Aortic Valve Replacement

• The cost of Aortic Valve Replacement in India ranges between USD 5500 to USD 6500.
• Patient has to spend 6 days in the hospital and approximately 8 days outside the hospital.
• Due to the use of latest technologies and advancements in the medical field, the success rate is around 94% to 97%. The Success rate has further improved in complicated cases by the use of TAVI (Transcatheter Aortic Valve replacement) especially in the cases where surgical correction is contraindicated.
• Tests required to detect damage in valves include Echocardiography (ECHO) Transesophageal echo (TEE), ECG, Chest X-Ray, Cardiac Catheterization, Stress Testing, or Cardiac MRI.

Treatment Cost

More About Treatment

• An Aaortic Valve Replacement is a type of open-heart surgery used to treat problems with the heart's aortic valve. Itinvolves removing a faulty or damaged valve and replacing it.During this surgery, the damaged valve is removed and replaced with an artificial valve.The valve replacement is mostly an open-heart surgery, in few cases a minimally invasive surgery or a catheter procedure may be possible.

  • Aortic stenosis- when the opening of the valve becomes smaller,obstructing the flow of blood out of the heart.
  • Aortic regurgitation- when the valve is leaky allowing blood to flow back through into the heart .

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  Signs of Heart Failure requiring Replacement
  
  • shortness of breath
  • Angina
  • Dizziness
  • Fainting
  • Swelling of ankles, feet and legs
  • Fatigue
  
  

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  Diagnosis

  Physical Exam
  
  • With stethoscope to check for heart murmur caused by a heart valve problem.
  • Your doctor will check for fluid in lungs.
  • check for swollen ankles and other signs for water retention.
  Diagnostic Tests
  
  • Echocardiography (echo)is the main test for diagnosing heart valve disease.
  • Transesophageal Echoor TEE,to get a better image of your heart.
  • ECG(electrocardiogram)to diagnose irregular heart beat and signs of previous heart attack.
  • Chest Xray- to see if heart enlarged or fluid in lung or calcium deposists in heart.
  • Cardiac Catheterization, Stress Testingor Cardiac MRIhelp your doctor assess how severe your condition is so he or she can plan your treatment.
  
  

  Helpful:Aortic valve

  Types of Aortic Valve Surgery
  
  • Open Aortic Valve Replacement via Sternotomy– wherein damaged aortic valve is replaced by surgery.
  • Transcatheter Aortic Valve Implantation(TAVI)– the replacement valve is guided into place through the blood vessels, rather thanthrough a large incision in the chest.
  • Minimally Invasive Cardiac Surgery (MICS)
  Procedure for Aortic Valve Replacement
  Before procedure
  
  • Standard blood andtests andperformed to check fitness for surgery.
  • Patient counselled about the procedure and after care.

  During Procedure

  • Procedure performed under general anaesthesia.
  • IV line inserted, breathing tube is inserted and catheter put in bladder.
  • Incision made in middle of chest, surgeon separates sternum to expose pericardium, then opens pericardium to expose heart.
  • Connects heart to heart lung machine, tubes are used to reroute the blood into machine which takes over the function of heart and lung during the operation.
  • Heart is temporarily stopped and blood removed, aortic valve is still and allows surgeon to see it.
  • Surgeon opens aorta to see aortic valve, makes incision around edge of damagedvalve and replaces it.
  • The surgeon then closes the aorta with stitches, blood allowed to flow into heart to check the function of heart, if needed electric shock given to heart to restart the heart.
  • Temporary pacemaker wires on surface to ensure normal rhythm of heart.
  After Procedure
  
  • After an aortic valve replacement, you'll usually need to stay in hospital for about a week.
  • You will be kept in intensive care unit (ICU) for the first day or two afteryour operation, before moving to a surgical ward.
  • the activity of your heart, lungs and bodily functions will be closely monitored, wiresattached tosensor padsto measure your heart rate, blood pressure and blood flow, and the air flow to your lungs.
  • you'll be given painkillers.
  • a tube attached to a ventilator will be placed until you're able to breathe.
  • You may have several tubes and monitors attached to you.
  • Draining tube– small tubes from your chest to drain away any build-up of blood or fluid.
  • Pacing wires– if necessary, these will be inserted near the chest drains to control your heart rate.
  After Care
  
  • Adviced to follow a cardiac rehabilitation programme
  • avoid strenuous exercise, sudden strains and heavy lifting for three months
  • you may not be able to drive for around six weeks
  • report to the physician if signs of infection

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  Risks of Aortic Valve Replacement Surgery

  The aortic valve replacement is a major surgery and like any other surgery carries risks.The risks of complications increase with the age of the patient and general health of patient.

  • Infection– there's a risk of wound infections, lung infections, bladder infections and heart valve infections
  • Excessive bleeding
  • Blood clots
  • Stroke
  • The valve may wear out
  • Temporaryarrhythmia (iregular heartbeat)
  • Kidney problemsfor few days after surgery–In a few cases, temporarydialysismay be needed.
  • A valve that fails-There is a small chance that the valve will not work.
  
  Factors Affecting Cost Of Aortic Valve Replacement
  

  The cost to the patient depends on a variety of factors like:

  • The hospital, the patient chooses
  • Room– Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate, and room service)
  • Fee for the team of doctors and OT charges
  • cost of medications
  • Standard test and diagnostic procedures.
  • cost of the valve selected
  • Cost of the follow –up care required after the procedure

FAQs

• What is the anatomy of heart ?

  Heart is a muscular organ that pumps blood throughout the body

  It consists of 4 chambers , upper two chambers right and left atria lower two chambers right and left ventricles .The atria connect to respective ventricle , right ventricle connects to pulmonary artery and left ventricle to aorta .

  Where is aortic valve located and what is its function ?

  • Aortic valve is located between left Ventricle and Aorta

  • When heart contracts aortic valve opens and blood is pumped into aorta from left ventricle .

  • When heart relaxes aortic valve closes to prevent blood to leak into left ventricle

  What are cusps ?

  Cusps are functional parts of valves, these are flaps of tissue which open and close . Aortic valve has three cusps which open widely and close tightly .

  What do you understand by Aortic regurgitation ?

  Aortic valve may be leaky , that is does not close properly causing blood to leak back into ventricle condition known as aortic regurgitation

  What is Aortic stenosis ?

  Aortic valve may be narrowed does not open enough which restricts blood passing from ventricle into aorta condition called aortic stenosis .

  What are the reasons for damaged Aortic valve ?

  • Congenitalmay be born with abnormal aortic valve example aortic valve may have only 2 cusps

  • Acquired aortic valve disease– damage of valve during lifetime during lifetime, the causes may include

  • Rheumatic Fever

  • Sclerosis

  What happens when damaged aortic valve is left untreated ?

  If left untreated the problems can increase over time and can lead to life-threateningproblems .

  After a period of time a faulty aortic valve can cause heart muscles to become enlarged and weakened , walls of left ventricle can become abnormally thick or thin and can effect the right side of heart leading to a condition known asheart failure .

  Is surgery the only option for damaged aortic valves ?

  As there are no medicines to treat aortic valve problems, so in severe cases replacing the valve is adviced .

  What are the types of artificial heart valve ?

  Artificial heart valves may be :

  • Mechanical valves

  • Tissue valves

  Is aortic valve replacement a risky surgery ?

  The aortic valve replacement is a major surgery. However, this risk is far lower than the risk associated withleaving severe aortic disease untreated.

  How much time does it take to fully recover from aortic valve replacement surgery ?

  The time it takes to fullyrecover varies depending on factors such as age and overall health. It may betwo to three monthsto recover.

  What are the warning signs of infection after surgery ?

  • Increasing redness, swellingor tenderness around the wound

  • Pus or fluid oozingfrom the wound

  • Pain that's getting worse

  • Fever

  • Increasingshortness of breath

  When can I return to work after Aortic valve replacement surgery ?

  It depends on the type of work you do ,maybe within six to eight weeks if your job mainly involves light work, or not before three months if it involves manual labour .