What you need to know about:

Heart Valve Surgery

Fast Fact

92%
Worth It Rating
Average Cost:
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Recovery Period:
4-8 weeks
Permanence:
Depends on patient condition.
177
Doctors
Time it takes:
2-4 hours
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Hospitals & Clinics
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Anesthetize:
General anesthesia

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Overview of

Heart Valve Surgery

in Thailand

Heart Valve Surgery is sometimes required to treat heart valve problems. The doctor may carry out repairs to correct or prevent future damage to the heart’s structures or may change the heart valve, improving quality of life and extending life as well as alleviating symptoms.

Goals of

Heart Valve Surgery

Valve problems can be caused by birth defects, aging, and certain diseases. The aortic, mitral, pulmonic, and tricuspid valves help keep blood flowing in the correct direction in your heart. When a heart valve does not open all of the way (stenosis), less blood moves through to the next chamber in the heart. If the valve does not close tightly (insufficiency or regurgitation), blood may leak backward. Symptoms of valve problems commonly include: -Chest pain -Shortness of breath -Fainting or heart failure

Price of

Heart Valve Surgery

Average Cost

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Price Range

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Pros and cons of

Heart Valve Surgery

Pros

There are 2 types of valves that can be used during a replacement valve surgery. They include mechanical valves and biological valves:  

Pros of mechanical valves:  -The advantage to mechanical heart valves is their sturdiness. -They are designed to last for many years.  

Pros of biological valves:  -Only have to take blood-thinning medications for the first few months after surgery.  -Most people do not need to take life-long blood thinners, unless they have other conditions (such as atrial fibrillation) that warrant it.  

Cons

Cons of mechanical valves:  -Due to the artificial material involved, people who receive these valves will need to take life-long blood-thinner medication (anticoagulants) to prevent clots from forming in the mechanical valve. These clots can increase the risk for a stroke.  - Increased risk of bleeding from taking blood-thinning medications for the rest of your life  -Patients may have to visit a doctor once a month to monitor levels of anticoagulation medications  -Some people report a valve ticking sound that is usually not bothersome. It is the sound of the valve leaflets opening and closing.  

Cons of biological valves:  -Durability is less than for a mechanical valve.  -Previously available biologic valves usually needed to be replaced after about 10 years. However, some studies show that some biologic valves may last at least 17 years without decline in function.

How It Works:

Heart Valve Surgery

During the procedure, general anesthesia is given so that you will sleep through surgery and not feel any pain. The cardiac surgeon makes an incision in the chest to expose the heart. A heart-lung bypass machine is used to provide blood to the body when the heart is stopped during the surgery. The different appraoches taken by the doctor during surgery may includ; -Using sutures to tighten the valve. -Remove a part of the valve. -Enforce the valve so it opens and closes as it should. -Remove the damaged valve and replace it with an artificial value. Your treatment depends on several factors, including your age, general health, condition of your heart valves, and your preference. Your doctor will discuss the options with you and determine the appropriate surgery to treat your condition.

Preparation before

Heart Valve Surgery

Pre - treatment

In preparing for surgery your doctor will explain your heart condition, the reason for surgery, the risks associated with the procedure, and the pros and cons of the surgery. Furthermore, please note the following: Before the procedure, you will undergo a health screening that includes a physical examination and laboratory tests. It is recommended that you visit the dentist to treat any problems with your teeth and gums as these can cause infection after the surgery. It is important that you tell your dentist that you have heart disease so they can prescribe antibiotics before and after the dental procedures. If you have a history of bleeding easily or clotting problems, or if you or family members have ecchymosis (discolorations on the skin due to bleeding), please inform the doctor. Please let the doctor know about any allergies you have to medication, food, and other substances, or if you have any implanted electronic devices. Avoid certain medications for 5-7 days, including anticoagulants and certain heart medication, as recommended by your doctor. You will need to avoid food and water for at least 8 hours before the procedure. Avoid drinking alcohol and smoking cigarettes for at least 1 week before the surgery. On the day of the procedure, please bring all medication you take regularly to the hospital. You will be instructed on post-procedure cardiac rehabilitation with exercise to help speed up your recovery.

Recovery after

Heart Valve Surgery

Post - treatment

You will stay in the hospital for 7-10 days and will spend the first 2-3 days in the Cardiac Care Unit so your heart rate and rhythm, blood pressure, body temperature, and respiration rate can be monitored. As soon as you are awake, you can begin the Cardiac Rehabilitation Program Phase 1 by making fists with your hands, flexing and pointing your toes to stimulate circulation. You will likely experience some pain and discomfort at your chest, especially in the first 48-72 hours after the procedure. You will be given pain medication to manage this. When your symptoms improve, the doctor will gradually remove the monitors as appropriate. After the breathing tube, which is inserted during surgery, is removed, you may notice you have mucus in your throat and will need to cough it out to prevent infection. You will also need to carry out breathing exercises by inhaling and exhaling deeply and using the TriFlow every hour to maintain lung function. When your doctor allows you to start drinking water, limit how much you drink at the beginning. When your doctor allows it, you will be moved to a special rehabilitation ward where you will be encouraged to walk until you reach the target set for you, and then you will be able to return home. Before you leave the hospital, you will be scheduled for regular follow-up appointments to see your doctor and for the cardiac rehabilitation program to assess your ability to exercise.

Risks & side effects

This procedure has a low risk of complications, but they are always possible, depending on your health before surgery. Possible complications of heart valve surgery include: -Excessive bleeding (2-3%) -New-onset atrial fibrillation (29.5-33%) -Renal failure (1.8-4.9%) -Permanent stroke (1.3-2.3%) -Superficial wound infection (2-6%) -Mediastinitis (0.2%) -Death (1.5-4.2%)

FAQs:

Heart Valve Surgery

What causes valvular heart disease?

There are several reasons that one or more of your heart valves may not work properly. The ultimate effect of a diseased heart valve is that it interrupts normal blood flow through the heart. Causes may include the following:  -Endocarditis – an infection of the valve tissue.  -Rheumatic fever – a specific type of infection more prevalent in developing countries where the valve tissue becomes inflamed and/or fused together.  -Calcification – over time, calcium in your body can build up on the tissue of your valves making it difficult for them to move properly.  -Congenital defects – a condition you are born with such as having only two leaflets on the aortic valve rather than three.  -Ischemia – also known as coronary artery disease, in which the heart’s own blood vessels become clogged and can no longer deliver the proper amount of blood.  -Degenerative disease -– a progressive process that represents slow degeneration from mitral valve prolapse (improper leaflet movement). Over time, the attachments of the valve thin out or rupture and the leaflets become floppy and redundant.

How can my heart valve be repaired?

In some cases, it is possible to repair your valve. Repair is most commonly performed on the mitral and tricuspid valves. The goal of the repair procedure is to fix your native valve so that it can open and close properly, thereby restoring normal blood flow through the heart. An implantable device which is usually ring-shaped with a metal core may be placed directly above your valve and tied in place with sutures. This procedure is called ring annuloplasty. The ring helps your valve maintain its proper shape so that blood does not leak out as the heart contracts and relaxes. This surgery can be performed with a conventional, full open-chest or through a less invasive or minimal incision approach as well.

How can my heart valve be replaced?

If your heart valve cannot be repaired, your doctor may decide to replace your native valve with a prosthetic valve. The aortic valve is the most commonly replaced heart valve. The prosthetic valves are usually one of two types: a mechanical valve or a tissue valve. A mechanical valve is made from synthetic (manmade) materials, primarily carbon. A tissue valve is usually made from either the tissue from a pig’s aorta or the tissue from the pericardium (sac surrounding the heart) of a cow. Valve replacement can be performed with a conventional, full open-chest or through less invasive or minimal incision approaches as well.

Should I have a mechanical valve or a tissue valve?

You should discuss this question with your doctor as there are advantages and disadvantages to both. The key is to choose the valve that best fits your lifestyle and your goals. A mechanical valve may last longer than a tissue valve (which can wear out over time). However, patients with mechanical valves are required to be on anticoagulants (blood thinners) for life. Tissue valves do not require you to be on blood thinners for the rest of your life. However, they can wear out over time which may require a re-operation.

How long after heart valve repair or replacement surgery can I resume “normal” levels of activity?

If you have a valve replaced or repaired, the normal recovery period is four to eight weeks, although minimally invasive approaches are often associated with more rapid recovery. Your ability to return to your normal daily activities depends on several factors, including the type of valve repair/replacement you’ve had, how you feel, how well your incision is healing, and the advice of your doctor. Regardless of the pace of your recovery, a supervised cardiac rehabilitation program is always helpful to regain energy and ensure overall good health.

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