking is both necessary for the patient and the easiest form of exercise that helps the formation of blood vessels that help in the treatment of the disease. Sometimes spa treatments can be useful.

How does Buerger’s disease pain go away?

The pain is relieved only when there is sufficient blood supply to the sore spot. For this purpose, patients need to be given strong narcotic drugs that calm the nerves during the treatment process. Normal painkillers do not help. Hyperbaric oxygen and ozone therapy also reduce the level of pain. If the pain persists, localized blockade (axillary, lumbar blockade or epidural anesthesia) can be applied to the nerves of the affected limb to increase blood flow and relieve pain. If these approaches are ineffective, unfortunately the only way to relieve the pain is to amputate the affected limb.

Is Buerger’s disease genetic?

There are very important scientific data suggesting a genetic origin. In the majority of patients, genetic tests are positive. However, the exact cause of the disease is still unknown.

Does Buerger’s disease go away?

The effect of smoking on Buerger’s disease is known. If the allergen is eliminated, the disease will also disappear. It is known that in about 90% of patients diagnosed with Buerger’s disease who quit smoking, the effects of the disease are visibly reduced.

At what age does Buerger’s disease usually occur?

It affects young men aged 25-40 years who smoke. In women, it is about 2% of the total cases.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

What ıs a heart aneurysm?

A heart aneurysm is a ballooning of the heart wall that usually develops 6-8 weeks after a heart attack. Rarely, it can develop independently of a heart attack. In the general public, a heart aneurysm can be confused with an aortic aneurysm, which is the main artery. Aortic aneurysm refers to ballooning and rupture of the aortic artery, while cardiac aneurysm refers to ballooning that occurs as a result of tissue weakening in the heart muscles in the area where the closed vessel feeds after a heart attack. While aortic aneurysm is a common disease in the society, the incidence of cardiac aneurysm is very low.

What causes heart aneurysm?

Heart aneurysms occur as a result of damage to the heart muscle after a heart attack, thinning of the heart wall, loss of its contractile function and ballooning due to this, unable to resist the blood pressure inside the heart.

What are the symptoms of a heart aneurysm?

Heart aneurysms do not cause any symptoms in most cases. However, due to the ineffective functioning of the aneurysm area, it may cause heart failure and consequently heart valve failure in the chronic period. These insufficiency conditions can cause constant fatigue, shortness of breath, palpitations and chest pain in patients. In addition, especially in patients who do not receive blood thinners, blood clots that may form in the ballooning area can lead to serious problems such as stroke or embolism (clotting) to other organs. In very rare cases, rupture of the aneurysm can lead to serious life-threatening conditions that require emergency intervention.

How ıs heart aneurysm dıagnosed?

Heart aneurysm is diagnosed by echocardiography. In patients for whom an operation is planned, imaging methods such as medicated tomography and MRI can also be used.

How ıs heart aneurysm treatment applıed?

Heart aneurysms are followed up as long as they do not cause serious heart failure or valve problems. Surgical treatment may be planned in cases of severe heart failure, heart valve involvement, clot formation in the aneurysm or rupture of the aneurysm wall. In addition, in patients undergoing cardiac surgery for another reason, the aneurysm should be treated simultaneously.

Frequently asked questıons about heart aneurysm

What are the advantages of heart aneurysm surgery?

Studies have shown that heart function improves in the majority of patients after heart aneurysm surgery. In addition, complications such as clotting and stroke are prevented.

What are the risk factors for heart aneurysm?

Risk factors for heart aneurysm include family history, certain genetic diseases, smoking, hypertension and age.

Is a heart aneurysm dangerous?

In some types of heart aneurysms, the integrity of the heart wall is completely destroyed. In these cases, surgical intervention may be required without waiting. Otherwise, it is inevitable that the patient will die due to bleeding. The most dangerous complication is thromboembolism (clotting). The immobile blood in the ballooned area can clot and throw it into vital organs such as the brain and kidneys and cause serious problems.

What are the risks of heart aneurysm surgery?

The risks of heart aneurysms are similar to those of standard heart surgery. Risks such as bleeding, rhythm disturbances, heart failure and stroke in the early period can be seen at a rate of 2-5 percent.

Does a heart aneurysm improve?

Heart aneurysms do not resolve spontaneously. However, small and uncomplicated aneurysms can remain silent and harmless for a lifetime without causing any complaints. Therefore, surgical treatment is planned for only a portion of heart aneurysms. Other cases are followed up with periodic echocardiography.

At what age does a heart aneurysm occur?

Although heart aneurysms can occur at any age, they are more common in male patients over the age of 60, as the most common cause is heart attack.

What should patients with a heart aneurysm consider?

The most important thing to consider in patients with a heart aneurysm is follow-up. Periodic echocardiography follow-up is absolutely necessary in terms of aneurysm size, heart failure, clot formation in the aneurysm and heart valve function.

Does a heart aneurysm cause pain?

Pain is not a typical symptom because the heart muscle cells are usually completely dead at the site of the aneurysm. However, since the cause in most patients is coronary artery disease, these patients may tell about a history of severe chest pain in the past.

Can a heart aneurysm be detected on MRI?

The definitive diagnosis of heart aneurysms is made by Echocardiography. However, in patients who require more detailed imaging, some features such as the type of aneurysm and whether it is complicated or not can be examined in more detail using MRI.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

What ıs chronıc venous ınsuffıcıency?

Chronic venous insufficiency is the general name of the clinical picture that begins with the deterioration of the valves of deep, superficial and connecting veins and occurs when left untreated for a long time.

What are the symptoms of chronıc venous ınsuffıcıency?

 Chronic venous insufficiency is not a disease that starts suddenly. It first starts as superficial varicose veins. Within 5-10 years, it continues with an increase in the diameter of the foot and then skin color changes, darkening and cracking. Finally, since there is a lot of pressure on the ankle in the vein system, it causes wounds around the ankle, which we call varicose ulcers either on the inner or outer side. The general name of this disease is chronic venous insufficiency.

How ıs chronıc venous ınsuffıcıency dıagnosed?

It is not correct to diagnose chronic venous insufficiency only in patients with foot pain but without any deterioration in the skin or varicose veins. Chronic venous insufficiency is a diagnosis that develops in a very long time, starting with superficial varicose veins and leading to varicose ulcers. It is not correct to talk about chronic venous insufficiency without ulceration or skin disorders. Varicose veins can range from thin capillaries to veins with much larger diameters. However, when it becomes chronic venous insufficiency, changes in the skin must have started. First of all, after a good physical examination, the diagnosis is made in a simple way with venous doppler ultrasound. No angiography or any painful procedure with needles is required. It is easily diagnosed by venous color doppler ultrasound performed by a radiologist or cardiovascular surgeons.

What ıs the treatment of chronıc venous ınsuffıcıency?

Patients who have reached what we call chronic venous insufficiency are usually patients who neglect their varicose veins, have lived with large varicose veins on their feet for many years, have never used compression stockings and are generally overweight.  Venous insufficiency is caused by neglect. It is neglected as a result of a misconception among the public that varicose veins reappear even if they are treated. The main purpose of varicose veins treatment is to prevent varicose veins from progressing and reaching chronic venous insufficiency.  The situation becomes serious when varicose veins turn into ulcers. The need for surgery may also develop due to deep vein obstruction or superficial vein insufficiency. If it is not due to a blockage in the vein, venous insufficiency can be treated simply with laser surgery. However, if varicose ulcers have formed, it is a problematic situation for both the patient and the doctor. Bandage treatments are available, special compression stockings called very tight ulcer kits are used in treatment. In addition, dressings and wound healing creams are used for wound care. Sometimes, not only a cardiovascular surgeon but also a plastic surgeon may need to be involved in wound care. In very severe non-healing wounds, chronic venous insufficiency can be reversed with vacuum treatments called “VAC” treatment, using bandages and tight stockings. If the patient is unable to undergo an intervention, if the chronic venous insufficiency has developed due to an old obstruction in the deep vein, the patient has to wear tight compression stockings almost for life. Patients with chronic venous obstruction below the groin level do not require surgery. Only tight stockings and medication treatments are applied. The aim is to prevent the formation of varicose ulcers again. The most important point for patients is not to neglect varicose veins as soon as they appear. The aim here is not only to correct the appearance. It is to prevent the patient from entering the chronic venous insufficiency picture leading to varicose ulcers. Therefore, varicose veins should not be neglected.

Frequently asked questıons about chronıc venous ınsuffıcıency

What happens if venous insufficiency is not treated?

It can lead to very serious conditions, ranging from an increase in the diameter of the leg to varicose ulcers.

Is venous insufficiency a chronic disease?

Venous insufficiency is a chronic disease. It is called chronic venous insufficiency. Because it is a condition that develops over 5-10 years, in which the valves of the veins deteriorate due to reasons such as pregnancy, the use of certain medications, standing for long periods of time or rapid weight gain, and the blood that should normally go up in the veins escapes down and affects the venous circulation, especially around the ankle, disrupting the tissue nutrition there, as well as complaints such as pain, swelling, fullness, as well as the appearance of varicose veins and finally the emergence of a condition called stasis dermatitis by disrupting the skin tissue. The most severe picture of chronic venous insufficiency is the appearance of varicose ulcers. Varicose ulcers are wounds on the inside or outside of the ankle.

The most severe form of the clinical classifications of chronic venous insufficiency is the condition in which varicose ulcers occur, which creates serious difficulties in treatment for both the patient and the doctor. It is a problem that requires advanced clinical treatments such as triple bandage treatments, very tight compression stockings, serious wound care and sometimes vacuum applications and sometimes takes months to treat. For this reason, patients with chronic venous insufficiency should not avoid this surgery before they reach this stage; when the first complaints begin to appear, that is, when the criteria for surgery appear. Because patients generally see varicose veins as a cosmetic problem or believe that varicose veins will recur even if they are treated with another false belief. For this reason, there are patients who postpone their surgeries for years. However, varicose vein surgeries can now be performed with very simple methods. For this reason, it is important to be treated before reaching the last stage of venous insufficiency, varicose ulcers. Surgery stops the progression of varicose veins. Although small or medium-sized varicose veins can sometimes be seen in local areas after the surgery, it prevents it from reaching varicose ulcer, which is the main problem. This is the purpose of the surgery.

What causes chronic venous insufficiency?

Deterioration of the valve structure in the vein, some changes in the vein wall, etc. can sometimes be genetic. For this reason, people who have varicose veins in one or more of their family members are more likely to develop varicose veins. Occupations where people work standing for long periods of time are risk factors for varicose veins. Sometimes it may start as superficial vein inflammation. In other words, varicose veins can develop after major surgeries that require lying down for a long time. Sometimes during pregnancy or the use of birth control pills can also cause this type of thrombosis. This condition can sometimes pose a risk to life. These clots, which travel from the deep veins to the lungs, can cause pulmonary embolism, which can be life-threatening. When there is no risk to life, secondary venous insufficiency occurs in these patients. Surgical intervention is not always recommended for these clots. In general, some clot dissolving methods are applied. For example, if the clot does not block a vein above the groin level, surgical intervention is not required. Another cause of varicose veins is varicose veins that develop as a second possibility instead of this condition called deep vein thrombosis. Contrary to popular belief, being a woman is not a risk factor for varicose veins. Varicose veins can develop in men at least as much as in women.

Does chronic venous insufficiency cause heart problems?

Chronic venous insufficiency alone does not cause any problems with the heart. A patient with venous insufficiency does not pose risks such as vascular problems in the heart or coronary heart disease. The process that leads to coronary heart disease in the heart is problems in the arteries. Vascular calcification is a result of atherosclerosis, which is the hardening of the arteries. However, if deep vein thrombosis causes pulmonary embolism, it can lead to increased pulmonary pressure and right heart failure. The treatment for this is surgery, but chronic venous insufficiency alone does not cause a problem in the heart.

How many hours does surgery for chronic venous insufficiency take?

In the past, varicose vein surgeries were performed by pulling out the vein through incisions in the groin, wrist and knee. However, with endovenous, laser, radiofrequency or Glue treatments, which have been applied for about 25 years, surgical procedures are successfully performed without the need for this. These methods, which are performed without a surgical incision, only by entering the vein through the needle hole, take only 3-4 minutes in the operating room. However, with the preparation of the patient for surgery, the amount of varicose veins cleaned by the surgeon and the subsequent stages, it takes up to 40-45 minutes. Cardiovascular surgeons remove finger-sized varicose veins in the leg. In some clinics, instead of this cleaning process, only the main vein is burned with a laser and the pockets that cause cosmetic defects and may lead to deep vein thrombosis in the future are not removed. In this case, patients need a second procedure. However, what needs to be done is to remove these pockets and not to force the patient to undergo a second procedure. Depending on the density of these varicose veins, the patient is either discharged on the same day or discharged after one day of hospitalization. That night, the patient stays with bandages and tight socks. However, the patient can walk 2-3 hours after the procedure.

How long does it take to return to daily life after chronic venous insufficiency surgery?

If the patient does not have many pakes and only the laser procedure is applied, the patient is discharged on the same day and can return to daily life provided that the patient wears compression stockings for about 10-15 days. However, if it is a long-neglected picture and the pockets are too many, the patient stays in the hospital for a night, stays at home with socks and bandages for a night, then the bandages are removed and the patient can return to normal life provided that he/she wears socks for 10-15 days.

Can patients who develop varicose ulcers lose their feet?

No, gangrene that starts in the foot with arterial problems goes upwards. However, varicose ulcers in patients with varicose veins do not occur on the fingertips, but usually around the ankle. This is the last stage of skin disorder. It can become wounds starting from the size of a hazelnut and reaching up to the size of an apple. However, if not treated well, it can lead to serious infections and problems. Therefore, the treatment must be performed by a cardiovascular surgeon.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

What ıs mıtral valve ınsuffıcıency?

The mitral valve is one of four valves in the heart that keep blood flowing in the right direction. Each valve has leaflets that open and close once during each heartbeat. If a valve does not open or close properly, the flow of blood from the heart to the body and lungs can become problematic.  This is how the question “What is mitral regurgitation?” can be answered: Mitral valve insufficiency is a type of heart valve disease in which the valve between the left heart chambers does not close completely, causing blood to leak backwards through the valve. It is the most common type of heart valve disease. If the leakage is severe, there will not be enough blood flowing to the body and as the amount of blood returning increases, the heart will have to do extra work and become tired.

Who has heart valve ınsuffıcıency?

Mitral valve insufficiency can be seen in people with certain hereditary diseases, those who had febrile illnesses in infancy and early childhood, people with damaged heart valves, those who eat irregular and improper diets, those who are overweight, those who live sedentary lives, and those whose heart rhythm is disrupted by factors such as age.

What are the causes of mıtral valve ınsuffıcıency?

To understand the causes of mitral valve insufficiency, it is helpful to know how the heart works. The mitral valve is one of four valves in the heart that keep blood flowing in the right direction. Each valve has leaflets that open and close once during each heartbeat. If a valve does not open or close properly, blood flow from the heart to the body can be reduced. In mitral valve regurgitation, the valves do not close tightly. When the valves are closed, blood leaks backwards, making it difficult for the heart to work properly. If mitral valve regurgitation is caused by problems with the mitral valve, the condition is called primary mitral valve regurgitation.

If a problem or disease affecting other parts of the heart causes the mitral valve to leak, this is called functional or secondary mitral regurgitation.

Possible causes of mitral valve regurgitation include:

Mitral valve prolapse:

In this condition, the flaps of the mitral valve protrude into the upper left heart chamber during heart contractions. This common heart problem can prevent the mitral valve from closing tightly and cause blood to leak backwards.

Rheumatic fever:  

Rheumatic fever is a complication of an untreated sore throat. Rheumatic fever can damage the mitral valve and lead to mitral valve regurgitation early or later in life. If rheumatic fever causes mitral valve disease, the condition is called rheumatic mitral valve disease.

Heart attack :

A heart attack can damage the area of heart muscle that supports the mitral valve. If the heart attack damage is too extensive, the event can cause sudden and severe mitral valve regurgitation. A leaky mitral valve caused by a heart attack is called ischemic mitral regurgitation.

Congenital heart diseases: 

Some people are born with heart structure problems, including damaged heart valves.

Thickening of the heart muscle (cardiomyopathy):

Cardiomyopathy makes it difficult for the heart to pump blood to the rest of the body. The condition can affect mitral valve function and lead to regurgitation. Types of cardiomyopathy due to mitral valve insufficiency include dilated cardiomyopathy and hypertrophic cardiomyopathy.

Endocarditis :

The mitral valve can be damaged by infection of the lining of the heart (endocarditis), which can involve the heart valves.

Radiation therapy:

Rarely, radiation therapy for cancer focused on the chest area can lead to mitral valve insufficiency.

What are the symptoms of mıtral valve ınsuffıcıency?

Mitral valve regurgitation can cause fatigue or shortness of breath. Some people may not have symptoms for years, but sometimes valve regurgitation develops acutely. This can cause some symptoms. Symptoms of mitral regurgitation can include heart murmur, irregular heartbeat, shortness of breath at rest, palpitations, swelling or edema of the ankles.

How is mitral valve insufficiency diagnosed?

To diagnose mitral valve regurgitation, a cardiologist will perform a physical examination and ask questions about symptoms and medical history, including whether mitral valve prolapse is present. During the physical examination, the heart is first listened to with a stethoscope. A heart murmur, also called a holosystolic murmur, may be heard. A mitral valve murmur is the sound of blood leaking backwards through the valve. Tests may be performed to confirm the diagnosis of mitral valve regurgitation or to check for other conditions that may cause similar signs and symptoms.

Common tests to diagnose mitral valve regurgitation include:

Echocardiogram:

Sound waves are used to create pictures of the heart in motion. An echocardiogram shows the structure of the mitral valve and blood flow in the heart. A standard echocardiogram, also called a transthoracic echocardiogram (TTE), can confirm the diagnosis of mitral valve regurgitation and determine its severity. Echocardiography can also help diagnose congenital mitral valve disease, rheumatic mitral valve disease and other heart valve diseases. Sometimes a transesophageal echocardiogram (TTE) can be performed to take a closer look at the mitral valve. In this type of echocardiogram, a small camera attached to the end of a tube is inserted through the esophagus at the level of the heart.

Electrocardiogram (ECG):

  Electrodes attached to pads on the skin measure electrical signals from the heart. An ECG can detect irregular heart rhythms (arrhythmias) due to mitral valve disease.

Chest X-ray :  

A chest X-ray shows the condition of the heart and lungs. This quick and easy test diagnoses an enlarged heart.

Cardiac MRI:

Uses magnetic fields and radio waves to create detailed images of the heart. This test can also help provide more details about the severity of mitral valve regurgitation and the size and function of the lower left heart chamber.

Exercise tests or stress tests:

These tests usually involve walking on a treadmill or riding a stationary bicycle while the heart is monitored. Exercise tests show how the heart responds to physical activity and whether symptoms of mitral valve regurgitation occur during exercise. If you are unable to exercise, you may be given medication that mimics the effect of exercise on the heart.

Cardiac catheterization:

This test is not usually used to diagnose mitral valve disease, but it can be helpful if other tests have not diagnosed the condition. A healthcare professional passes a thin tube (catheter) from a blood vessel in the arm or groin into an artery in the heart and injects dye through the catheter. This allows the arteries in the heart chambers to show up more clearly on an X-ray.

How ıs mıtral valve ınsuffıcıency treated?

The goal of mitral valve insufficiency treatment is to improve heart function while reducing signs and symptoms and avoiding future complications. Some people, especially those with mild regurgitation, may not need treatment. The stage of mitral valve regurgitation also shapes the treatment. First of all, healthy lifestyle changes are necessary. A cardiologist should follow up regularly. Some medications can be used to prevent complications related to mitral valve insufficiency. Surgery may also be needed to repair or replace the mitral valve. In any case, it is important that mitral valve insufficiency is treated at a healthcare facility with a heart center staffed by experienced specialists.

In general, treatments include the following:

Medications:

Medications may be needed to reduce the symptoms of mitral valve regurgitation and prevent complications of heart valve disease. Diuretics, blood thinners, blood pressure medications may be recommended.

Surgery or other procedures:

Even without symptoms, a diseased or damaged mitral valve may eventually need to be repaired or replaced. Surgery for mitral valve disease includes mitral valve repair or mitral valve replacement. The cardiologist decides which procedure is beneficial based on the patient’s condition. If surgery is needed for another heart condition, a surgeon may perform mitral valve repair or replacement at the same time as the other surgery. Mitral valve surgery is usually done through an incision in the chest. Surgeons at some medical centers sometimes use robot-assisted heart surgery, a minimally invasive procedure in which robotic arms are used to perform the surgery.

In general, there are two types of valve disease that may require surgery:

– Stenosis:

Narrowing of the valve

– Inadequacy:

Incomplete closure of the lid

In valve surgery, the surgeon has to open the heart and enter it to reach the diseased valve. In this case, the patient must be connected to a heart-lung machine to stop the heart. In these operations, the surgeon can replace the diseased valve with an artificial valve (replacement) or, especially in mitral and tricuspid valves, he/she may prefer to perform repair (plasty).

Sometimes heart valves cannot perform their mechanical function due to certain diseases. In this case, the problem with the heart valves is solved by surgical treatment. The valves that most often need repair and have the most satisfactory results are those located between the atria and ventricles. The valve between the right atrium and ventricle is called the “Tricuspid Valve” and the one on the left side is called the “Mitral Valve”.

Not all types of valves can be repaired. In valve diseases caused by rheumatic diseases, the possibility of repair is limited due to thickening and calcification caused by increased connective tissue in the valve tissue. In addition, in some patients, very successful results are obtained in valve insufficiencies caused by reasons such as enlargement of the valve ring or prolapse and elongation of a part of the valve. Mitral valve insufficiency can also occur as a result of a heart attack. After a heart attack or endocarditis (heart infection), the valve functions deteriorate due to the rupture of one of the cords holding the mitral valve or thinning of the heart wall (aneurysm). In these patients, valve repair is required in addition to coronary bypass surgery.

The targeted durability of valve repair is 10 years and beyond. The structure and function of the heart valves can be evaluated in detail with the “Transesophageal Echocardiography” device placed in the esophagus during and after the operation. The experience of the anesthesiologist and cardiologists who perform the echocardiographic examination plays a major role in this process, as well as the surgeon and his team. In this way, it is possible to confirm the success of the surgery even before the patient leaves the operation.

Heart valve prostheses have some weak points compared to the heart’s own valves. Mechanical valve prostheses, also known as metal valves, require the use of drugs (with the active ingredient warfarin) that reduce blood clotting. If these drugs are not used, a clot may form on the valve and this clot may break off and disrupt the circulation of some organs. For example, impaired cerebral circulation can lead to a stroke. Bioprosthetic valves, also known as tissue valves, require very short-term (3 to 6 months) medication. However, the weak point of such valves is that they can be subject to calcification and degeneration over a period of up to 10 years.

Another disadvantage of replacing a mitral or tricuspid valve with a prosthetic valve is that the muscles and fibers that hold these valves to the base of the heart are cut. Cutting these muscles, which facilitate the opening and closing of the heart valve and play a role in the contraction of the heart, affects the performance of the heart. Therefore, if it is possible to repair the heart valve and if it is thought that it can provide physiological conditions for a long time, it is much better than replacing the valve.

After valve repair, a certain period of time is needed for the suture ends in the intervened intracardiac area and the ring-shaped prosthesis called “Ring”, which is often placed to support the repair, to be covered with tissue. This period varies between 3 and 6 months. During this period, an anticoagulant drug with the active ingredient warfarin is used to prevent the prosthesis and suture ends from causing a clot formation. To evaluate the effect of this medication, blood tests should be performed at least once a month and at intervals to be determined by the cardiologist. In recent years, the use of home devices to check INR has made it much easier to regulate this capricious drug. Once this period is over, a yearly examination by a cardiologist and echocardiography will be sufficient.

The basic principle of valve surgery is to provide the unidirectional flow that is present in normal physiology. Metal and tissue (bioprosthetic) valves are used for this purpose. Patients with metal valves are required to take the anticoagulant drug warfarin for life. Patients with tissue valves only need to take warfarin for 3 months. Although metal valves can last for a very long time, tissue valves may deteriorate after 10 years and need to be replaced. Metallic valves can make a sound like a clock that can be heard in very quiet environments. The metallic valves we prefer to use in our hospital are brands whose quality and durability have been proven all over the world. While very few patients state that they can hear such a sound in the early period, they state that the sound is never at a disturbing level with the time that has passed since the surgery. When choosing which type of valve to use, your surgeon will take into account your general condition, age, desire to give birth in female patients (patients on warfarin are not preferred to become pregnant), etc. Please inform your doctor if you have any condition that you think may be decisive in your valve preference before the operation.

Frequently asked questıons about mytral valve ınsuffıcıency

What are mitral valve diseases?

Apart from congenital mitral valve diseases, mitral valve diseases of rheumatic disease origin or degenerative origin with age-related deterioration of the valve are the most common. Mitral valve diseases usually present as mitral valve insufficiency or mitral valve stenosis.

What are the complications of mitral valve insufficiency?

People with mitral valve insufficiency or mitral valve stenosis may develop a heart rhythm disorder. This condition, called atrial fibrillation, can also cause stroke. High pulmonary hypertension may also develop. In addition, mitral valve insufficiency can lead to heart failure if left untreated.

When should people with mitral valve disease undergo surgery?

The valve should be replaced if there is severe stenosis of the heart valves, severe regurgitation, severe calcification of the valve, clots in front of the valve, clots in the heart, problems with heart rhythm.

What happens if mitral valve diseases are not treated?

Blood flows into the lungs and pulmonary pressure rises. This can lead to heart failure and can be life-threatening.

How is valve repair performed in the treatment of mitral valve insufficiency?

It is the process of eliminating problems such as mitral valve insufficiency and stenosis without replacing the valve and preserving the valve structure. During surgery, the mitral valve is accessed and the damaged parts are removed. In the meantime, the mitral valve is repaired. If repair is not sufficient, the valve is replaced.

Is mitral valve repair or mitral valve replacement surgery more difficult?

Both repair and replacement surgery have their own difficulties. It also depends on the patient whether the operation or repair is difficult or not. There may be patients who return for replacement during the repair procedure. However, both procedures should be performed in full-fledged hospitals in safe hands with a heart health center.

How is mitraclip procedure applied in mitral valve insufficiency?

Mitraclip is a non-surgical mitral valve insufficiency repair procedure. It is a minimally invasive treatment. Normally, in the classical method, mitral valves are treated with open surgery. Sometimes this treatment can also be performed with a robot. But with mitraclip, it can be performed without incision in the form of angiography. The mitraclip procedure can be performed by interventional cardiology specialists in elderly patients and selected patients with risks that are too high to undergo open heart surgery.

How is robot and minimally invasive mitral valve surgery performed?

In minimally invasive robotic surgeries, which are performed with incisions smaller than the small incision method, the integrity of the chest wall is preserved as the bone in the anterior chest wall is not cut. This ensures that respiratory system problems, which are the most common postoperative problem, are much less common. Apart from robotic surgery, minimally invasive surgery is also performed with smaller incisions than open surgery, without cutting the sternum. In both robotic and minimally invasive surgery, all surgical instruments are under the control of the cardiovascular surgeon. For this technique to be applied, the anatomy of the chest wall and heart must be appropriate. There are different minimally invasive approaches depending on the valve type.

Can mitral valve insufficiency be treated with herbal therapy?

Herbal supplements have no therapeutic efficacy in mitral valve insufficiency and may cause more harm than good. Such products should not be used unless recommended by a physician.

What is tricuspid regurgitation? What are the symptoms of tricuspid regurgitation?

Tricuspid regurgitation, like other valvular heart diseases, is the inability of blood to pass through the tricuspid valve due to various reasons. Tricuspid stenosis is also rare and is usually caused by rheumatic heart disease. Symptoms include enlarged liver and edema in the legs. It may also be called rheumatic mitral insufficiency or rheumatic valve disease.

What are the degrees of mitral valve insufficiency?

Generally, the degrees of mitral valve insufficiency are considered in 4 stages. In mitral valve insufficiency grade 1 and grade 2, that is, in the first two stages, the patient is frequently followed up and the problem is tried to be kept under control. In stages 3 and 4, the patient’s treatment should be initiated.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

WHAT IS PERIPHERAL ARTERY DISEASE?

The arteries that take the blood pumped from the heart to all other tissues and organs (brain, legs, arms, all organs in the abdomen) are generally called ‘peripheral arteries’.

Peripheral arterial disease is a condition in which the arteries become narrowed due to atherosclerosis (hardening of the arteries caused by excessive fatty deposits between the walls of the arteries) and as a result, the blood supply to the area that the arteries supply cannot be adequate. These diseases develop slowly but affect different parts of the body, causing different problems. The most commonly affected arteries are the carotid artery and the arteries to the kidneys, intestines and legs.

What ıs the ımportance of perıpheral artery dısease?

Today, ‘cardiovascular diseases’ are considered as a whole due to the increased mortality rates and the fact that stenosis occurs in the heart and brain vessels by the same mechanism. Therefore, peripheral arterial disease is a serious disease that affects all systems, apart from causing malnutrition in the organs involved.

The most common cause of peripheral arterial disease, especially in people over the age of 50, is atherosclerosis, but inflammatory diseases of the arterial wall, rheumatic diseases, congenital blood diseases or clotting disorders can also cause this disease.

The carotid arteries are the arteries on either side of the neck, known as the carotid arteries. They deliver oxygen-rich blood from the heart to the head and brain. Carotid artery disease, also known as carotid stenosis, is a serious condition. Blood clots can easily form in the areas where stenosis occurs, they can become blocked, or the plaque or blood clot can break off and block another smaller artery in the brain, causing a stroke.

Who ıs at rısk for perıpheral artery dısease?

1. Older age (45 years for men, 55 years or older for women or early menopause), although it is more common in men
2. High LDL-cholesterol (bad) and low HDL-cholesterol (good)
3. Smoking
4. Diabetes
5. Presence of high blood pressure (hypertension)
6. Family history of arteriosclerosis-related diseases
7. Disease in another area (e.g. heart vessels)
8. Obesity
9. Inadequate physical activity
10. Irregular and fatty diet

What are the symptoms of perıpheral artery dısease?

In the majority of patients with carotid stenosis, there are no obvious symptoms until the artery is severely narrowed or there is an acute arterial blockage due to clot formation. Plaque build-up in the carotid arteries can begin in early adulthood, but it takes decades for symptoms to appear. Symptoms can manifest directly as a transient ischemic attack or stroke.

In the case of a transient ischemic attack, blood flow to the brain is temporarily interrupted. A transient ischemic attack is similar to a stroke but lasts a few minutes and the symptoms usually disappear within an hour and the person returns to normal.

Transient ischemic attacks should be taken seriously because they are a warning that stroke and permanent brain damage may occur.

Symptoms of a transient ischemic attack or stroke may include

• Dizziness or unsteadiness,
• A sudden, severe headache with no known cause,
• Sudden vision problems in one or both eyes,
• Sudden one-sided weakness or numbness in the face or limbs,
• Difficulty speaking or understanding

The symptoms of a stroke are the same as those of a transient ischemic attack, but the consequences are different. A stroke can cause permanent brain damage, resulting in paralysis, long-term disabilities such as vision or speech problems, or death.

In the event of a stroke or paralysis, it is very important to get treatment as early as possible. If treatment is given to open the blocked artery within 4 hours of symptoms, a full recovery is likely.

Pain in the arteries of the legs, which goes away at rest and increases with fatigue. Sometimes the pain may radiate to the thighs and buttocks. In addition, there may be delayed wound healing, ulcers and gangrene in the leg. Other symptoms include progressive weakening and thinning of the calf muscles, a feeling of chilliness and coldness in the legs and feet, discoloration of the feet, loss of foot hair, thickening of the nails and even impotence.

What ıs the treatment of perıpheral artery dısease?

In addition to increased treatment options, the most important thing is not to delay treatment and to correct preventable risk factors such as diet, exercise and smoking.

In cases where the disease is not very advanced, follow-up with medical (drug) treatment can be performed.

In these patients, angiography is used for both diagnosis and treatment.

Surgical treatment includes peripheral bridging ‘bypass’ procedures and endarterectomy. Surgery can be performed for long segmented lesions within the vessel and vessels with multiple stenoses.

What are the surgıcal optıons ın perıpheral artery dısease?

Carotid Surgery:

Stroke surgery is an early surgical method applied in strokes related to the carotid artery. The surgery, which is performed to remove the stenosis in the carotid artery and prevent a possible stroke, is also applied to stroke patients who are suitable for surgery. Patients who are 7-10 days post-stroke can be treated with this method. These patients should be evaluated not only for vascular problems but also for diabetes mellitus (DM), hypertension (HT), heart disease or other large vessel disease. In carotid surgery, the inside of the vessel is cleaned and closed quickly. The operation is completed in about 1 hour.

Peripheral Vascular Surgery:

Peripheral vascular surgery means bypassing/bridging the blockage in the main artery carrying blood to the arm or leg. Bypass provides more blood flow to the tissue and relieves pain, allows healing of existing wounds and reduces the risk of serious infection and limb loss. The most appropriate treatment approach is decided after the obstruction is detected following Doppler ultrasonography of the affected area or after medicated computed tomography or MRI examinations.

In the open surgery technique, bridging (by-pass) surgery is performed using spinal anesthesia, leg vein (saphenous vein) or artificial vein (graft). After the operation, which is completed in about an hour, the patient is taken to the ward. The patient can walk the next day and is discharged in 2-3 days.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

What ıs varıcose veıns?

Varicose veins appear as enlarged purplish veins mostly seen in the legs. As it can be veins alone, it is actually often a symptom of the insufficiency of the venous system (venous insufficiency). Varicose veins can be classified in 3 ways. These are spider-like capillaries (telangiectasias) that cause discomfort only on the surface of the legs in terms of aesthetic appearance, larger, bulging veins (puckers), which are an important symptom of venous insufficiency, i.e. venous insufficiency, and more severe cases where both of these are combined.

What causes varıcose veıns?

It used to be thought that varicose veins were caused only by the deterioration and enlargement of the valves of the superficial veins as a reflection of increased pressure in the venous system due to various reasons. However, according to recent findings, it has been understood that the main problem in varicose vein patients is the deficiency of certain substances that provide the strength and durability of the vein walls. In fact, this information explains why varicose veins are more common in some families. The presence of a family history of varicose veins increases the likelihood of varicose veins 4.5 times compared to other people.

Who can get varıcose veıns?

Varicose veins can be seen in almost everyone. When a detailed whole body scan is performed in a completely normal population, the rate of varicose veins, albeit small, in different places and degrees increases up to 70-75%. However, clinically varicose veins;

– In women,

– Increased levels after pregnancy,

– Along with a sedentary lifestyle,

– People with a family history of varicose veins,

– In professions where you are sedentary and standing for a long time (such as hostess, teacher, barber, surgeon)

– And recently, it is actually more common in people who work in sedentary jobs (such as bankers and accountants who spend hours in front of a computer).

What are the symptoms of varıcose veıns?

Visual symptoms are more prominent in varicose veins. The most common symptoms are purple and raised thin or thick veins on the legs that did not attract attention before and appear later. Other symptoms can be listed as follows:

– Discomfort, heaviness and a feeling of fullness in the legs that increases towards the end of the day, and rarely pain.

– Swelling in the legs, especially in the ankles, may also progress upwards towards the end of the day.

– There may also be permanent purple color changes called pigmentation in the ankles.

– In more advanced varicose veins, sores may form on the legs.

– There may also be sudden bleeding in the veins.

What are the types of varıcose veıns?

Varicose veins can generally be classified into two types.

1. In varicose veins that develop due to insufficiency of the superficial veins of the legs, the superficial veins thicken and form thick, curved and raised veins under the skin towards the skin. Since this type of varicose veins can also disrupt the deep vascular system over time, they require intervention after a certain level. They may pose a risk for leg health.
2. Thin superficial varicose veins that occur and increase with the effect of the hormonal system, genetic and structural effects can also be called “Telangiectasia” or “Spider veins” varicose veins. These are more aesthetically troublesome. In other words, its appearance disturbs. They do not pose a serious threat to leg health or general health.

What are the condıtıons that ıncrease the rısk of varıcose veıns?

Heredity, that is, genetic transmission from the family, is perhaps the most important risk factor for varicose veins. If there is varicose veins in the family, the likelihood of varicose veins in the person is between 45% and 90%. Varicose veins are 4 times more common in women than in men. Pregnancy and overweight, birth control pills and hormone treatments also increase the susceptibility to varicose veins. Therefore, when all these factors are taken together, the risk increases significantly in women who have had a pregnancy and if there is a family history of varicose veins. Each pregnancy, with its hormonal effects and the serious burden it places on the body each time, increases the risk even more.

Another risk factor is long periods of sedentary standing or sitting work. The risk of developing varicose veins increases 2.7 times in those who stand for more than 4 hours a day. In the past, varicose veins were associated with certain professions such as teachers, air hostesses, dentists and surgeons. This was the case because such professions involved long hours of standing without moving. However, the modern working environment in office environments, where hours are spent in front of a computer, has now made almost everyone risky. While all risks seem to be more pronounced in women, men who live sedentary in a modern office environment and do not have sports habits are also at risk. It should not be forgotten that genetic transmission is also valid for men.

What symptoms does varıcose veıns cause?

Complaints vary with the severity of the disease. The first and most striking symptom is the appearance on the surface of the leg of thin or thick, tense veins that did not exist before. This is followed by leg pain when standing for long periods of time, a feeling of heaviness and more pronounced swelling, especially in the ankles. At this stage, the veins on the surface increase further and larger veins (pockets) appear, bulging outwards from deeper inside. In longer-term leg varicose veins, the swelling in the ankle is now more permanent. Below the knee and especially on the ankles, a permanent purple discoloration has begun. At a more advanced stage, sores (ulcers) begin to open in these areas, and because the walls of the veins on the surface are weakened by the tension, serious bleeding can occur due to scratching, impact or spontaneous bleeding. Since severe varicose veins are also a sign of severe venous insufficiency, the slowed upward flow can also cause sudden clotting and sudden vascular blockages.

How ıs varıcose veıns dıagnosed?

Varicose veins may be caused by superficial capillaries only, or may be accompanied by advanced insufficiency and obstruction of deep veins. For this reason, clinical examination by a physician is the most important in the first stage. During the examination, if the physician thinks that the patient’s complaints may be related to the severity of the patient’s visible varicose veins, he/she will request “Doppler Ultrasonography (USG)”. This is an examination performed without any medication, injection, etc. into the body. It is performed by applying a gel to the leg and gently moving an ultrasound probe that emits ultrasonic waves over the leg. The important thing here is that this examination is performed by an experienced physician with patience, taking his/her time, and especially afterwards by making the patient stand up and making the measurements precisely. Since varicose veins are caused by the valves in the veins not working properly, it is very important to evaluate the functioning of these valves while the patient is standing. A “Doppler Ultrasonography” result that is not performed under ideal conditions by people who do not have sufficient experience in varicose veins clinic can be very misleading on its own and may cause an unnecessary surgery.

How ıs varıcose veıns treated?

The aim of varicose vein treatment is to improve quality of life. The disease usually has a benign course and does not require surgery in most patients. It is very important to determine that the patient’s complaints and varicose veins are indeed related. Most of the time, when varicose veins are seen in the legs of all patients with leg pain, it is seen that varicose veins are considered to be the cause of the pain and varicose veins are treated. Varicose veins cause significant pain only at advanced levels. Usually these pains can be associated with neurological or orthopedic problems.

If there are only spider-shaped varicose veins (telangiectasias) on the skin and there is no serious leakage in the main veins inside on Doppler, this is only an aesthetic problem. Laser applications can be performed on these veins through the skin. 

Foam sclerotherapy can be applied for larger veins. In this application, which is also performed in an outpatient setting, a drug application is made with very thin needles to irritate the thin veins from the inside. These veins coagulate over time and are eliminated by the body over time. In an average period of 2 months, most of the varicose areas are eliminated. 

In more advanced varicose veins, the veins called saphenous veins must be removed. The classical method is to remove the diseased part of the vein (stripping). The other method is to leave this vein in place and to coagulate or close it by burning it with an intervention made from inside the vein. In these so-called endovenous methods, laser, radiofrequency and sometimes intravascular glue applications may be preferred. The physician decides which method is appropriate for the patient on a patient-by-patient basis based on examination and Doppler USG findings. The location, degree and diameter of the insufficiency in the veins are very important in determining the treatment options.

In severe varicose veins, there may also be edema in the leg. In this case, some medications can be used. Vasotonic drugs can be used to make the veins more tight against blood pressure. These medications will help with pain and heaviness and will also reduce edema.

Compression stockings are still important in treatment. When there is insufficiency in the internal veins, it is difficult for the blood to flow upwards, so these stockings, which are specially knitted to direct the blood from the bottom upwards, will support the circulation and prevent the disease from progressing further by preventing the ongoing high pressure on the vein. Compression stockings do not eliminate the disease, they only slow down or prevent it from progressing further. Therefore, compliance with the stockings is important. On the other hand, as they are tight stockings, they are not always easy to put on and patients are often reluctant to continue with this treatment. For this reason, interventions to be performed before varicose veins reach very advanced levels, while there is still a chance of intervention, can also protect you from lifelong use of stockings.

Products such as horse chestnut and red grape extract can also be used for varicose veins if deemed appropriate by the doctor. These can be useful in relieving the symptoms of the disease, but they are not used to solve the actual vascular insufficiency.

What are the methods used ın varıcose veıns treatment?

Treatment options vary according to the level and type of varicose veins. In mild varicose veins, the first option is to prevent its progression by making some lifestyle changes. Especially moving more is the most important factor. Again, tight compression stockings (compression stockings) that provide external pressure support to the leg can be used to prevent progression. If there is edema in the leg, a group of drugs called vasotonic drugs can be used. Capsules and ointments made from horse chestnut can also be used to reduce the patient’s discomfort.

If an attempt is to be made to eliminate varicose veins in the legs, there are also different options.

– Transdermal/Epidermal Laser:   For the thinnest capillary varicose veins (telangiectasia), these veins can be burned with radiofrequency or laser application on the skin.

– Foam sclerotherapy: In slightly thicker telangiectasias, a foamy sclerosing substance is injected into the vein to coagulate these veins and then eliminated by the body.

– Phlebectomy: Even thicker and bulging veins can be removed from the inside through a 1-2 millimeter incision in the skin.

– If there is insufficiency in the superficial main veins, there may be two approaches to eliminate this large vein:

1. Stripping: Removing the vein from the inside between two small incisions.
2. Endovenous Laser Ablation (EVLA): Burning the vein from the inside using radiofrequency or laser energy, leaving the vein inside.
3. Glue-Glue application: Gluing the vein by applying glue from the inside.

Which method is suitable for which patient may vary depending on the level of the disease in the leg and the experience and preferences of the doctor.

How can varıcose veıns be prevented?

Being genetically predisposed to varicose veins does not mean that you will develop varicose veins. Lifestyle and preferences are very important here. It is necessary to avoid excessive weight gain and loss, to take regular walks, to keep the leg muscles strong, to get up and walk around in 1-2 hour intervals if you work at the computer for long hours during the day. It is recommended to keep the legs a little higher by placing a height under the table. In women, it is important to be active again, especially during pregnancy, to avoid excessive weight gain and to support the legs with compression stockings, especially in the last period.

Frequently asked questıons about varıcose veıns

How does varicose veins disappear?

Formed varicose veins do not disappear spontaneously. If it is desired to disappear, it requires intervention in a way that one of the treatment methods suitable for the type of varicose veins of the person will be applied. The main goal should be to prevent varicose veins from forming and to prevent its progression if it has already formed.

 Why does varicose veins occur at a young age?

Varicose veins can be seen not only at older ages but also at a young age. There are various reasons for this. If there is a family history of varicose veins, if you lead a very sedentary life, if you work in professions where you stand or sit for a long time, and during pregnancy, the likelihood of varicose veins in young patients increases.

What is good for varicose vein pain?

Varicose veins do not actually cause much pain. However, towards the end of the day, it creates a feeling of fullness and discomfort, also described as pain in the leg. The best thing will be to rest the legs by stretching them. When lying down, the pressure in the venous system will decrease and the discomfort will decrease. It is even better if a slight elevation is placed under the legs. At the last stage during showering, washing the legs with water that is slightly colder than normal shower water will also help with the discomfort. Vasotonic drugs and creams made with horse chestnut extract also help to relieve the pain in the legs.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

What ıs vasculıtıs?

Vasculitis, which means inflammation of the walls of blood vessels (arteries, veins and capillaries), causes damage to the vessels by causing changes such as thickening, narrowing and weakening of the vessels. As a result, tissue and organ damage occurs as blood flow to the tissues and organs supplied by the vessel is limited. Since any type and size of vessel can be affected anywhere, vasculitis is not a single disease, but a group of very large and diverse diseases. It can affect one organ or multiple organs and systems. It can be acute (short-term) or chronic (long-term). Behçet’s disease, giant cell arteritis (temporal arteritis), Takayasu’s disease, polyarteritis nodosa, granulomatous polyangiitis, eosinophilic granulomatous polyangiitis, henoch schönlein purpura, cutaneous small vessel vasculitis are some examples of vasculitis. It can affect people of all ages and races, but some specific types of vasculitis are more likely to be seen in certain age groups.

What are the symptoms of vasculıtıs?

Fever, headache, fatigue, weakness, weight loss, shortness of breath, bloody sputum, chronic sinusitis, bloody crusted nasal discharge, recurrent canker sores, sores in the genital area, chronic ear infections, hearing loss, joint pain and swelling, muscle pain, night sweats, skin rashes, skin sores, numbness and muscle weakness in the body, redness in the eyes, loss of vision.

How ıs vasculıtıs dıagnosed?

Findings, clinical examination, laboratory tests, sometimes biopsy and imaging techniques (radiographs, ECHO, Doppler, CT angiography, MR angiography) are evaluated together. Since vasculitides are rare diseases, differential diagnosis with other diseases that cause similar findings and symptoms should be made well. Vasculitis should be considered especially when there is an undiagnosed disease affecting systems. It is especially important to exclude infections since immunosuppressive drugs will be prescribed.

What ıs the treatment of vasculıtıs?

The treatment of vasculitis varies according to the vessel involved, the organ-system damaged and the severity of the disease. While some types of vasculitis regress spontaneously and do not require treatment other than simple painkillers, in others, treatment should be started quickly with cytotoxic and cortisone-containing drugs and vasculitis should be controlled before life-threatening organ damage develops. Since some vasculitis tends to recur, long-term maintenance treatment is usually given. Some vasculitis may be accompanied by chronic hepatitis B and chronic hepatitis C infections; in such cases, these infections should be treated first. Sometimes rheumatic diseases such as cancer diseases, rheumatoid arthritis and connective tissue diseases may occur under vasculitis. Again, these underlying diseases should be treated first.

Frequently asked questıons about vasculıtıs

Why does vasculitis occur?

The exact cause of vasculitis is not yet known. The immune system (immune system) works incorrectly and perceives the vessels as a foreign invader and declares war on them. It can occur in the presence of certain environmental factors such as a person’s genetic predisposition, infections. Smoking, being a carrier of chronic hepatitis B and hepatitis C, having other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus can cause vasculitis. Some foreign substances, medicines and cancers can also cause vasculitis.

What does vasculıtıs cause?

If left untreated, some vasculitis can lead to organ damage (kidney failure, lung damage), blood clots, stroke, aneurysms, permanent vision loss, and serious infections.

What to eat and what not to eat for vasculitis?

There is no special diet for vasculitis. It is important to eat a healthy, mediterranean-type diet, high-fiber foods, low-fat dairy products, lean meat products, plenty of fruits and vegetables and a balanced diet. Fatty and sugary foods should be avoided. Drink plenty of water. Alcohol should not be consumed together with the inflammation suppressing drugs given as it may affect the liver. Since these patients usually use cortisone, they should eat salt-free, and it is useful to take calcium and vitamin D supplements due to the bone resorption side effects of cortisone drugs.

What is good for vasculitis?

Regular exercise (walking, swimming, aerobics, pilates, cycling, dancing) is beneficial for vasculitis patients as it provides happiness, protects against osteoporosis, keeps them fit and vigorous. Everyone should do their favorite exercise that is good for them and should not force themselves to exercise excessively. Since vasculitis can cause fatigue and weakness, patients with vasculitis should also get enough rest and sleep well. It is essential to quit smoking, as smoking can lead to narrowing of the vessel walls and lung disease. Social support, spending as much time as possible with family and friends is effective in reducing stress. Creating patient groups with other patients with vasculitis and getting together with them can also be useful in terms of patients not feeling alone.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.

What are the causes of ventrıcular septal defect (vsd)?

Ventricular Septal Defect (VSD) can be caused by genetic factors such as chromosomal abnormalities, consanguineous marriages and unconscious use of drugs during pregnancy. Ventricular Septal Defect (VSD) occurs during the development of the baby during pregnancy.

What are the symptoms of ventrıcular septal defect (VSD)?

Although it can cause different clinical symptoms depending on its type and size, in patients with Ventricular Septal Defect (VSD), there is an extra blood flow from the left heart to the right heart due to the hole, so too much blood goes to the lungs. This can cause the following symptoms:

– Frequent recurrent lung infections

– Growth and development retardation

– Systolic murmur, that is, a murmur during contraction of the heart

– Rapid breathing and shortness of breath

How ıs ventrıcular septal defect (VSD) dıagnosed?

The first preliminary diagnosis of Ventricular Septal Defect (VSD) is made with the systolic murmur (murmur that occurs during contraction of the heart) heard on examination. The definitive diagnosis is made by echocardiography. Echocardiography can evaluate the number of holes in the heart, the type and size of the Ventricular Septal Defect (VSD), the direction and amount of blood flowing through the hole in the heart, and changes in the heart cavities due to the Ventricular Septal Defect (VSD).

What ıs ventrıcular septal defect (VSD) treatment?

Ventricular Septal Defect (VSD) treatment depends on the size, location and severity of the hole, but is usually performed after about 4 months and the hole is closed. While some of these can be closed by angio/umbrella method, most are closed by open heart surgery. If left untreated, increased pulmonary blood pressure and heart failure may develop.

The small-sized ones can be followed clinically as they may close spontaneously.

Is Atrial Septal Defect (ASD) or Ventricular Septal Defect (VSD) more dangerous?

Ventricular Septal Defect (VSD) is more dangerous. Atrial Septal defect (ASD) can remain asymptomatic for many years. Pulmonary hypertension can develop at an advanced age in Atrial Septal Defects (ASD), but in Ventricular Septal Defects (VSD) it can develop at a very early age, even in infancy, and can eliminate the chance of treatment.

How is Ventricular Septal Defect (VSD) surgery performed?

Ventricular Septal Defect (VSD) surgery is performed by open heart surgery, that is, by stopping the heart. Open heart surgery is preferred for the treatment of the majority of Ventricular Septal Defect (VSD) surgeries. A patch or suture may be used to close the hole between the heart chambers. During the period when lung and heart functions are stopped, these tasks are performed by a heart-lung machine.

Some Ventricular Septal Defects (VSDs) can also be treated with the angio/umbrella method. In this method, which does not require open heart surgery, the hole in the heart can be closed with the help of a catheter placed in the groin vein.

How many mm does the hole in the heart require surgery?

The size of the hole in the heart is important for surgery. However, rather than the size of the hole, the amount of blood flowing to the lungs and the right/left heart shunt ratio determine the decision for surgery.

What should be considered in babies with Ventricular Septal Defect (VSD) surgery?

It is important to keep babies who have undergone Ventricular Septal Defects (VSD) surgery in healthy environments in the near postoperative period. Therefore, it is recommended to keep them away from sick individuals and crowded environments for two weeks.

In the long term, children who have had this surgery can engage in similar physical activities as their peers without special precautions and without any increased risk. However, these children should be followed up regularly by a pediatric cardiologist.

How many hours does Ventricular Septal Defect (VSD) surgery take?

The duration of Ventricular Septal Defects (VSD) surgery may vary depending on the number of holes in the heart. However, in general, Ventricular Septal Defects (VSD) surgery takes approximately 3 hours after the patient enters and leaves the operating room.

Can patients with Ventricular Septal Defects (VSD) do sports?

Heavy sports are not recommended in the first three months after Ventricular Septal Defect (VSD) surgery. Afterwards, they can do any sport they wish under completely normal living conditions.

What are the risks that can be seen after Ventricular Septal Defect (VSD) surgery in infants?

After Ventricular Septal Defect (VSD) surgery, heart rhythm disorders and incomplete closure of the hole may occur with a very low percentage.

Is there a drug treatment for Ventricular Septal Defect (VSD)?

There is no medical treatment for Ventricular Septal Defect (VSD), but medication is used in cases of heart failure due to this disease and pulmonary hypertension that occurs in untreated VSDs.

When does a Ventricular Septal Defect (VSD) close in infants?

About half of small holes can close spontaneously. Holes that do not close over the age of one year require close and careful follow-up and treatment.

What are the types of Ventricular Septal Defect (VSD)?

The holes on the structure called the septum, which separates the two ventricles (ventricles), form the types of VSDs according to their location. Holes in the area called perimembranous septum are known by this name and are the most common type of VSD. Muscular VSD is characterized by multiple, large and small holes. Inlet and outlet VSDs are used for VSDs located in the middle and outlet of the heart.

What is the incidence of Ventricular Septal Defect (VSD)?

Ventricular Septal Defect (VSD) can occur in approximately 2 in every 1,000 live births.

Does a Ventricular Septal Defect (VSD) grow?

VSD can shrink but does not grow. However, its size may change with the child.

What happens if the VSD is not closed? What are the complications?

All important VSDs that do not close spontaneously should be closed. If not closed, recurrent lung infections, growth and developmental retardation may occur in the early period. Later, very serious conditions such as pulmonary hypertension, endocarditis and heart failure may develop.

*Page content is for informational purposes only. Please consult your doctor for diagnosis and treatment.