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Heart Valve Replacement Surgery

Heart Valve Replacement is generally an open heart operation, which means the surgeon will open the chest & heart so as to remove damaged valves. The new artificial valve is subsequently sewn into place. Some operations are also performed through minimally invasive surgery, which is without opening the chest. For this purpose a small incision is made near breastbone or under the right chest muscle. Almost 65,000 heart valve replacements & repairs are performed each year in United States alone. Twice as many women compared to men are affected by mitral valve stenosis. Mitral valve prolapsed is one of the most common condition of heart valves which affects about 2% of the general population. Mitral valve prolapsed however does not guarantee development of mitral insufficiency. Mitral valve stenosis can be congenital or found in patients with history of rheumatic fever, collagen vascular disease, ineffective endocarditis or coronary artery disease.

Heart Valve Replacement

What is Heart Valve Replacement?

Heart valve surgery is generally used to replace or repair diseased heart valves. Blood flowing through different chambers of heart must essentially flow through heart valves. Even the blood flowing in & out of heart must pass through heart valves. These valves are designed to open up for blood to flow through & close in order to keep blood from rushing backwards.

There are four types of valves in human heart.

  • Aortic Valve
  • Mitral Valve
  • Tricuspid Valve
  • Pulmonic Valve

Aortic valve is the most common type of valve which is replaced, since it cannot be repaired. Mitral valve is the most common valve which is repaired through surgery. Tricuspid valve & Pulmonic valve are rarely repaired or replaced.

When You Need Heart Valve Replacement?

 

When You Need Heart Valve Replacement?

Surgery is normally required when valves fail to work properly –

  • Some valves do not close completely & allow blood to leak backward; this condition is called regurgitation.
  • Some valves do not fully open & limit forward blood flow; this condition is called stenosis.

Following reasons also call for heart valve surgery –

  • Defects in heart valves causing heart symptoms like angina or chest pain, syncope or fainting spells, shortness of breath or heart failure.
  • When tests determine changes in heart valve are beginning to seriously affect heart function.
  • When surgeons want to repair or replace heart valve combined with open heart surgeries like coronary artery bypass graft surgery (CABG).
  • Endocarditis – when heart valve is damaged by infection.
  • When previous heart valve replacement is not working properly.
  • You have problems of bleeding, infection or blood clots.

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Treatments for Heart Valve Repair & Replacement

Heart Valve Associated Problems Treated with Surgery –

  • Aortic Stenosis
  • Aortic Insufficiency
  • Congenital Heart Valve Disease
  • Mitral Stenosis
  • Mitral Regurgitation – Acute
  • Mitral Regurgitation – Chronic
  • Mitral Valve Prolapse
  • Tricuspid Valve Stenosis
  • Tricuspid Regurgitation
  • Pulmonary Valve Stenosis

Mitral valve is one of the most common heart valves repaired. Aortic, Tricuspid & Pulmonic heart valves also undergo repairs at times. When heart valves can be repaired, surgeons may perform any of the following forms of heart valve repair procedures.

  • DecalcificationThis procedure removes calcium deposits so as to allow leaflets flexibility for proper closure.
  • CommissurotomyFused valve leaflets are separated in this procedure so as to widen valve opening.
  • Reshape LeafletsThis is usually done when one of the leaflets is floppy. Segments may be cut & leaflet sewn together so as to allow valve close tightly. This procedure is termed quadrangular resection.
  • Patched LeafletsTissue patches are often used by surgeons so as to repair leaflets with holes or tears.
  • Annulus SupportRing of tissue supporting heart valve is called annulus. When valve annulus is too wide, it is tightened or reshaped by sewing a ring structure around annulus. This ring may be made of synthetic material or rissue.
  • Chordal TransferWhen anterior leaflet of mitral valve is floppy & lacking support, chordae are transferred from posterior leaflet to anterior leaflet. Posterior leaflet is repaired by quadrangular resection in mitral valve prolapsed.

Heart Valve Replacement Procedure

Surgeons normally open up the chest in order to solve heart valve problems. During majority of procedures, patient’s heart is temporarily stopped & put on heart/lung machine which takes over breathing & blood circulation. Minimally invasive technique is also a good option in certain cases. With recent advances in procedural techniques, many cardiac surgeons are using minimally invasive procedures for replacing heart valves as they potentially reduce scarring, pain & time for recovery. Surgeons will however, determine which one is the most ideal procedure to be employed in individual cases.

1. Before Heart Valve Replacement

Normally performed under general anesthesia, preparations for procedure with generally depend upon the type of valve replacement surgery. In order to help patients learn more about procedure, doctors may suggest they talk with different members of the surgical team including anesthesiologist, cardiologist, surgeon, respiratory therapist & nurses. Discussions with family members about details of operation are also encouraged. Patients are also advised to visit the intensive care unit (ICU) where they will spend time for postoperative recovery.

2. During Heart Valve Replacement Procedure

Most patients are admitted to hospital on the day prior to surgery, or in the morning of surgery in some cases. Due to general anesthesia, patients will be asleep & unable to feel anything during surgery. Small metal discs known as electrodes will be attached to patient’s chest which is connected to an electrocardiogram machine so as to monitor cardiac rhythm & electrical activity. For patients undergoing open heart surgery, surgeons will make a large incision in the breastbone so as to reach heart & aorta. Connected to a bypass pump or heart-lung bypass machine, patient’s heart will be completely stopped during the operation. Minimally invasive heart valve surgery is performed through smaller incisions, or through catheter inserted through skin. After the surgeon has finished repair or replacement the heart is then restarted & disconnected from heart-lung machine. Surgeries can take anywhere between 2 – 4 hours depending upon the number of valves which need to be replaced or repaired.

Techniques used for Heart Valve Replacement & Repair

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Procedures for Heart Valve Replacement & Repair

  • Ring AnnuloplastySurgeons repair ring like tissue around valve by sewing ring of tissue, plastic or cloth around valve.
  • Valve RepairSurgeons trim, shape or rebuild one or more leaflets of valve. Leaflets are flaps aiding opening & closing of valves. Valve repair is ideal procedure for tricuspid & mitral valves. Valve replacement surgery is employed when valves are damaged beyond repair. Surgeons will remove the damaged valve & put a new prosthetic in place.

Main Types of Replacement Valves

  • Mechanical ValvesThese valves are made of man-made materials like titanium, stainless steel or ceramic. While these last long, patients will require to take, blood-thinning medications like asprin or warfarin for the rest of his/her life.
  • Biological Valves Made of animal or human tissue, these valves last for 12 – 15 years, & patients need not take blood-thinning medications for life.

In quite a few cases, surgeons use patient’s own pulmonic valve so as to replace damaged aortic valve. This is called Ross Procedure, where subsequently the pulmonic valve is replaced with artificial valve. This procedure is effectively useful for patients who do not want to take blood thinners for the rest of his/her life. But then, this new aortic valve does not last long & will need to be replaced again with a biologic or mechanical valve.

After Heart Valve Surgery

Recovery after heart valve repair or replacement surgery will depend upon the procedure & surgery you choose to undergo. Average stay in the hospital is about 5 – 7 days. Before discharge, nurses will also tell you how to take care at home. Complete recovery might take anywhere between a few weeks to several months depending upon the procedure & overall health. Success rate of heart valve surgery is pretty high & can effectively relieve symptoms & prolong life. Mechanical valves rarely fail & last 8 – 20 years on average depending upon the type. Blood clots can however develop on valves & increase risk of having a stroke. Although rare, bleeding may also occur at times. Clicking of mechanical heart valves can often be heard by patients in chest & which is considered normal.

Benefits & Risks of Heart Valve Replacement

Depending upon individual condition, most patients begin to feel effects of heart valve repair soon after operation.

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Benefits

Most patients immediately feel results after valve repair surgery. Others notice gradual improvement spanning over several weeks following surgery. Doctors will help evaluate progress & recommend activities & programs so as to help restore energy & strength.

Risks

Possible Risk of Heart Valve Replacement

Risks involved with heart valve replacement & repair surgery include –

  • Abnormal heart rhythms
  • Blood clot formation around valve
  • Problem with valve as it may cause narrowing of opening
  • Damage to red blood cells
  • Blood leakage in small amounts through valve after closing
  • Bleeding or hemorrhage relating to anti-clotting medication
  • Endocarditis – Inflammation of heart lining

Heart Valve Repair Surgery Cost

In most cases, heart valve repair surgery is an open heart procedure. This means that it is an extensive operation which involves the cardiac surgeon to open up the patient’s chest & heart in order to repair the defective heart valve. However, heart valve repair surgery is also performed through the minimally invasive surgical technique involving mini incisions made within the sternum (breastbone) or under the right pectoral muscle so as to access the heart valve. Cost of heart valve repair surgery will therefore depend upon the type of procedure, the hospital facility & the expertise of the cardiac surgeon. Nevertheless, India is one of the leading global medical tourism destinations offering high quality of heart valve repair surgery at affordable costs. In fact, price of heart valve repair surgery in India is just a fraction of what it costs in medically advanced countries like Australia, United Kingdom, Canada & United States, while the standard of cardiac surgery is at par with the best in the world. IndianMedTrip is associated with top cardiac surgeons & internationally accredited hospital facilities in the country & are well placed to offer the best treatment packages at the most competitive prices. International patients can also avail free online consultation with IndianMedTrip doctors alongside availing the most affordable heart valve repair surgery packages.

Heart Valve Replacement Surgery in India

India is a renowned global destination to undergo affordable heart valve replacement & repair surgeries. Cardiac surgeons associated with IndianMedTrip are top heart specialists with most successful heart valve repair & replacement operations to their credit. IndianMedTrip services are some of the best you can get in the country which include assistance for medical visas, choosing the best surgical procedure & hospital, warm reception at airport, transportation, accommodation, scheduling appointments with doctors & check-in to hospitals for treatment. Offering extraordinary & hassle-free healthcare packages for international tourists, IndianMedTrip healthcare consultants will work out every detail for you throughout this medical experience.

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