Heart Valve Repair/Replacement


DESCRIPTION

Heart valve disease is a disease in which one or more of your heart valves don't work properly. Heart valves can have three basic kinds of problems: Regurgitation, Stenosis, and Atresia.  Regurgitation occurs when a valve doesn’t close tightly and blood leaks back into the chambers rather than flowing forward through the heart.  The Mitral valve of the heart is mainly affected due to this problem, this condition is also known as Mitral Valve Prolapse. Stenosis occurs when the flaps of the valve thicken, stiffen or fuse together preventing the heart from fully opening. Atresia occurs when a heart valve lacks an opening for blood to pass through. Patients can be born with a heart valve disease or can acquire it later in life. The heart valve disease which develops before birth is known as congenital heart defect. They mainly affect the pulmonary valves or aortic valves that don’t form properly. Acquired heart valve disease usually involves the aortic or mitral valve.  Both of these diseases can cause stenosis or back flow. Some common causes for heart valve diseases are, heart disorders, age related changes, rheumatic fever, infections etc.



THE PROCESS

Proper diagnosis is very important in the treatment of any disease or ailment. For diseases concerned with the heart valve, the doctor follows the following diagnostic procedures,
  • Echocardiography
  • Transesophageal echocardiography
  • Cardiac catheterization
  • Cardiac MRI


HEART VALVE REPAIR PROCEDURES

Commissurotomy – Fused valve leaflets or valves are separated to widen the valve opening.

Decalcification – Calcium deposits are removed to allow the leaflets to be more flexible and close properly.

Reshape Leaflets – In case of a floppy leaflet, a segment is cut out and the leaflet is sewn back together, allowing the valve to close more tightly.

Chordal Transfer – If a leaflet has a prolapsed, the chordate are transferred from one leaflet to the other. Then, the leaflet where the chordate was removed is repaired.

Annulus Support – If the valve annulus is too wide, it may be reshaped or tightened by sewing a ring structure around the annulus.

Patched Leaflets – The surgeon may use tissue patches to repair any leaflets with tears or holes.

Valvuloplasty – It is a technique aimed at making sure that the flaps of the valves close properly, preventing blood from backing up into the atrium. The most common form of Valvuloplasty called Balloon Valvuloplasty, in which an inflated balloon helps to widen the openings of the valve.


HEART VALVE REPLACEMENT PROCEDURE

Heart valve replacement is a surgery procedure in which one or more of the patient’s heart valve is replaced by a different valve. During the surgery, the faulty valve is removed and a new valve is sewn to the annulus of the original valve. The new valve can be a:

Mechanical valve – made up of mechanical parts that are tolerated well by the human body.

Biological valve – tissue valves which are made up of human or animal tissues.

Homograft valve – an aortic or pulmonic human valve that has been removed from a donated human heart, preserved and frozen under sterile conditions.


General anesthesia is used on the patient to start off. The surgeon then makes an incision down the center of the chest, separating the breastbone in order to gain access to the heart. Before further action, a heart-lung machine is attached to the patient and the heart’s function is stopped temporarily. The heart-lung machine takes over the job of heart and lungs and enables the flow of blood throughout the body. After this, the surgeon makes another incision in the heart or aorta and removes the damaged valve. The new replacement valve is properly positioned and sewn into place. The incisions in the heart are then sewn closed, the heart-lung machine withdrawn and the heart is brought back to normal functioning. The breast bone is rejoined with wires and the incision closed. Apart from the conventional open chest procedure for valve replacement surgery, technological innovations have allowed surgeons to perform valve replacements with less invasive techniques.  This approach involves shorter procedure time, reduced hospital stay, and quicker recovery for patients.



DURATION OF THE PROCEDURE

The procedure may last 3 to 6 hours.


HOSPITALIZATION PERIOD

The patient may be hospitalized for 3 to 7 days after the surgery.



TIME SPAN FOR RECOVERY

Medical tourists/patients can return to their home country within 7 to 10 days after the surgery. After 6 to 8 weeks, the patient can completely return to his/her normal routine and work.

AFTERCARE GUIDELINES

After the surgery, the patient will be shifted to the incentive care unit for recovery. He/she will be monitored for 24 hrs in most cases. Given below are some guidelines to be followed for effective and speedy recovery,
  • Physical therapy is likely to be prescribed for patients who had undergone heart valve surgery.
  • After discussion with the doctor, the patient should bring in required lifestyle changes like, changes in diet, quitting smoking etc.
  • Contact doctor immediately if there arise symptoms like fever, muscle aches, persistent chest pain or shortness of breath, severe headache, cough, sudden weight gain etc.
  • Proper intake of medicine as prescribed by the doctor.
  • Regular check ups with the doctor should be done.


THE RISKS

Although these procedures claim more success rate than failures or risks, there are some common complications with the heart valve repair/replacement surgeries.

  • Breathing problems
  • Infection
  • Memory Loss
  • Kidney Failure
  • Chest Pain
  • Bleeding
  • Heart Rhythm problems
  • Reaction to anesthesia or medication
  • Post-pericardiotomy  syndrome
  • Heart Attack
  • Stroke
  • Chances of death in 2% to 5% of patients


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