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What is Aortic Valve Replacement Surgery?
Aortic valve replacement Surgery is an open-heart surgery technique that replaces a damaged or diseased aortic valve with an artificial one. The aortic valve helps blood flow from the heart into the aorta and to the rest of the body. It also prevents blood from flowing back into the heart when it closes. If the valve is damaged, leaky, or partially blocked, your doctor may recommend valve replacement surgery. A malfunctioning aortic valve can obstruct blood flow and increase the pressure on the heart.
The aortic valve replacement procedure can be performed via open heart surgery, aortic valve replacement, minimally invasive cardiac surgery (MICS), or transcatheter aortic valve replacement (TAVR). This complex operation isn't suitable for everyone and may require a longer recovery time.
In some cases, aortic valve disease may not show symptoms for years, while others may:
- Experience breathlessness
- Weakness
- Chest pain
- Loss of consciousness
- Arrhythmia
- Heart attack
- Sudden cardiac arrest.
Aortic valve repair or replacement can cure valve disease, restore normal blood flow, reduce symptoms, and improve heart function.
Symptoms of Aortic Valve Disease
Aortic valve disease can lead to severe symptoms that worsen as the disease progresses and may become fatal if left untreated. Even in cases when there is severe stenosis (narrowing) or insufficiency (leak), some people may not show any symptoms at all.
The following are typical indications and symptoms of aortic valve disease:
- Breathlessness
- Loss of consciousness
- Fainting during physical activity
- Chest pain or tightness
- Abnormal heartbeat (Arrhythmia)
- Tiredness after being active
- Swollen ankles and feet
Risks of Aortic Valve Replacement
Aortic valve replacement is a complex operation with potential risks and complications, some of which can be life-threatening. Patients with aortic stenosis and aortic regurgitation who do not receive treatment are at higher risk. Additionally, older adults and those in poor health face a greater risk of complications.
The following are some possible dangers connected to heart valve treatment:
- During or after cardiac valve replacement, excessive bleeding or blood vessel dysfunction is a typical concern. In rare circumstances, the doctor might need to perform another procedure to stop the bleeding after inserting tubes into your chest to drain blood.
- If you had mechanical Aortic valve replacement surgery, blood clots are likely to happen.
- Blood clotting is a common cause of heart attacks and strokes.
- Infection at the surgical site of the heart valve replacement.
- Surgery to replace an aortic valve frequently results in endocarditis, or infection of the new valve. If you have an illness, your doctor might prescribe antibiotics to you.
- Shortness of breath due to lung infection.
- Aortic valve replacement surgery may cause arrhythmia, or an irregular heartbeat, in certain patients. This condition typically resolves on its own with time. A pacemaker should be installed in some situations, nevertheless, in order to regulate the heartbeat.
- A cardiac infection or age-related valve tearing are two possible causes of valve failure.
- In certain instances, renal dysfunction following surgery may lead to kidney difficulties and the need for short-term dialysis.
Aortic Valve Replacements Alternatives
The most effective treatment for disorders of the aortic valve is replacement surgery. Only those who are not in good enough overall condition to undergo aortic valve replacement are typically advised to pursue alternative treatment options.
Aortic valve replacement Alternatives include:
Transcatheter Aortic Valve Implantation (TAVI)
The main advantage of this technique is that it places less strain on the body. A small incision in the chest leads to quicker recovery, minimal blood loss, and reduced risk of infection, with a high success rate. TAVI is recommended for those too weak to undergo traditional aortic valve replacement surgery.
Aortic valve balloon valvuloplasty
Aortic valve balloon valvuloplasty is recommended only for individuals who are not suitable for conventional open surgery. This procedure is a short-term solution, typically used for babies and children until they are old enough for valve replacement. The main disadvantage is that the effects last up to a year, requiring further treatment.
Sutureless aortic valve replacement
Sutureless aortic valve replacement is a modern alternative to open-heart surgery. Unlike traditional methods, this procedure does not use stitches to secure the replacement valve. It reduces operation time and the duration on a bypass machine. This option is suitable for individuals at high risk of complications during standard procedures.
The main risks of this treatment include blood leakage or clot formation around the replacement valve, which increases the risk of stroke. Leakage may require a repeat procedure or an alternative treatment to address the issue.
Preparing for aortic valve surgery
- Pre-Admission Assessment: A few weeks before the procedure, visit the hospital for a pre-admission assessment to determine if the operation is suitable.
- Assessment Components: Includes a physical examination, medical history review, and questions about allergies and current medications. General heart health tests such as blood tests, X-rays, ECGs, and echocardiograms will be performed.
- Procedure Explanation: Your doctor will explain what to expect before, during, and after the procedure, as well as the potential risks.
- Smoking Cessation: If you smoke, the doctor may advise quitting to reduce the risk of complications like chest infections or blood clots.
- Questions and Preparation: Use this time to ask any questions about the procedure.
- Hospital Stay: Expect to stay in the hospital for at least a week. Make practical arrangements by bringing clothes, toiletries, and any personal equipment such as a hearing aid or walking stick.
During Aortic Heart Valve Surgery
Aortic valve repair and replacement surgeries are performed under anaesthesia, ensuring the patient is unconscious and does not feel pain. The procedure usually takes 2-4 hours.
In order to guarantee that blood flows throughout the body during the procedure, the patient will be hooked up to a heart-lung bypass machine.
- In order for the surgeon to reach your heart during the procedure, a major incision is created in the middle of your breastbone, though occasionally a smaller incision may be done.
- Your heart and major blood vessels will have tubes put into them to link to a heart-lung bypass machine. This machine will control heart activity and divert your blood away from the heart, pumping oxygen-rich blood to your body until the operation is complete.
- Your heart is stopped with medication, and the main artery is clamped shut so the surgeon can operate on your heart without blood flowing through it.
- Before removing you from the bypass machine, the surgeon will use controlled electric shocks to restart your heart.
- Your breastbone will be stitched in place with a thin wire, the chest wound will be closed with dissolvable stitches, and the Aorta will be opened to replace a malfunctioning or damaged heart valve.
- Chest drains are tiny openings in your chest that are filled with tubes that are used to empty any accumulated blood or fluid.
Aortic Heart Valve Surgery Recovery
- After aortic valve replacement surgery, you may spend a day or more in the ICU, depending on your condition and the procedure.
- You will be moved to a regular ward for about a week following your ICU stay.
- Fluids, oxygen, nutrition, and medications will be administered through intravenous (IV) lines.
- The fluid and blood in your chest as well as the pee in your bladder will be drained using tubes.
- Your surgeon will monitor blood pressure, respiration, heart rate, and any post-surgery pain in addition to looking for any indications of infection.
- You will be instructed to rest and restrict your activities at first. Later on, your physician might advise breathing techniques, walking, or enrolling in a cardiac rehabilitation program.
- Recovery time varies based on age, type of surgery, and overall health.
- The breastbone typically takes 6 to 8 weeks to heal, with full recovery possibly taking 2 to 3 months.
Aortic Valve Repair or Replacement
Aortic valve damage is determined by a number of causes, like as:
- The severity of aortic valve condition
- Patient's age and overall health before surgery
- Structure of the heart
- Results of your diagnostic tests
- It is possible to treat both aortic valve disease and another heart condition at the same time if a patient requires heart surgery to address both illnesses.
Your physician might recommend Aortic valve repair surgery if you have a malfunctioning or damaged heart valve. Heart valve repair is generally advised over valve replacement due to the decreased risk of infection, preservation of valve strength and function, and reduced requirement for lifelong blood-thinning medication.
The most common reason for aortic valve replacement surgery is when the valve can no longer close to its natural position and needs to be replaced. Nevertheless, a person's particular circumstances and the heart team's knowledge and competence may determine the optimal course of action.
What is the cost of aortic valve replacement surgery in India?
The cost of aortic valve replacement surgery in India can vary based on factors such as the hospital's location, the heart surgeon's experience, the type of valve used, and any additional medical needs or complications.
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Book an AppointmentFrequently Asked Questions
Open-heart surgery for aortic valve replacement typically takes about 2 to 4 hours. This includes time for preparation, the actual procedure, and post-operative care to ensure the patient's stability.
The cost of aortic valve replacement surgery in India ranges from INR 3,00,000 to INR 7,00,000. Prices may vary based on the hospital, surgeon's expertise, and additional medical expenses.
The success rate of aortic valve replacement surgery is over 95%. Most patients experience significant improvements in symptoms and quality of life, with a low risk of complications.
There is no strict age limit for heart valve replacement. Decisions are based on the patient's overall health, existing conditions, and potential benefits of the surgery.
Yes, many patients live a normal life after aortic valve replacement. With proper follow-up care and lifestyle modifications, they can enjoy improved heart function and quality of life.
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