Dr. Huynh Hoang Khang, Head of the Department of Cardiovascular Surgery at Tam Anh General Hospital's Interventional Cardiology Center in Ho Chi Minh City, diagnosed Hue with severe mitral valve stenosis, aortic valve stenosis and regurgitation, and tricuspid regurgitation. These conditions led to pulmonary hypertension, enlargement of both ventricles and atria, causing the heart to double in size. His heart's pumping function was severely reduced (ejection fraction of 35%), and he also suffered from stage 3B kidney failure.

Mitral valve stenosis occurs when the mitral valve cannot fully open, restricting blood flow from the left atrium to the left ventricle. The accumulated blood in the left atrium increases pressure and causes blood to pool in the lungs, leading to fatigue and shortness of breath. Without prompt treatment, the condition can cause dangerous complications such as pulmonary hypertension, heart failure, atrial fibrillation, and stroke.

According to Dr. Khang, if Hue had undergone surgery when the condition was first discovered 17 years prior, only the mitral valve would have needed repair or replacement, and the other valves would have remained undamaged. Due to the disease's progression, he required a complex surgery to repair and replace multiple valves. Without intervention, his heart's pumping function would have further deteriorated, potentially causing complete heart failure and worsening pulmonary hypertension, leading to pulmonary edema and severe shortness of breath, at which point surgical intervention would no longer be an option.

The surgical team replaced Hue's mitral and aortic valves and repaired his tricuspid valve. Due to his pre-existing kidney failure, the use of a heart-lung machine during surgery carried the risk of heart and kidney failure. To mitigate these risks, doctors provided intensive care, including an intra-aortic balloon pump and continuous renal replacement therapy. After two days, his heart and kidney function stabilized, and the balloon pump and dialysis were discontinued.

Hue's health gradually improved, with his heart's pumping function increasing to a normal 56%, and his heart chambers began to shrink. He was discharged after 10 days and did not require regular dialysis.

Dr. Khang advises Hue to adhere to follow-up appointments and maintain a healthy lifestyle after discharge. Photo: Ha Vu

Dr. Khang advises Hue to adhere to follow-up appointments and maintain a healthy lifestyle after discharge. Photo: Ha Vu

Early-stage mitral valve stenosis often presents no noticeable symptoms. The disease progresses slowly over many years, and patients often discover it incidentally during an echocardiogram. As the disease advances, symptoms may include shortness of breath during exertion or sudden nighttime shortness of breath, fatigue, weakness during physical activity such as running or climbing stairs, swollen legs, palpitations, rapid heartbeat, dizziness or fainting, coughing up blood, and chest pain or discomfort.

After valve replacement surgery, patients require regular check-ups to monitor the artificial valve's function. They should limit their intake of salty foods and drinks, maintain a healthy weight, lose weight if obese, avoid alcohol and smoking, limit caffeine consumption due to the increased risk of arrhythmia, reduce strenuous activities, exercise regularly, take prescribed medications, and attend follow-up appointments as directed by their doctor. Women of childbearing age with mitral valve stenosis should consult their doctor before becoming pregnant.

Thu Ha