Heart Valve Repair

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ABOUT HEART VALVE REPAIR

Valve replacement or repair is recommended when you have symptoms of heart failure, or when your ejection fraction is lower to over 60%. The decision between repairing and replacing the valve depends on the type of damage to the Mitral valve. Repair is more successful if there is limited damage to certain areas of the mitral valve flaps (leaflets) or to the tough fibers that control movement of the Mitral valve leaflets (chordae tendineae). Replacement, however, is usually preferred for people who have a hard, calcified Mitral valve ring (annulus) or widespread damage to the valve and surrounding tissue.

The following steps are done during repair;

Reshape the valve by removing excess valve tissue
Add support to the valve ring by adding tissue or a collarlike structure around the base of the valve
Attach the valve to nearby cord like heart tissues (chordal transposition)

Valvuloplasty

Valvuloplasty is a technique aimed at making sure the flaps of the valves (or leaflets) close properly, preventing blood from backing up into the atrium. In the healthy heart, blood flows from the upper chamber (atrium) to the lower chamber (ventricle) and from the ventricle to the body.

Commissurotomy is a special form of Valvuloplasty. Commissurotomy is used when the leaflets of the valve become stiff and actually fuse together at the base, which is the ring portion (or annulus) of the valve. Sometimes a scalpel is used to cut the fused leaflets (commissures) near the ring, which may help them open and close better. In other cases, a balloon catheter, similar to a catheter used during angioplasty, is inserted into the valve. The balloon is inflated, splitting the commissures and freeing the leaflets to open and shut fully. Unlike other Valvuloplasty procedures, this procedure can be done in the cardiac catheterization lab, and the chest does not have to be opened.

Annuloplasty

Annuloplasty is a technique aimed at repairing the fibrous tissue at the base of the heart valve (the annulus). Sometimes, the annulus becomes enlarged, which enables blood to back up into the atrium. To repair this, sutures are sewn around the ring to make the opening smaller. This creates a purse string effect around the base of the valve and helps the leaflets meet again when the valve closes.

Sometimes when repairing the annulus, it is necessary to implant an annuloplasty ring. A ring is used to correct a problem, provide support for the valve, and reinforce other repair techniques or any combination of these.

Infection, bleeding, stroke and heart attack are some of the risks and complications following a valve repair.

BRIEF ABOUT THE PROCEDURE

General anesthesia is used for this procedure. An incision is done at the center of the chest, Heart Valve Repairseparating the breastbone. The heart is then connected to the heart-lung machine to take over the job of the heart and the lungs. The right atrium is accessed with a special tube that will carry blood from the body to the machine, which oxygenates the blood. The machine then pumps the oxygenated blood through another tube that has been placed into the aorta to circulate the blood back through the body. The term bypass is often used to describe this method of bypassing the heart and lungs.

Once the repair is made, the heart-lung machine is withdrawn; and the heart is started again to circulate blood through the lungs and body. The breastbone is rejoined with wires and the incision closed.

This is the conventional open-chest procedure for valve replacement or repair surgery. Recent technology has allowed surgeons to perform valve replacement or repair with less invasive techniques.

The other major cardiac procedures are:

HOSPITALS FOR HEART VALVE REPAIR

Few Major Hospitals for Heart Valve Repair are:

DESTINATIONS FOR HEART VALVE REPAIR

Thailand, Malaysia, Singapore, Turkey and India are the most cost effective locations that offer up to almost 80% savings in comparison to the US.

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