Mitral Valve Surgery - Surgery Series, 2/2/21
34:34-36:49
So considerations that you make when you're, when you're deciding about surgery so clearly repair is the goal just like it is now with the aortic valve but you always have to talk ahead of time with a surgeon and, and with a cardiologist about what you would do if repair is not possible.
僧帽弁手術では、大動脈弁の場合と同様に修復を目指すべきなのですが、修復できない場合にどうするかについては、必ず事前に心臓外科医や循環器内科医と話し合っておく必要があります。
So before the surgery and if, you know, in the surgery if the, if the decision is made that these leaflets are, are too degenerated or there's calcification of that annulus and it makes repair unlikely to, to work a replacement is then indicated and you have to make a decision ahead of time about whether you would want a mechanical valve or a tissue valve.
弁尖にかなりの変性がみられたり、弁輪が石灰化しているなど、修復が不可能と思われる状況が術前あるいは術中に判明した場合には、置換術が選択されることになります。そこで、機械弁にするか生体弁にするかを事前に決めておかなければなりません。
There are pros and cons to each but the crux of the mechanical valve is that they last longer but they do require a lifelong blood thinning with a blood thinner called warfarin and one difference with mitral valves, mechanical mitral valves is that they require a higher INR goal. The blood has to be thinner than it does with a mechanical aortic valve. The the pro of a tissue valve is that coumadin is not necessary but these valves don't last as long.
両方の弁にはそれぞれ長所と短所があります。機械弁は長持ちしますが、血液をサラサラにするため、生涯にわたってワーファリンという薬を飲み続けなければなりません。僧帽弁を機械弁に置換した場合、大動脈弁を機械弁に置換した場合よりも、INRを高い数値に保つ必要があります。生体弁に置換した場合、ワーファリンを飲む必要はありませんが、耐久性に劣ります。
Both types of valves both a mechanical valve and a tissue valve are at risk for infection, which is known as endocarditis, which occurs when bacteria gets into the bloodstream from some type of infection usually from the mouth source or the skin that can come from anywhere that these bacteria will, will set up shop will, will actually veget, will form vegetations on the prosthetic valve.
機械弁、生体弁ともに感染症のリスクがあり、感染性心内膜炎として知られています。通常、口腔や皮膚の感染症などから細菌が血流に侵入することで発症しますが、感染症の場所によらず発症する可能性があります。これらの細菌は置換された弁で増殖します。
So having a prosthetic valve of any type requires very meticulous dental and wound care. It requires that you take antibiotics before dental work and just kind of common sense in general making sure that you're looking out for signs and symptoms of infection like fevers and chills.
そのため、人工弁の種類を問わず、歯や傷のケアには細心の注意が必要です。歯科処置の前には抗生物質を服用し、発熱や悪寒といった感染症の症状に敏感にならなければなりません。
In the big picture, though, it is not easy to infect a valve and usually these infections are rare if people are taking care of skin and teeth.
とはいえ、全体的にみれば、歯や皮膚のケアを行っていれば、弁への感染はそう簡単には起こりませんし、こうした感染症には滅多にかかりません。
The Marfan Foundation did not participate in the translation of these materials and does not in any way endorse them. If you are interested in this topic, please refer to our website, Marfan.org, for materials approved by our Professional Advisory Board.
The Marfan Foundation は、当翻訳には関与しておらず、翻訳内容に関してはいかなる承認も行っておりません。このトピックに興味をお持ちの方は、Marfan.org にアクセスし、当協会の専門家から成る諮問委員会が承認した内容をご参照ください。
