Heart Double Valve Replacement Surgery
The human heart consists of four types of main valves that are- tricuspid, aortic, mitral and pulmonary valve. The mitral and tricuspid valve lies between the upper and lower chambers of the heart whereas the aortic and pulmonary valve can be found in two arteries that go out through the heart.
Usually it is the aortic and mitral valve that suffers due to the pathological changes caused by the degenerative valve disease, infective endocarditis and rheumatic heart disease. These diseases interfere with the opening and closing activity of the valve.
Some of the most common causes of heart valve disease are -
- Cardiac stenosis or narrowing.
- Constant high blood pressure and sudden heart failure, which results in enlarging of the arteries.
- Formation of scar tissue due to injury to the heart or heart attack.
- Common diseases such as rheumatic fever or strep throat can initiate valve related problems.
- Infective endocarditis- germ infection that enters the bloodstream.
- Autoimmune disease such as Lupus.
- Carcinoid syndrome
- Marfan syndrome.
- High blood cholesterol
- Metabolic disorder such as Fabry.
- Radiation therapy taken directly on the chest
What Are The Symptoms of Heart Valve Disease?
Some of the common symptoms of heart valve disease are -
- Retention of fluid in the lower limbs.
- Severe chest pain.
- Light-headedness and fatigue.
- Shortness of breath and dizziness.
Types of Valves Used in Replacement Surgery
Double valve replacement surgery is not that common and is overall a complicated procedure as compared to single valve replacement surgery. In case of double valve replacement surgery, both the diseased valves are replaced at once with a synthetic or biological valve.
The components used in synthetic also known as mechanical valves are not organic or natural. They are formed with a unique combination that includes carbon material and polyester which can be easily accepted by the human body.
Bioprosthetic valves also known as biological valves are created through biological resources such as human and animal tissues. There are three subtypes of biological valves, which are –
- Bovine valve – It is usually created using the tissues of a cow and is attached with the heart with the help of a silicone material rubber.
- Porcine valve – It is created with the use of a pig tissue and is attached with the heart like a stent- with or without frame.
- Homograft – Also known as allograft is the most original valve and is collected directly from the heart of the donor.
Procedure Before The Treatment
Before starting the surgery, the doctors announce a list of tests that are mandatory to be conducted on the patient. It gives an in-depth idea of the patient’s overall health and any other condition that is not visible.
Certain specific routine tests are conducted before the surgery such as X-ray and transthoracic echocardiography. Some of the other points that are assessed as contraindications for double valve replacement surgery are –
- Associated aortic aneurysm.
- Aortic arch aneurysm.
- Low chest profile.
- Chest surgery or trauma.
- Highly calcified mitral valve annulus or aortic valve.
- The requirement for aortic root reconstruction.
- Coronary artery bypass grafting.
- Peripheral atherosclerosis.
- Stent less aortic bioprosthesis implantation.
The patient is advised to stop certain things weeks before the surgery such as smoking or having any sort of heavy or spicy food that can affect the digestive system.
Procedure During The Surgery
- An intravenous line (IV) will be inserted in the arm of the patient for easy transfer of IV fluids and injecting medicines. Catheters will be placed in the blood vessels of wrist and neck to continuously monitor the activities related to blood pressure and heart.
- For the surgery related to heart, the next most important step is to stop the heart. For this purpose a heart-lung bypass machine is attached with the heart through the tubes that can pump the blood.
- Once the blood flow from the heart is diverted through the bypass machine the doctor starts with the operating procedure.
- The diseased valve is removed from the heart and is replaced by an artificial or biological valve, whichever has been decided by the surgeon before the start of the surgery.
- Once the surgery is over, the next step is to start the heart again for which the doctor gives shock to the heart and removes the tube of the bypass machine so that the blood can re-enter the heart.
- When the heart starts beating again, the doctor closely monitors the functionality of valves and heart to see if the surgery is a sure success.
Cost of Heart Double Valve Replacement Surgery
The average cost of heart double valve replacement surgery in India ranges somewhere in between $6000 USD to $7500 USD. It also varies from hospital to hospital.
Recovery time -
Once the surgery is over the patient is shifted to intensive care unit (ICU) and the recovery process is closely monitored keeping a strict check on breathing rate, blood pressure, ECG and oxygen level.
The total stay of the patient at hospital will be somewhere between 5 days to one week. During the stay the patient will be kept on ventilator to regularize the breathing activity. As the patient will start improving, showing signs of growth and improvement the breathing machine will be adjusted according to it.
After a while the patient does not need to depend on any external breathing mechanics and can start breathing properly on its own. Finally all the tubes- stomach tube and breathing tubes are removed so that the patient can be discharged from the hospital.