Page 1711 - Saunders Comprehensive Review For NCLEX-RN

1. Valvular heart disease occurs when the heart valves
cannot open fully (stenosis) or close completely
(insufficiency or regurgitation).
2. Valvular heart disease prevents efficient blood flow
through the heart.
B. Types
1. Mitral stenosis: Valvular tissue thickens and narrows
the valve opening, preventing blood from flowing
from the left atrium to the left ventricle.
2. Mitral insufficiency, regurgitation: Valve is
incompetent, preventing complete valve closure
during systole.
3. Mitral valve prolapse: Valve leaflets protrude into the
left atrium during systole.
4. Aortic stenosis: Valvular tissue thickens and narrows
the valve opening, preventing blood from flowing
from the left ventricle into the aorta.
5. Aortic insufficiency: Valve is incompetent, preventing
complete valve closure during diastole.
6. For aortic disorders, see Table 52-2.
7. For tricuspid disorders, see Table 52-3.
8. For pulmonary valve disorders, see Table 52-4.
C. Repair procedures
1. Percutaneous balloon valvuloplasty
a. A balloon catheter is passed from the
femoral vein through the atrial septum
to the mitral valve or through the
femoral artery to the aortic valve.
b. The balloon is inflated to enlarge the
orifice.
c. Monitor for bleeding from the catheter
insertion site.
d. Institute precautions for arterial
puncture if appropriate; site care and
monitoring is similar to that after
cardiac catheterization.
e. Monitor for signs of systemic emboli.
f. Monitor for signs of a regurgitant valve
by monitoring cardiac rhythm, heart
sounds, and cardiac output.
2. Mitral annuloplasty: Tightening and suturing the
malfunctioning valve annulus to eliminate or greatly
reduce regurgitation; percutaneous or open surgical
approach.
3. Commissurotomy, valvotomy
a. Thrombi are removed and calcium
deposits are debrided; the valve is
incised and widened.

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