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Heart Valve Replacement: Definition
For the heart to function right, blood must flow in only one direction, which is done by the heart valves. Healthy valves open and close in a precise way as the heart pumps blood. Each valve has a set of flaps called leaflets that open to allow blood to pass from the heart chambers into the arteries. Then they close pack to stop blood from flowing back into the chambers.
Heart surgery is performed to fix leaflets that don’t open as wide as they should, hampering the amount of blood flowing through the valve into the artery. Heart surgery also is done to fix leaflets that don’t close tightly. This means blood can leak backward into the chambers, rather than only moving forward into the artery as it should. To fix it, surgeons either repair the valve or replace it. Replacement valves are taken from animals, made from human tissue, or made from man-made substances.
Surgery for Heart Valve Repair / Replacement:
Stenosis (valve narrowing) may be corrected by cutting, separating or reconstructing the valve leaflets, or other valve components, to widen the valve opening. Most patients with stenosed valves require valve replacement.
Regurgitation (valve leakage) may be corrected by replacing or shortening the supporting valve structures to allow the valve to close tightly, or by inserting a prosthetic ring to reshape a deformed valve. Valve flaps (leaflets) may also be modified to stop blood from flowing backwards.
Annuloplasty is the surgery performed on the valve’s annulus, the ring of tissue that supports the valve leaflets. Purse-string sutures are sewn around the ring to make the opening smaller which helps the leaflets meet again when the valve closes. Sometimes when repairing the annulus, it is necessary to implant an annuloplasty ring where the leaflets meet the fibrous annulus to downsize an abnormally enlarged valve opening so the leaflets can come together properly.
Repair of structural support
Repair of structural support replaces or shortens the cords that support the valves (chordae tendineae and papillary muscles). When the cords and muscles are the right length, the valve leaflet edges meet and eliminate the leak.
Valve repair (Valvuloplasty)
Valve repair may be done when a valve leaflet is floppy and prolapses. The procedure involves surgically separating, cutting out a section, or pleating a valve leaflet.
In Valve replacement, the defective valve is replaced with an artificial (prosthetic) valve by sewing it to the annulus of the natural valve. Approximately, 95 percent of all valve replacements are performed for mitral or aortic valves. It is the replacement of one or more of the heart valves with either an artificial heart valve or a bioprosthesis (homograft from human tissue or xenograft e.g. from pig).
There are four procedures:
- Aortic valve replacement
- Mitral valve replacement
- Tricuspid valve replacement
- Pulmonary valve replacement
Aortic Valve Replacement is a cardiac surgery in which the patient’s aortic valve is replaced by a different valve. The aortic valve can be affected by a range of diseases; the valve can either become leaky (aortic insufficiency / regurgitation) or partially blocked (aortic stenosis). Aortic valve replacement currently requires open heart surgery.
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What to Expect Before the Procedure?
Your doctor will ask you for the blood tests, heart tests, including the EKG, catherization, stress tests and echocardiography, unless you already had them before your hospital admission for the surgery. How long the procedure will take depends on how much heart disease is present. Your surgeon will discuss with you about this before the heart valve replacement procedure. Find out the Valve replacement surgery cost in Narayana Hrudayalaya at India Cardiac Surgery Site.
Aortic valve replacement is most frequently done through a median sternotomy, meaning the chestbone is opened in half. Once the pericardium has been opened, the patient is placed on cardiopulmonary bypass machine, also referred to as the heart-lung machine.
This machine takes over the task of breathing for the patient and pumping his blood around while the surgeon replaces the heart valve.
Once the patient is on bypass, an incision is made in the aorta. The surgeon then removes the patient’s diseased aortic valve and a mechanical or tissue valve is put in its place. Once the valve is in place and the aorta has been closed, the patient is taken off the heart-lung machine. Transesophageal echocardiogram (TEE, an ultra-sound of the heart done through the esophagus) can be used to verify that the new valve is functioning properly. Pacing wires are usually put in place, so that the heart can be manually paced should any complications arise after surgery. Drainage tubes are also inserted to drain fluids from the chest and pericardium following surgery. These are usually removed within 36 hours while the pacing wires are generally left in place until right before the patient is discharged from the hospital.
Mitral valve replacement is a cardiac procedure in which a patient’s mitral valve is replaced by a different valve. Mitral valve replacement is typically performed robotically or manually, when the valve becomes too tight (mitral valve stenosis) for blood to flow into the left ventricle, or too loose (mitral valve regurgitation) in which case blood can leak into the left atrium and back up into the lung. Some individuals have a combination of mitral valve stenosis and mitral valve regurgitation or simply one or the other.
A mitral valve replacement/repair is performed to treat severe cases of mitral valve prolapse, heart valve stenosis, or other valvular diseases. Since a mitral valve replacement is an open heart surgical procedure, it requires placing the patient on cardiopulmonary bypass to stop blood flow through the heart when it is opened up.
When the valve narrows or is stenotic the valve doesn’t let blood flow easily into the heart, causing the blood to back up and pressure to build up in the lungs. This is dangerous because when the leaflets in the valve don’t meet correctly, blood may leak backwards into the lungs each time the heart pumps. If blood leaks backwards, the heart has to pump harder in order to push the same amount of blood forward. This is known as volume overload. The heart may compensate for this overload for many months or even years but eventually the heart begin to fail and patients show symptoms of shortness of breath or fatigue. Know the Heart valve replacement surgery cost in india on our website.
- How can I find the best hospital for the affordable Heart Valve Replacement in India?
- The best hospital for heart valve replacement in India provides great value proposition for patients seeking affordable cost valve replacement surgery in India. Our network of hospitals have modern infrastructure and facilities, the best heart valve surgeons in india uses the most advanced heart valve replacement surgery techniques for our patients.
- How long will I have to stay in the hospital?
- You can expect to stay in the hospital for about a week, including at least 1 to 3 days in the Intensive Care Unit (ICU).
- What to expect after I wake up after surgery?
- As you wake up from the anesthesia after surgery, the breathing machine will be adjusted to allow you to take over more of the breathing. When you are awake enough to breathe completely by yourself and are able to cough, the breathing tube will be removed. The stomach tube will also likely be removed at this time. A nurse will help you cough and take deep breaths every two hours and show you how to hug a pillow tightly against your chest while coughing to help ease the discomfort. You will get pain medication if you are hurting, and you should ask for the medication before you become extremely uncomfortable. You may be on special IV (intravenous) medicines to help your blood pressure and your heart and to control any problems with bleeding. When your healthcare provider decides that you are ready, you will be moved from the ICU to a surgical unit or acute care unit. Your recovery will continue there. Your activity will be gradually increased as you get out of bed and walk around for longer periods. You can begin to eat solid foods as you tolerate them. Arrangements will be made for you to go home and a follow-up visit with your healthcare provider will be scheduled.
- When will I be able to eat?
- Once the breathing and stomach tubes have been removed and you are stable, you may start to drink liquids. Your diet may be gradually advanced to more solid foods as you tolerate them.
- How long will it be until I can take shower/bathe?
- You will be given specific bathing instructions. You may shower as usual using warm, instead of hot water. It is OK to let warm water run down over your incisions; however do not take a tub bath, soak in a Jacuzzi or go in a pool for approximately four weeks. Have someone help you get in and out of the shower until you regain your strength. Use a shower stool if you feel weak or unsteady. Wash your incision gently every day with warm water and mild soap then pat dry with a soft towel. Do not apply lotion, powder, or ointments until the scab has fallen off for approximately 3-4 weeks. If you have paper strips on your incisions, they should peel off as you shower daily. If they don’t, you may gently peel them off five days following discharge.
If the sutures are in your chest, shower with your back facing the water spray. Take a quick 10 minute bath is okay, but do not soak in the bathtub. Use only normal soap, not perfumed soap or body wash. Do not put the soap directly onto the incision and do not rub the incisions. Put soapy water on your hand or washcloth and gently wash your incisions. Only use a washcloth to rub when the scabs are gone and the skin is completely healed. After the shower, dry yourself thoroughly. Pat your incisions dry, ensure not to rub them.
- Are there any diet restrictions after I return back to my home?
- If your doctor has recommended a particular diet, it’s important that you follow it. If a special diet has not been recommended, balanced, heart-healthy nutrition can speed healing and lessen fatigue. During recovery and returning back to my home, ensure to eat a variety of fruits, whole grains, vegetables, lean meats including fish, breads and low-fat dairy products. Limit the foods that are high in saturated fats, sugar, salt, and sodium and avoid processed meats. In general, a low-fat, low-cholesterol, high-fiber diet is best.
What to Expect After the Procedure?
After the replacement of your heart valve, the surgery is completed and your heart starts beating on its own. All the incisions made during the surgical procedure will be sewn or stapled closed.
Post surgery, you will spend some time in the Intensive Care Unit (ICU), where you’ll be closely monitored to ensure there are no complications. After that, you’ll be moved to another room in the hospital where your family and friends will be able to visit you. Check out the Cost of Heart Valve Replacement in India on our website.
Most patients can endure surgery without complications; however, there are some whose heart functions are too weak to endure a surgery. Non-surgical approaches are divided into three categories: Clinical Practice treatment (this is used in everyday clinical practice), Investigational treatment (current clinical studies that are underway), Early Development treatment (early stages of investigation).
With mitral valve replacement surgery, there are risks such as bleeding, infection, or a complicated reaction to anesthesia. Each risk is determined best with each patients own cardiologist and cardiothoracic surgeon. They will better know each individuals medical history and conditions. Risks depend on a patient’s age, general condition, specific medical conditions, and heart function.
In a clinical study done of 99 patients who had mitral valve surgery for regurgitation from January 1990 to June 1996, long-term and short-term outcomes were evaluated. These evaluations included; mortality rate, clinical complications, readmissions, valve deterioration, reoperation, and health perception. Overall mortality was 4%, which included 3 operative deaths and 4 late deaths. Overall 5-year survival rate was 92%.
Condition after mitral valve replacement:
After the surgery the patient is taken to a post-operative intensive care unit for monitoring. A respirator may be required for the first few hours or days after surgery. After a day, the patient should be able to sit up in bed. After two days, the patient may be taken out of the intensive care unit. Patients are usually discharged after about seven to ten days. If the mitral valve replacement is successful, patients can expect to return to their regular condition or even better.
Why Prefer India for Heart Valve Replacement Surgery?
Top standard heart valve replacement surgery is performed in India at the hands of brilliant and experienced cardiac experts. The added benefit of receiving treatment in India is the cost saving. With 120,000 to 150,000 different cardiac procedures performed every year, Cardiac Surgery In India is a comprehensive process combining approaches to reduce risks with strategies targeting individuals at high risk. With increasing number of cardiac disease patients in India, experience of the best cardiac surgeons in India has also increased tremendously in the country, eventually leading to higher success rates of the Cardiac Surgery procedures. India is home to some of the most advanced technological environment for aortic valve replacement surgery. From Robotic Heart Surgeries to Hybrid Operating Suites, India is ready to serve and is at par with any of the best international hospitals. Get in touch with us to know the Valve replacement surgery cost in india, the price of heart valve replacement, tissue valve price in India, cost of artificial heart valve and the cost of mechanical heart valve in India. The Heart valve replacement surgery cost in Mumbai is quite affordable which is why India is preferred for Heart Valve Replacement Surgery.
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