Heart Valve ReplacementDamaged valve from the heart is removed to be substituted with a healthy one in this surgical procedure, by the surgeons.
Understanding the anatomy of the heart and the purpose of this procedure:The heart consists of four valves whose function is to direct blood through the heart to and from the body. These valves are: the aortic valve, the pulmonic valve, the tricuspid valve, and the mitral valve. These valves may malfunction cause of any birth defect, infection, disease or trauma. Sometimes, the blood flow through the heart is interfered with due to severity of the malfunction. This leads problems like, palpitations, fainting spells, and/or difficulty breathing. These symptoms may progressively worsen and cause death unless the damaged valve is replaced surgically.
Need of the procedure:
- A patient may require this surgery in case any of the four valves does not work properly,
- Regurgitation: a valve that does not close all the way causing blood leak backwards.
- Stenosis: a valve that does not open fully causing restriction in blood flow.
- Chest Pain (also called angina), shortness of breath, or heart failure.
- The heart function may be seriously affected with changes in the heart valve.
- Repair of heart valve concurrent or requirement of replacement to open heart surgery for another reason.
- damage of the heart due to infection of the heart valve (endocarditis).
- Replacement of heart valve implanted in the past due to various reasons.
- Following heart valve problems are also treated with surgery are:
- Aortic insufficiency
- Aortic stenosis
- Mitral regurgitation - acute
- Mitral regurgitation - chronic
- Mitral stenosis
- Mitral valve prolapse
- Pulmonary valve stenosis
- Tricuspid regurgitation
Procedure:If the surgeon can cover the aortic valve depending upon the requirement, following procedure may be performed:
- Ring annuloplasty – by sewing a ring of metal, cloth, or tissue around the valve in this the ring-like part around the valve is repaired.
- Valve repair – one or more of the leaflets of the valve is reshaped or rebuildIn this. The leaflets are flaps that open and close the valve.
- A new valve is required in case the valve is too damaged. This is called valve replacement surgery
A. In an open heart surgery:
- First the breastbone and ribs are separated with a cut.
- To perform the functions of the heart and lungs during the operation Surgeons place the patient on a cardiopulmonary bypass machine. Then to locate the faulty valve the heart is opened.
- The valve is loosened by slicing around the edges of the valve from the tendons (these tendons connect it to the rest of the heart), and withdraw it.
- The new valve is inserted and sutured into place.
- The patient taken off the bypass machine. Finally, the chest is closed.
- The surgery takes three to five hours.
Description of the replacement valves:There are three types of replacement valves:
- animal tissue valve, usually a pig's aortic valve.
- Mechanical valve, made of metal and plastic.
- human valves, removed from an organ donor or sometimes even the patient's own pulmonic valve.
B. In Minimally invasive valve surgery several different techniques are used. It is done through much smaller cuts than open surgery.
- Laparoscopy or endoscopy
- Percutaneous surgery (through the skin)
- Robot-assisted surgery
- The patient is kept for 2-3 days in the hospital ICU to monitor the working of heart and circulation.
- Immediately once transferred to the ICU the patient undergoes a neurological examination to ensure that the patient has not suffered a stroke.
- Till the patient is fully awake from anesthesia and has unfaltering circulation the patient is put on mechanical ventilation.
- The patient is transferred to a room once the vitals of the patient are stabilized, and to prevent excess fluid from building up around the heart the patient is prescribed drugs.
- As soon as possible once the surgeon permits, the patient can resume normal physical activity and to regain strength begins walking and exercising.
- A specific diet plan is prescribed to the patient which is low in salt and cholesterol.
- A daily exercise regime with good physical activity is advised to the patient.
- The patient may also join a Cardiac rehabilitation program.
- The patient usually returns to work and other normal activities within two months of the surgery.
- Animal valves may have to be replaced as develop calcium deposits over time. and if the deposits hinder the function of the valve.
- These valves may also become dislodged.
- Blood clots may form on the surface of the replaced valve, which and may result in fainting spells, stroke, kidney failure, or loss of circulation to the legs when these break off into the general circulation of the blood, as they sometimes are lodged in arteries.
- the patients with heart valve replacement are sometimes also affected by the infection of heart muscle.
Benefit:The success rate of heart valve replacement surgery is substantially high. The procedure can relieve symptoms and prolong your life.
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- Hospital Stay in a Private Room as indicated above. One attendant can stay with the patient.
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- Routine lab tests
- Admitting Consultant's visit charges
- Surgeon’s Fees and OT Charges
- Cost of the implant/prosthesis
- Hospital stay after the said period.
- Visit charges after the said period.
- Cross consultations, if any.
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