Structural Challenges in Native Atrioventricular Valves Replacement

Area of Science:

• Cardiology
• Biomedical Engineering
• Pathophysiology

Background:

• Atrioventricular (AV) valve disease presents a major health burden, especially in the Indian subcontinent where rheumatic heart disease remains prevalent, contrasting with the degenerative causes more common in Western populations.
• Annual global heart valve replacements exceed 300,000, yet these procedures are associated with significant complications.
• Interactions between native tissue properties (macroscopic and microscopic) and artificial heart valves/rings introduce complex challenges.

Purpose of the Study:

• To emphasize the critical need for understanding the intricate and diverse anatomy of Atrioventricular (AV) valves.
• To correlate anatomical understanding with the pathophysiology of AV valve disease.
• To inform the selection of optimal treatment strategies for AV valve disease.

Main Methods:

• Review of existing literature on AV valve anatomy and pathophysiology.
• Analysis of complications associated with heart valve replacements.
• Comparative study of disease prevalence (rheumatic vs. degenerative) in different global regions.

Main Results:

• Rheumatic heart disease is a dominant cause of AV valve disease in the Indian subcontinent.
• Degenerative heart disease is more prevalent in Western countries.
• Complications in valve replacement surgeries are linked to the interaction between biological tissues and prosthetic devices.

Conclusions:

• A comprehensive understanding of AV valve anatomy is essential for diagnosing and treating valve diseases.
• Knowledge of complex anatomical variations is key to mitigating complications from valve replacement therapies.
• Tailoring treatment based on a deep understanding of AV valve pathophysiology and patient-specific anatomy is paramount.