Types of Valve Replacement Surgery - Valve Replacement Surgery in India

Valvular heart disease is a form of heart disease that occurs when one or more of the heart’s four valves don’t function properly. Valve replacement surgery is a solution for patients whose valves are too fragile, scarred, or otherwise damaged to repair.

Reasons for Replacement

The valves of the heart are responsible for allowing nutrient-rich blood to flow to the chambers of your heart. Like a locked gate, each valve is supposed to close completely after ushering in the blood flow. Diseased heart valves aren’t always able to perform the job as well as they should.

Stenosis, or a narrowing of the passageway, causes a less-than-normal amount of blood to flow to the heart, causing the muscle to work harder. Leaky valves can also pose a problem. Instead of closing tightly, a valve may remain slightly open, letting blood flow backwards. Signs of valvular heart disease can include:

• fatigue
• dizziness or lightheadedness
• shortness of breath
• chest pain
• fluid retention, especially in the lower limbs

Heart valve repair is also a solution for valve disease, but in some people, the damage is too far advanced and a total replacement of the affected valve is required.

Types of Replacement Valves

Mechanical and biologic valves are used to replace faulty valves. Mechanical valves are artificial components that fulfill the same job as a natural heart valve. They’re created from carbon and polyester materials that are well-tolerated by the human body, and can last between 10 and 20 years, according to the National Institutes of Health (NIH). However, one of the risks associated with mechanical valves is blood clots. Recipients of mechanical heart valves are required to take blood-thinning medication for the rest of their lives to reduce their risk of stroke.

Biologic valves, also called bioprosthetic valves, are created from human or animal tissue. Three types of biologic heart valves exist:

• human: called allografts or homografts, tissue is taken from a donor heart
• porcine: made from pig tissue, the valves can be implanted with or without a frame called a stent
• bovine: crafted from cow tissue, bovine valves connect to your heart with silicone rubber

Biologic valves don’t increase your risk of developing blood clots. Therefore, you most likely won’t need to commit to a lifetime of anti-clotting medication. The lifespan of a bioprosthetic isn’t as long as a mechanical valve, explains the Mayo Clinic, and may require replacement at a future date. Your age, overall health, age, and ability to take anti-coagulant medications, as well as the extent of the disease, will help determine which type of valve you receive.

Types of  Valve Replacement Surgery

Aortic Valve Replacement

The aortic valve is located on the left side of the heart and serves as an outflow valve. Its job is to allow blood to leave the left ventricle (the heart’s main pumping chamber) and close so that blood doesn’t leak back into the ventricle. Surgery on the aortic valve may be required due to a congenital (from birth) defect or disease that causes the valve to narrow (stenosis) or leak (regurgitation).

Mitral Valve Replacement

The mitral valve is located on the left side of the heart. It serves as an inflow valve. Its job is to allow blood from the left atrium to flow into the heart’s main pumping chamber, the left ventricle. Surgery may be required if the valve doesn’t fully open or completely close. When the valve is too narrow, blood may have difficulty entering and can back up, causing pressure in the lungs. When the valve doesn’t close properly, blood can leak back into the lungs. This can be due to a congenital defect, infection, or a degenerative disease (a worsening over time due to age or normal wear and tear).

Double Valve Replacement

Double valve replacement is replacement of both the mitral and the aortic valve, or the left side of the heart. This type of surgery is not as common as the others and the mortality rate is slightly higher. 

Pulmonary Valve Replacement

The pulmonary valve separates the pulmonary artery—which carries blood to the lungs for oxidation—and the right ventricle (one of the heart’s chambers). Its job is to allow blood to flow from the heart to the lungs, via the pulmonary artery. The need for pulmonary valve replacement is usually due to stenosis, which restricts blood flow. Stenosis may be caused by a congenital defect, infection, or carcinoid syndrome.     

The Procedure

Heart valve replacement surgery is performed under general anesthesia with techniques that are either conventional or minimally invasive. Conventional surgery requires a large incision spanning from your neck to your navel. Less invasive measures can reduce the length of incision and also reduce your risk of infection.

For a surgeon to successfully remove the diseased valve and replace it with a new one, your heart must be still. You’ll be placed on a bypass machine that keeps blood circulating through your body and your lungs functioning during surgery. The surgeon will make incisions into your aorta, through which the valves will be removed and replaced. Cleveland Clinic reports a 1.8 percent risk of death associated with valve replacement surgery.

Recovery

The majority of heart valve replacement recipients remain in the hospital for approximately five to seven days. If your surgery was minimally invasive, you may be able to go home earlier. Medical staff will offer pain medication as needed and continuously monitor your blood pressure, breathing, and heart function during the first few days after a heart valve replacement.Full recovery may take a few weeks or up to several months, depending on your rate of healing

Heart Valve Repair or Replacement Surgery in India - Best Heart Hospital India

Heart Valve Repair or Replacement Surgery 

Blood is pumped through your heart in only one direction. Heart valves play a key role in this one-way blood flow, opening and closing with each heartbeat. Pressure changes on either side of the valves cause them to open their flap-like "doors" (called cusps or leaflets) at just the right time, then close tightly to prevent a backflow of blood.

There are 4 valves in the heart:

• Tricuspid valve
• Pulmonary valve
• Mitral valve
• Aortic valve

Nearly all of these operations are done to repair or replace the mitral or aortic valves. These valves are on the left side of the heart, which works harder than the right. They control the flow of oxygen-rich blood from the lungs to the rest of the body.

Valve Disease

If valve damage is mild, doctors may be able to treat it with medicines. If damage to the valve is severe, surgery to repair or replace the valve may be needed.

What is valve repair?

Valve repair can usually be done on congenital valve defects (defects you are born with) and has a good success record with treating mitral valve defects.

Here are some procedures surgeons may use to repair a valve:

• Commissurotomy, which is used for narrowed valves, where the leaflets are thickened and perhaps stuck together. The surgeon opens the valve by cutting the points where the leaflets meet.
• Valvuloplasty, which strengthens the leaflets to provide more support and to let the valve close tightly. This support comes from a ring-like device that surgeons attach around the outside of the valve opening.
• Reshaping, where the surgeon cuts out a section of a leaflet. Once the leaflet is sewn back together, the valve can close properly.
• Decalcification, which removes calcium buildup from the leaflets. Once the calcium is removed, the leaflets can close properly.
• Repair of structural support, which replaces or shortens the cords that give the valves support (these cords are called the chordae tendineae and the papillary muscles). When the cords are the right length, the valve can close properly.
• Patching, where the surgeon covers holes or tears in the leaflets with a tissue patch.

What is valve replacement?

Severe valve damage means that the valve will need to be replaced. Valve replacement is most often used to treat aortic valves and severely damaged mitral valves. It is also used to treat any valve disease that is life-threatening. Sometimes, more than one valve may be damaged in the heart, so patients may need more than one repair or replacement.

There are 2 kinds of valves used for valve replacement:

• Mechanical valves, which are usually made from materials such as plastic, carbon, or metal. Mechanical valves are strong, and they last a long time. Because blood tends to stick to mechanical valves and create blood clots, patients with these valves will need to take blood-thinning medicines for the rest of their lives.
• Biological valves, which are made from animal tissue (called a xenograft) or taken from the human tissue of a donated heart (called an allograft or homograft). Sometimes, a patient's own tissue can be used for valve replacement (called an autograft). Patients with biological valves usually do not need to take blood-thinning medicines. These valves are not as strong as mechanical valves, though, and they may need to be replaced every 10 years or so. Biological valves break down even faster in children and young adults, so these valves are used most often in elderly patients.

You and your doctor will decide which type of valve is best for you.

During valve repair or replacement surgery, the breastbone is divided, the heart is stopped, and blood is sent through a heart-lung machine. Because the heart or the aorta must be opened, heart valve surgery is open heart surgery.

What to Expect

The operation will usually be scheduled at a time that is best for you and your surgeon, except in urgent cases. As the date of your surgery gets closer, be sure to tell your surgeon and cardiologist about any changes in your health. If you have a cold or the flu, this can lead to infections that may affect your recovery. Be aware of fever, chills, coughing, or a runny nose. Tell the doctor if you have any of these symptoms.

Also, remind your cardiologist and surgeon about all of the medicines you are taking, especially any over-the-counter medicines such as aspirin or those that might contain aspirin. You should make a list of the medicines and bring it with you to the hospital.

It is always best to get complete instructions from your cardiologist and surgeon about the procedure, but here are some basics you can expect when you have valve repair or replacement surgery.

Before the Hospital Stay

Most patients are admitted to the hospital the day before surgery or, in some cases, on the morning of surgery.

The night before surgery, you will be asked to bathe to reduce the amount of germs on your skin. After you are admitted to the hospital, the area to be operated on will be washed, scrubbed with antiseptic, and, if needed, shaved.

A medicine (anesthetic) will make you sleep during the operation. This is called "anesthesia." Because anesthesia is safest on an empty stomach, you will be asked not to eat or drink after midnight the night before surgery. If you do eat or drink anything after midnight, it is important that you tell your anesthesiologist and surgeon.

If you smoke, you should stop at least 2 weeks before your surgery. Smoking before surgery can lead to problems with blood clotting and breathing.

Day of Surgery

Before surgery, you may have an electrocardiogram (ECG or EKG), blood tests, urine tests, and a chest x-ray to give your surgeon the latest information about your health. You will be given something to help you relax (a mild tranquilizer) before you are taken into the operating room.

Small metal disks called electrodes will be attached to your chest. These electrodes are connected to an electrocardiogram machine, which will monitor your heart's rhythm and electrical activity. You will receive a local anesthetic to numb the area where a plastic tube (called a line) will be inserted in an artery in your wrist. An intravenous (IV) line will be inserted in a vein. The IV line will be used to give you the anesthesia before and during the operation.

After you are completely asleep, a tube will be inserted down your windpipe and connected to a machine called a respirator, which will take over your breathing. Another tube will be inserted through your nose and down your throat, into your stomach. This tube will stop liquid and air from collecting in your stomach, so you will not feel sick and bloated when you wake up. A thin tube called a catheter will be inserted into your bladder to collect any urine produced during the operation.

A heart-lung machine is used for all valve repair or replacement surgeries. This will keep oxygen-rich blood flowing through your body while your heart is stopped. A perfusion technologist or blood-flow specialist operates the heart-lung machine. Before you are hooked up to this machine, a blood-thinning medicine called an anticoagulant will be given to prevent your blood from clotting. The surgical team is led by the cardiovascular surgeon and includes other assisting surgeons, an anesthesiologist, and surgical nurses.

After you are hooked up to the heart-lung machine, your heart is stopped and cooled. Next, a cut is made into the heart or aorta, depending on which valve is being repaired or replaced. Once the surgeon has finished the repair or replacement, the heart is then started again, and you are disconnected from the heart-lung machine.\

The surgery can take anywhere from 2 to 4 hours or more, depending on the number of valves that need to be repaired or replaced.

Recovery Time

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).

Recovery after valve surgery may take a long time, depending on how healthy you were before the operation. You will have to rest and limit your activities. Your doctor may want you to begin an exercise program or to join a cardiac rehabilitation program.

If you have an office job, you can usually go back to work in 4 to 6 weeks. Those who have more physically demanding jobs may need to wait longer.

Minimally Invasive Valve Surgery

Minimally invasive heart valve surgery is a technique that uses smaller incisions to repair or replace heart valves. This means there is less pain. Minimally invasive surgery also reduces the length of the hospital stay and the recovery time.

Minimally invasive valve surgery can only be done in certain patients. This type of surgery cannot be done in patients

• With severe valve damage
• Who need more than one valve repaired or replaced
• Who have clogged arteries (atherosclerosis)
• Who are obese

In some cases, minimally invasive valve surgery can be done using a robot. Robotic surgery does not require a large incision in the chest. It is not available at all hospitals, and patients with severe valve damage cannot have the procedure. The Texas Heart Institute has a robot.

With robotic surgery, the surgeon has a control console, a side cart with 3 robotic arms, a special vision system, and instruments. A computer translates the surgeon's natural hand and wrist movements made on the control console to instruments that have been placed inside the patient through small incisions. The robot's controls can read even the tiniest of movements the surgeon makes.

Robotic surgery can reduce the time it takes to do valve surgery, as well as shorten the hospital stay and recovery time. 

Heart Valve Repair or Replacement Surgery - Best Heart Surgery Hospital in India

Heart Valve Repair or Replacement Surgery 

Blood is pumped through your heart in only one direction. Heart valves play a key role in this one-way blood flow, opening and closing with each heartbeat. Pressure changes on either side of the valves cause them to open their flap-like "doors" (called cusps or leaflets) at just the right time, then close tightly to prevent a backflow of blood.

There are 4 valves in the heart:

• Tricuspid valve
• Pulmonary valve
• Mitral valve
• Aortic valve

Nearly all of these operations are done to repair or replace the mitral or aortic valves. These valves are on the left side of the heart, which works harder than the right. They control the flow of oxygen-rich blood from the lungs to the rest of the body.

Valve Disease

If valve damage is mild, doctors may be able to treat it with medicines. If damage to the valve is severe, surgery to repair or replace the valve may be needed.

What is valve repair?

Valve repair can usually be done on congenital valve defects (defects you are born with) and has a good success record with treating mitral valve defects.

Here are some procedures surgeons may use to repair a valve:

• Commissurotomy, which is used for narrowed valves, where the leaflets are thickened and perhaps stuck together. The surgeon opens the valve by cutting the points where the leaflets meet.
• Valvuloplasty, which strengthens the leaflets to provide more support and to let the valve close tightly. This support comes from a ring-like device that surgeons attach around the outside of the valve opening.
• Reshaping, where the surgeon cuts out a section of a leaflet. Once the leaflet is sewn back together, the valve can close properly.
• Decalcification, which removes calcium buildup from the leaflets. Once the calcium is removed, the leaflets can close properly.
• Repair of structural support, which replaces or shortens the cords that give the valves support (these cords are called the chordae tendineae and the papillary muscles). When the cords are the right length, the valve can close properly.
• Patching, where the surgeon covers holes or tears in the leaflets with a tissue patch.

What is valve replacement?

Severe valve damage means that the valve will need to be replaced. Valve replacement is most often used to treat aortic valves and severely damaged mitral valves. It is also used to treat any valve disease that is life-threatening. Sometimes, more than one valve may be damaged in the heart, so patients may need more than one repair or replacement.

There are 2 kinds of valves used for valve replacement:

• Mechanical valves, which are usually made from materials such as plastic, carbon, or metal. Mechanical valves are strong, and they last a long time. Because blood tends to stick to mechanical valves and create blood clots, patients with these valves will need to take blood-thinning medicines for the rest of their lives.
• Biological valves, which are made from animal tissue (called a xenograft) or taken from the human tissue of a donated heart (called an allograft or homograft). Sometimes, a patient's own tissue can be used for valve replacement (called an autograft). Patients with biological valves usually do not need to take blood-thinning medicines. These valves are not as strong as mechanical valves, though, and they may need to be replaced every 10 years or so. Biological valves break down even faster in children and young adults, so these valves are used most often in elderly patients.

You and your doctor will decide which type of valve is best for you.

During valve repair or replacement surgery, the breastbone is divided, the heart is stopped, and blood is sent through a heart-lung machine. Because the heart or the aorta must be opened, heart valve surgery is open heart surgery.

Minimally Invasive Valve Surgery

Minimally invasive heart valve surgery is a technique that uses smaller incisions to repair or replace heart valves. This means there is less pain. Minimally invasive surgery also reduces the length of the hospital stay and the recovery time.

Minimally invasive valve surgery can only be done in certain patients. This type of surgery cannot be done in patients

• With severe valve damage
• Who need more than one valve repaired or replaced
• Who have clogged arteries (atherosclerosis)

In some cases, minimally invasive valve surgery can be done using a robot. Robotic surgery does not require a large incision in the chest. It is not available at all hospitals, and patients with severe valve damage cannot have the procedure. 

With robotic surgery, the surgeon has a control console, a side cart with 3 robotic arms, a special vision system, and instruments. A computer translates the surgeon's natural hand and wrist movements made on the control console to instruments that have been placed inside the patient through small incisions. The robot's controls can read even the tiniest of movements the surgeon makes.

Robotic surgery can reduce the time it takes to do valve surgery, as well as shorten the hospital stay and recovery time. 

For more information visit:         http://www.mymedopinion.com    
                  

Please scan and email your medical reports  to us at free@mymedopinion.com and we shall get you a Free Medical Opinion from India’s Best Doctors.

About MyMedOpinion.com

MyMedOpinion affiliated  Best hospitals in India provide an medical opinion from experienced surgeons and the treatment cost includes companion stay  , surgeon fee, medicines and consumables, nursing care, patient's food and airport pick up & drop etc. etc. We offer free, no obligation assistance to international patients to find world class medical treatment in India. We offer support and services to facilitate the care you require. We can help you find the best hospital in India

Send us a Medical Report to Get FREE Medical Opinion from India's Top Doctors

MyMedOpinion.com  is the hub of Surgeons and specialists for major diseases. We give you a chance to speak to our doctors and discuss your health issues directly. 

Email Us: Free@mymedopinion.com  Call Us: +91-7503537224