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Heart Valve Replacement Surgery Cost in India

Heart Valve Replacement Surgery

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I believe, a tricky question to ask is “What is the heart and why do we need to care about it so much?” The answer arrives only when someone in your family suffers a cardiac condition.

Let’s enable us to have a brief idea about the heart itself and yes to the great beginning of a basic understanding of heart conditions.

The heart itself is a vital organ but it is a modified blood vessel which to my surprise when I came across the book of anatomy. It has 4 chambers: 2 upper chambers, called atria, and 2 lower chambers, called ventricles. Four one-way valves between each of the heart chambers keep the blood streaming forward through the heart. Blood entering the heart initially goes through the tricuspid valve and afterward the aspiratory valve. After getting back from the lungs, the blood circulates through the mitral (bicuspid) valve and ways out utilizing the aortic valve. Cardiovascular diseases comprise a group of diseases about the heart and vascular system.

The first surgery performed on the heart was in 19th surgery when the surgeons tried to explore newer aspects of operating a heart condition with ligation of the vessels which were bleeding due to stab injuries.
To my surprise, the statistical data about the cardiac conditions are an eye-opener. In the world as estimated death rate that is 17 million people suffer from Cardiovascular
diseases, which indirectly interprets 1/3rd of the deaths occurred in middle-aged adults.

In India, an estimated value of 46.9 million patients are diagnosed cases of CVD, and mortality of 1.2 million IHD and 0.8 million due to Stroke.

India is a land of the heritage of Ayurveda and the most diversified culture of Advanced Medicine and Research Centre. Thus, imbibing all the potential to develop skillful hands to cater to the disease about Cardiac Conditions. It is roughly estimated that India is progressing to a whopping 30% of the growth rate in the Medical Tourism Industry. An estimated
9.2-billion-dollar industry by 2021.

This fact integrates me to understand and learn more about the Medical tourism sector and yes to my knowledge being used to enable better productivity in this sector.


Symptoms


Few patients may remain asymptomatic for several years. Following are the signs and symptoms of heart valve disease:

•     Chest pain

•     Abdominal swelling

•     Fatigue 
•     Shortness of breath

•     Oedema on ankles and feet region

•     Dizziness

•     Irregular heartbeat


Causes


Each valve has flaps that open and closes once during each heartbeat. Sometimes, the valves don't open or close properly, disrupting the blood flow from the heart to the body. Heart valve disease may be congenital i.e., since birth. 


It can occur or develop in grown-ups because of numerous causes and conditions, for example, infection and other heart conditions.

•    Regurgitation. In this condition, the valve flaps don't close appropriately, making blood release in reverse in the heart. This generally happens because of valve flaps swelling back,
a condition called prolapse.

•      Stenosis. In valve stenosis, the valve folds become thick or firm and they may meld.
This leads to a limited valve opening and decreased blood movement through the valve.

•    Atresia. Valve formation is not seen in this condition, and a solid layer of tissue restricts the blood flow between the heart chambers.

Risk factors


Various factors can lead to heart valve disease, including:


•     Growing age

•     Heart can be affected by certain infections

• About heart disease or history of heart attack

•     Heart diseases.  High blood pressure, high cholesterol, and diabetes

•     Congenital heart disease (Heart problem since birth)

•     Cigarette smoking

•     Obesity 
•     Sedentary Habits

•     Stress

•     Alcohol


Complications

Heart valve disease can cause several complications such as:


•     Heart failure

•     Stroke

•     Blood clots

•     Abnormal heart rate/heart rhythm

•     Death

Diagnosis

•    By listening to the heart during physical examination doctor can get the idea of the sound of valves during blood flow between the chambers
•    Echocardiography
•    Transesophageal echocardiography
•    Cardiac catheterization (angiogram)
•    Radionuclide scans
•    MRI Scan

Results from these tests can be used to conclude heart valve disease

Types of Replacement Valves


Two types of valves are used to correct the damaged valve


1] Mechanical valve:


These have a similar objective as a heart but these are the artificial valves. These are made up of polyester and carbon material which can be tolerated by the human body. They have a life span of 10 to 20 years. There’s a risk of blood clots because of these valves and to reduce this risk blood thinners are prescribed to the patient for a lifetime.


2] Biological valves:


Also known as bioprosthetic valves and these are made up of animal or human tissues. These are again available in three types: 
a)  Valve made up of cow tissue called a bovine valve. It attaches to the heart with silicone rubber.
b)  Valve made of tissues extracted from donor’s heart is called as Allograft or
homograft.
c)  A porcine valve that is made of pig tissue can be implanted with or without using a stent.


Using biological valves doesn’t increase the risk of blood clotting and the use of blood thinner is not required for the patient. But these valves have a very short life span as compared to mechanical valves.


Depending upon the following factors doctor will recommend the type of valve to be used:


•     age

•     overall health condition

•     response to anticoagulant medications

•     severity of the disease


Types of Valve Replacement Surgery


Aortic Valve Replacement


The aortic valve is on the left half of the heart and fills in as a surge valve. Its responsibility is to permit blood to leave the left ventricle, which is the heart's fundamental pumping chamber. Its work is likewise to close so that blood doesn't spill once again into the left ventricle. You may require a medical procedure on your aortic valve if you have an innate imperfection or infection that causes stenosis or regurgitation

A recent study found that aortic valve replacement surgery has a 95% five-year survival rate. Survival rates depend on:


•     age

•     overall health

•     medical conditions of an individual

•     heart function/condition 


Mitral Valve Replacement


The mitral valve is situated on the left half of the heart. It fills in as an inflow valve. Its responsibility is to permit blood from the left chamber to stream into the left ventricle. The medical procedure might be required if the valve doesn't completely open or close. At the point when the valve is excessively thin, it can make it hard for blood to enter. This can make it back up, causing pressure in the lungs. At the point when the valve doesn't close appropriately, blood can spill once again into the lungs. A congenital defect, infection, or degenerative disease could be the reason for this condition.


The defective valve will be replaced with either a metal artificial valve. The five-year survival rate is about 90%. The following also play a role in survival rate:


•     age

•     overall health

•     other medical conditions you have

•     heart function


Before Procedure

•    Proper physical examination including blood tests and another diagnostic test before the procedure.
• Eight-hour fasting before the procedure.
•    History is related to the allergic drug, medication the patient is taking, history of any disorder. It is necessary to collect this information before the procedure
•    If a patient is having a pacemaker then this must be informed to the doctor. 
The Procedure


Heart valve replacement surgery is performed under broad sedation with strategies that are either traditional or insignificantly intrusive. The regular medical procedure requires a large incision from the neck to your navel. If less invasive surgery is performed, the length of cut can be more limited and can likewise lessen the danger of contamination or infection.


For a surgeon to successfully remove the diseased valve and replace it with a new one, your heart must be still. The patient will be placed on a bypass machine that keeps blood circulating through the body and lungs functioning during surgery. The surgeon will make incisions into your aorta, through which the valves will be removed and replaced. There’s almost a 2% risk of death associated with valve replacement surgery.

Post Surgery


•     Monitoring of operative site to avoid the infection.

•     Regular check-up of blood pressure, pulse rate, pain around the incision site.

•     Swelling on the body

•     Breathing problem

•      Patient will be assisted by the physiotherapist to help the patient do a breathing exercise.

Recovery

Recovery time depends on the procedure, overall health before the procedure, and any complications. The patient will be kept in ICU for 2 to 3 days after the operation and monitored regularly. The average hospital stay is 1 to 14 days. Few weeks to several months are required to get recovered fully and this period depends on the individual’s age and the health condition before the procedure.

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