Heart surgery is performed when:
- patient’s condition is getting worse: pain becomes unbearable, risk of heart attack increases;
- if the state is already severe and regular medications don’t help;
- patient shows signs of valve dysfunction.
Additional examinations, medications, or lifestyle changes may be prescribed to avoid undergoing the procedure. Valve repair is a preferable alternative to replacement since it allows to preserve the heart and the valve. The procedure is performed on the open heart with the use of heart-lungs bypass machine. The success rate of the operation is up to 92%.
Indications and contraindications for heart valve replacement
Physicians make a decision whether a patient needs valve replacement based on examination results. In case of the following conditions, a doctor may prescribe the valve replacement:
- shortness of breath;
- chest pain or discomfort;
- arrhythmia;
- loss of stamina;
- lightheadedness;
- dizziness;
- swelling of feet or ankles.
Any patient with known heart issues must be cautious about above mentioned signs and perform check-ups whenever any of them manifest. Early diagnosis is crucial for this disease. Patients who are not aware of their condition, may suffer heart damage due to malfunctioning heart valves. This damage may lead to heart attacks, critical conditions and sudden death.
Contraindications for heart valve operation:
- oncology;
- conditions that predispose to bleeding (poor coagulation);
- HIV;
- severe infections (including STDs);
- renal dysfunction.
Operation
Minimally invasive replacement operation
The operation is performed while a patient is under general anesthesia. Heart-lung machine is used to sustain blood flow during the procedure. Minimally invasive surgery is conducted by a team of cardiac surgeons. Physicians utilize long instruments and optical devices that are inserted through a small incisions in patient’s chest. The procedure puts patient's body under less stress and is considered less risky.
Minimally invasive surgery presumes shorter patient hospital stay and quicker recovery.
Transcatheter aortic valve replacement (TAVR/TAVI)
TAVR is a minimally invasive replacement of aortic valve. Sometimes referred to as “implantation”(TAVI). A catheter is utilized in this procedure. During the operation surgeons reach patient’s heart through a small incision in the chest or through the vein. Once in position, replacement valve is either self installed or expanded and set with a balloon. TAVR is used in patients who are at high risk of surgery-related complications. TAVR is also applied for biological valves replacement.
Replacement of the heart valve (operation on the open heart)
In cases when patient’s valve cannot be repaired, a replacement becomes viable. Damaged valve is removed and replaced with the mechanical or biological one. Biological valves are made of cow, pig, or human heart tissue. Biological valves degrade over time, so there will be a need for a replacement in 10-15 years.
Patients with mechanical valves need to take blood-thinning medicine for the rest of their lives to prevent formation of blood clots.
Surgeons will discuss all the details related to the valve type before the operation, including valve replacement surgery cost. Biological valves can be replaced utilizing catheters, without the need of open heart surgery.
Heart valve repair
Valve repair operation is always chosen over the replacement. This procedure may include:
- stitching holes in a valve;
- separating valve flaps that have grown together;
- tightening annulus muscle ring around the valve;
- replacement of supporting cords of the valve;
- reconnecting valve flaps;
- cutting out excess valve tissue.
Some procedures may be carried out with the use of catheter, guided through patient’s artery. For example, narrowed valve opening is treated with balloon valvuloplasty. During this operation, a balloon attached to the catheter is guided to the narrowed valve. The balloon is then inflated, expanding the valve and allowing blood to pass freely.
Preoperative preparation
Before the operation a patient undergoes standard examinations:
- ECG;
- blood and urine tests;
- chest x-ray.
Patients shouldn’t smoke 2 weeks before the operation, as it increases the risk of complications.
If the operation is not minimally invasive, a patient is administered general anesthesia and connected to heart-lungs bypass machine. After that, the repairs or replacements are done. When it’s over, the heart is started and a patient is disconnected from heart-lung bypass.
The operation takes 2-5 hours to complete, but may take longer if additional procedures are required.
Rehabilitation
Recovery
After the operation, a patient spends first 1-3 days in the Intensive Care Unit (ICU). In-hospital postoperative stay lasts for up to 2 weeks. Physicians may assign a special exercise regimen or rehabilitation program to a patient. During hospital stay patient’s vitals are constantly monitored, any pain syndromes are treated with anabolics, and antibiotics are issued if any signs of infection manifest.
Recovery period varies depending on patient’s overall health state. On average, patients can return to non-physically demanding work 4-6 weeks after the operation.
Home care
Patients are usually dismissed from the hospital 2 weeks after the operation. Physicians recommend commiting to 150 minutes of exercise weekly. It is also advisable that a patient quits smoking and/or drinking. Bad habits are known to reduce replaced valve’s life time and cause complications.
If a patient has received mechanical valve, they should take blood-thinning medicine. Any doctor should be notified about that fact because thinned blood has greater potential for passing infections. Before performing any operations that may cause bleeding, patients need to be administered special antibiotic.
Outlook
The operation is considered low-risk and doesn’t put organism under too much stress. Patients must always stay on lookout for possible signs of heart valve malfunction, because there is a little chance that replaced valve will fail. Usually it happens with biological valves 10-15 years after the operation. The symptoms are typical for heart valve malfunction and include fatigue, short breath, and lightheadedness. In such cases it is advisable to undergo another operation.
Heart valve replacement surgery cost
Heart valve replacement cost is influenced by the following factors:
- Type of conducted operation. Minimally invasive mitral valve replacement costs more than procedures on the open heart. Heart valve surgery cost also depends on whether a valve will be repaired or replaced.
- Type of replacement valve. Biological valve replacement cost differs from mechanical aortic valve replacement cost.
- Patient condition. Tavr procedure cost may increase due to prolonged hospital stay. TAVR cost may also increase due to any additional received medicines.
- Additional operation. In some cases it may be viable to perform two operations in succession. For example, additional stenting or bypass surgery will increase mitral valve surgery cost.
- Hospital location. Heart valve repair surgery cost in the USA is 2-3 times higher than in India or Turkey.
How to receive valve replacement abroad?
Submit a request on Bookimed website and our Medical Coordinator will contact you at earliest notice. You will receive answers to all questions regarding cost of mitral valve replacement surgery, what type of procedure is suitable for you, etc. We will also help you to pick the best hospital for heart valve replacement surgery and process all your paperwork. If needed, you will receive assistance in acquiring of visa and transfer.
