Cardiac Valve Replacement Treatment Cost in Thailand

Cardiac Valve replacement is performed to replace or repair a valve in the heart that stops working properly due to Valvular Heart Disease, also called Heart Valve Disease.

Heart valve replacement surgery involves a significant procedure that is performed through an open-heart approach, accessing the chest via the breastbone. This major operation, lasting two hours or more, requires a substantial recovery period, often extending over several weeks. While advancements have introduced less invasive alternatives for specific cases of valvular heart disease, these procedures are currently limited to select hospitals.

The main types of cardiac valve impairment include:

1. Valvular Stenosis: Narrowing of the valve opening, restricting the flow of blood through the valve. Common valves affected include the aortic and mitral valves.
2. Valvular Regurgitation (Insufficiency or Incompetence): Leakage or backward flow of blood through a valve that does not close properly, leading to inefficient pumping. The aortic and mitral valves are commonly affected.
3. Valvular Prolapse: This occurs when the valve leaflets bulge or collapse backward into the atrium during the heart's contraction. Mitral valve prolapse is a well-known example.
4. Valvular Atresia: Complete blockage or absence of a heart valve, hindering blood flow. This condition is often congenital and may require surgical intervention.
5. Infective Endocarditis: Inflammation of the heart valve, typically caused by an infection. It can lead to valve damage and impairment.
6. Rheumatic Heart Disease: A condition resulting from untreated streptococcal infections that can cause inflammation and scarring of the heart valves, affecting their functionality.
7. Bicuspid Aortic Valve: A congenital condition where the aortic valve has only two leaflets instead of the usual three, potentially leading to stenosis or regurgitation over time.
8. Calcific Aortic Stenosis: A gradual accumulation of calcium deposits on the aortic valve, causing it to become stiff and narrow over time.
9. Degenerative Valve Disease: Age-related wear and tear on the heart valves, leading to conditions such as calcification, stenosis, or regurgitation.
10. Traumatic Valve Injury: Damage to heart valves due to injury or trauma, which can affect their structure and function.

Valve replacement includes four procedures:

• Aortic valve replacement (AVR)
• Mitral valve replacement (MVR)
• Tricuspid valve replacement (TVR)
• Pulmonary valve replacement (PVR)

The aortic valve and the mitral valve replacements are the most common. Pulmonary and tricuspid valve replacements are uncommon in adults.

Valve replacement or repair can be done in several ways, depending on the problem. The most common valve replacements are:

Aortic Valve Replacement (AVR)

Surgical procedure- In Aortic valve replacement the incision is made by cutting through the sternum. After the pericardium is opened, the patient is put on a cardiopulmonary bypass machine, which is also known as the heart-lung machine. This machine performs the task of breathing for the patient and pumping their blood around while the surgeon replaces the heart valve.

The surgeon makes a cut in the aorta when the patient is on bypass and applies a crossclamp. The patient's diseased aortic valve is removed and is replaced by a mechanical or tissue valve. After the placement of the artificial valve and closing the aorta, the heart-lung machine is taken off from the patient. A transesophageal echocardiogram helps to confirm whether the new valve is functioning properly.

Mitral Valve Replacement (MVR)

Surgical procedure- General anesthesia is given to the patient before mitral valve replacement. An incision is made horizontally under the left breast, or vertically through the sternum. After exposing the heart, a cannula is placed and blood is directed to the heart-lung machine for cardiopulmonary bypass. The mitral valve is exposed by creating an incision in the left atrium. Then the valve is replaced. The left atrium is closed and the cardiopulmonary bypass is removed. The patient is taken to an intensive care unit after the surgery.

Post cardiac valve replacement, patients typically undergo a recovery period that involves monitoring for signs of infection, managing pain, and gradually resume normal activities. Short-term restrictions on strenuous activities may be advised, and a cardiac rehabilitation program could be recommended to enhance overall recovery.

Regular follow-up appointments with healthcare professionals help track progress and address any concerns, ensuring a smooth transition back to daily life while promoting optimal heart health.