Best Hospitals for Heart Double Valve Replacement

Aortic Valve Replacement/ Mitral Valve Replacement (AVR/MVR) 

There are four types of cardiac valves that control the flow of blood to and fro the heart. Over a period of time, the heart valves may get diseased or damaged because of several reasons. A reduction in the functioning of the valves can cause serious complications.

The aortic and the mitral valve are most commonly affected by the heart valve disease. Aortic valve replacement (AVR) and mitral valve replacement (MVR) are the two types of valve replacement surgeries in which the diseased aortic or the mitral valve are replaced. Sometimes, both the valves are replaced in the same surgery. Such a surgery is known as double valve replacement surgery.

Types of Valves

The following types of valves may be used to replace the diseased or damage valve:

Tissue valves: These valves are created from animal tissue, wither heart valve tissue or pericardial tissue. These types of tissue valves reduce the risk of rejection and calcification. In some of the cases, a homograft may be used to replace the diseased valve. The homograft is either retrieved from a deceased donor or the patient’s own pulmonary valve.

Mechanical valves: These are made up of flexible and durable material and they tend to last for an entire lifetime of the patient. However, there is an increased risk of blood clotting in patients who receive mechanical valves. This is the reason why they may have to take blood-thinners for their entire life.

Immediately after the procedure, the patient is shifted to intensive care for at least 12 to 36 hours. This is followed by a day or two of hospital stay. The patient is discharged after four to six days of the surgery. Total recovery may take around four to six months.

Treatment and Cost

21

Total Days
In Country
  • 5 Day in Hospital
  • 2 No. Travelers
  • 16 Days Outside Hospital

Treatment cost starts from

USD 9000

173 Hospitals


The Hospital has world-class infrastructure with a capacity of over 1000 beds and much more-

  • 265 Licensed beds
  • 13 Operation Theatres
  • 24*7 Cath Lab
  • 24*7 available Blood Bank
  • 24*7 Emergency Department
  • 24*7 Open Pharmacy

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32

DOCTORS IN 14 SPECIALITIES

6+

FACILITIES & AMENITIES

USD 9610 - 10800

FOR Heart Double Valve Replacement


Apollo Hospitals located in Hyderabad, India is accredited by JCI, NABH. Also listed below are some of the most prominent infrastructural details:

  • A premier multi-specialty hospital with 477-bed capacity
  • More than 50 specialties, super-specialties
  • 12 Centers of Excellence
  • The Institutes for Heart Diseases, Neurosciences, Cancer, Emergency, Orthopaedics, Renal Diseases, and Transplants
  • Centers of Excellence are known for patient care, training and research
  • Doctors with years of truly global experience in healthcare delivery

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37

DOCTORS IN 14 SPECIALITIES

6+

FACILITIES & AMENITIES

USD 9060 - 10630

FOR Heart Double Valve Replacement


Artemis Hospital is a 400 plus bed multi-speciality hospital, which aims at providing a depth of expertise in the spectrum of advanced medical and surgical interventions. Some of the features of the infrastructure include:

  • A 400 plus bed multi-speciality hospital.
  • A large number of ICU beds equipped with modern technologies.
  • Imaging techniques include 64 Slice Cardiac CT Scan, Dual Head Gamma Camera, |  16 Slice PET CT, Fan Beam BMD, RIS - HIS Integrated Department, High -end Colour Doppler Ultrasound Systems.
  • Cardiology department supported by Philips FD20/10 Cath Lab with Stent Boost Technology, C7XR OCT - Optical Coherence Tomography, Lab IVUS - Intravascular Ultrasound, Rotablator - for calcified lesions, FFR -Fractional Flow Reserve, Ensite Velocity Cardiac Mapping System, and Endovascular Hybrid Operating Suite.
  • ICU is backed by High-Frequency Ventilator for NICU, Central Venous Pressure Monitoring, Intra - aortic Balloon Pump, Invasive Intraarterial Blood Pressure Monitoring, Ab4 Monitoring, Bedside Percutaneous Tracheostomy, Portable X - ray Viewer, Temperature Regulating Blankets/Warmers, Bedside ECHO Cardiology.
  • Operation Theatre Technologies: Total Knee Replacement - Navigation System, Motor Evoked Potentials (MEP) for Spine Surgeries, Fiber Optic Bronchoscope, Patient Controlled Analgesia (PCA) Pump, Somatosensory Evoked Potential (SSEP) in DBS Surgery.

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53

DOCTORS IN 14 SPECIALITIES

6+

FACILITIES & AMENITIES

USD 9440 - 10320

FOR Heart Double Valve Replacement

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Sterling Wockhardt Hospital located in Mumbai, India is accredited by NABH. Also listed below are some of the most prominent infrastructural details:

  • The bed capacity of Sterling Wockhardt Hospital is 50.
  • Critical care and complex cases resolution is done with excellent results.
  • Emergency departments with 3 beds capacity and Intensive Care Unit with 10 beds capacity.
  • The healthcare delivery focus of the hospital is both on prevention as well curing the conditions.
  • Diagnostics are well developed with the latest technological developments.
  • Pharmacy, operating rooms, lab services are at par with the best in the country.
  • 24/7 ambulance services to cover healthcare requirements in Panvel and Vashi.
  • Accommodation, airport transfers, flight bookings and translation services are all available for international patients.

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16

DOCTORS IN 14 SPECIALITIES

6+

FACILITIES & AMENITIES

USD 9810 - 10030

FOR Heart Double Valve Replacement


Star Hospitals located in Hyderabad, India is accredited by NABH, NABL. Also listed below are some of the most prominent infrastructural details:

  • The bed capacity of Star Hospitals, Hyderabad, India is 130.
  • The hospital has Intensive Care Units which are upgraded with the latest technologies.
  • International patient care services are applied to make the process of medical travel easier for international patients.
  • Centres of Excellence across disciplines such as Cardiac Sciences, Renal Sciences, Critical Care, ENT, Spine Surgery etc.
  • A radiology centre which has been digitised.
  • There are Centers of Excellence for prominent specialties such as cardiac care and neurosciences, there are a total of six.

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28

DOCTORS IN 12 SPECIALITIES

6+

FACILITIES & AMENITIES

USD 9020 - 10660

FOR Heart Double Valve Replacement


Parkway East Hospital located in Joo Chiat Pl, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:

  • Total capacity for 143 beds
  • Hospital rooms are available- Single room, 2-bedded room (8), 4-bedded room (2), Deluxe room, and Orchid/Hibiscus Suite
  • All rooms are equipped with all ensuite facilities like Free wifi, mini fridge, sofa couch, telephone, in-room safe, TV, etc.
  • Maternity wards- Accredited as a baby-friendly hospital under the World Health Organisations Baby-Friendly Hospital Initiative (BFHI)
  • 1 Neonatal Intensive Care Unit (NICU) with 14 cots
  • Intensive Care Unit
  • 1 Operation Theatre with 5 Operating rooms
  • 1 Nursery with 30 cots
  • 1 Parentcraft room
  • 24-hour walk-in-clinic (for emergency)
  • 24-hour Pharmacy

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14

SPECIALITIES

6+

FACILITIES & AMENITIES


Medanta - The Medicity located in Gurugram, India is accredited by JCI, NABH. Also listed below are some of the most prominent infrastructural details:

  • 1250 beds facility
  • 800+ professionally trained & experienced Doctors
  • Patient Support Services Team in International Patients Department, assists patients from different nation during their medical travel journey
  • Hotels and Lodging Arrangements
  • International Lounge
  • Medantas own Air-ambulance service can reach you in any part of the world (fully functional ICU at 30,000 feet above the ground)

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62

DOCTORS IN 14 SPECIALITIES

6+

FACILITIES & AMENITIES

USD 9660 - 10880

FOR Heart Double Valve Replacement


Mount Elizabeth Hospital located in Singapore, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:

  • 345 bedded Hospital
  • Maternity wards
  • The Mount Elizabeth Patient Assistance Centre (MPAC)
  • 1 major operating unit with 12 operating rooms and 1 operating theatre dedicated to in vitro fertilisation (IVF)
  • Intensive Care Unit
  • High Dependency Unit (HDU)
  • Neonatal Intensive Care Unit (NICU)
  • Accident & Emergency Department
  • Rooms are categorized as Single rooms, 2-bedded rooms, 4-bedded rooms, Executive deluxe suite, Daffodil/Magnolia suite, VIP Room, and Royal Suite
  • All patient rooms are equipped with electric safe, LCD, sofa cum bed, wardrobe, radio channels, and much more
  • Parking lot

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14

SPECIALITIES

6+

FACILITIES & AMENITIES


Fortis Malar Hospital located in Chennai, India is accredited by ISO, NABH. Also listed below are some of the most prominent infrastructural details:

  • Fortis Malar Hospital has outstanding healthcare infrastructure and it is equipped with the latest cutting edge equipment.
  • The hospital has around 650 employees in addition to the 160 consultants.
  • The bed capacity of the Fortis Malar Hospital is 180.
  • There are as many as 60 ICU beds in the hospital.
  • There are 4 modern fully equipped operation theatres.
  • It also has a digital flat panel Cath lab.

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20

DOCTORS IN 9 SPECIALITIES

6+

FACILITIES & AMENITIES

USD 9680 - 10200

FOR Heart Double Valve Replacement


Interventional Cardiology Centre at Venkateshwar Hospital follows global standards for valve replacement in India. The Centre is committed to using cutting edge technology with full ethical expertise to provide personalized care to the patient undergoing valve replacement. The hospital expertise in an effective cardiac catheterization process that avoids the need for open-heart surgery.

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36

DOCTORS IN 13 SPECIALITIES

6+

FACILITIES & AMENITIES

USD 9610 - 10310

FOR Heart Double Valve Replacement


Gleneagles Hospital located in Napier Road, Singapore is accredited by JCI. Also listed below are some of the most prominent infrastructural details:

  • 270+ bedded medical facility, which includes suites, single rooms, two-bedded, four-bedded rooms and maternity wards (9 delivery rooms)
  • 12 operating rooms
  • Surgery ward with 40 beds
  • State-of- the-art intensive care unit (ICU) with 16 beds
  • State-of- the-art neonatal intensive care unit (NICU) with 14 cots
  • Separate transplant unit
  • Endoscopy Centre (VIP room)
  • 24-hour accident and emergency (A&E) and outpatient Unit
  • Accommodation availability for the patients
  • The Hospital has a dedicated Patient Assistance Centre, which is to cater to multi-faceted needs of international patients. It provides services like air evacuation and repatriation, visa application and extension, language interpretation assistance, etc.

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14

SPECIALITIES

6+

FACILITIES & AMENITIES


Medicana International Istanbul located in Istanbul, Turkey is accredited by ISO, JCI. Also listed below are some of the most prominent infrastructural details:

  • Covers an indoor area of 30.000 m
  • Capacity of 191 beds
  • 34 ICUs
  • 8 NICUs
  • 8 Operation Theatres
  • Inpatient Floors
  • Outpatient Floors
  • Internal and Surgical Intensive Unit Care
  • Cardiovascular Surgery Intensive Care Unit
  • Coronary Intensive Care Unit
  • Neonatal Intensive Care Unit
  • Patient comfort CIP, VIP and Standard Patient Rooms
  • Intensive care patient rooms
  • Technology Advancement- PET-CT, ERCP, BT/MR 1.5 Tesla

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27

DOCTORS IN 10 SPECIALITIES

6+

FACILITIES & AMENITIES


Memorial Antalya Hospital located in Antalya, Turkey is accredited by JCI. Also listed below are some of the most prominent infrastructural details:

  • 114 patients and 28 intensive care beds
  • 5 Operating theatres
  • Radiology Department with advanced technology
  • Intensive care units
  • Interventional Radiology Unit
  • Chemotherapy and Art Center
  • The Hospital uses advanced technologies like Hydra Facial, Cardiac MR, Heart Tomography-Coronary CT Angiography and many more
  • Patient rooms and living spaces with all the 5-star hotel features

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24

DOCTORS IN 11 SPECIALITIES

6+

FACILITIES & AMENITIES


Medicana International Samsun Hospital located in Samsun, Turkey is accredited by ISO, JCI. Also listed below are some of the most prominent infrastructural details:

  • International Samsun Hospital provides services in a closed area of 30.000 m2
  • 9 elevators with pressure control have been designed for you in the hospital with 3 blocks, two of which are 11 floors and the other 10 floors
  • Capacity of 249 beds
  • 7 Operating Theatres
  • 109 Intensive Care beds (19 Newborn, 7 Paediatric, 20 Coronary, 8 CVS, and 54 General)
  • Laboratories - Biochemistry, Pathology, Hormone, Microbiology, Sleep Lab
  • IVF Center
  • Oncology Center
  • The Hospital serves patients with a team of about 99 specialists and academicians in 40 branches and 631 employees
  • Medicana International Samsun uses advanced technology & modern equipment such as BT/MR 1.5 Tesla, 3d Conformal, Thermal Welding, Holmium Laser, 4D Ultrasonography, Color Doppler Ultrasonography, Mammography, and Radiotherapy; in order to perform safe, authentic and quick treatment
  • All kinds of rooms are available for the patients- Single, Suite and VIP Rooms. Patient rooms are equipped with the latest technology and comfort
  • Amenities provided in the room for patients and their relatives- TV and Minibar in each room, 24-hour interrupted Cafeteria service, central air-conditioning ventilation system in each room, Internet access, phones in rooms, and much more
  • Cafeteria/Restaurant
  • Pharmacies on Duty
  • Parking lot with a capacity for 50 vehicles

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31

DOCTORS IN 11 SPECIALITIES

6+

FACILITIES & AMENITIES


NMC Royal Hospital, Khalifa City located in Abu Dhabi, United Arab Emirates is accredited by JCI. Also listed below are some of the most prominent infrastructural details:

  • Capacity for 500 beds
  • 53 Critical Care beds
  • 24-hour Emergency Services
  • 24-hour Ambulance Service
  • OPD (Outpatient department treatment)
  • An Automated Laboratory
  • The Hospital has the first hybrid Operating Theatre with flex move system
  • First NICU and PICU Combination set up

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36

DOCTORS IN 11 SPECIALITIES

6+

FACILITIES & AMENITIES

About the Heart Double Valve Replacement

There are four types of valves in the human heart – the mitral, aortic, tricuspid, and pulmonary valve. The mitral and the tricuspid valve are present between the upper and the lower chambers of the heart. On the other hand, the aortic and the pulmonary valve are present in the two arteries that leave the heart.

Most often, it is the mitral and the aortic valve that undergoes certain pathologic changes due to degenerative valve diseases, rheumatic heart diseases, or infective endocarditis. This may result in problems associated with the valve opening and closure.

These dysfunctions can be treated with either valve repair or valve replacement surgery. Aortic valve replacement or mitral valve replacement is carried out when just one of the valve is diseased or damaged. However, when both the valves are diseased or damaged, a double valve replacement surgery is conducted.


About the ailment

The heart valves present in the heart are responsible for permitting the flow of nutrient-laden blood through the heart chambers. After allowing the ushering of blood, each valve is expected to close completely. The diseased or damaged valves are not able to open and close properly, thus allowing the mixing and backflow of blood (regurgitation).

 A double valve replacement surgery mainly aims at correcting the problem of valvular heart disease and involves both aortic valve replacement and mitral valve replacement. The mitral valve is situated between the left atrium and the left ventricle while the aortic valve is located in between the aorta and the left ventricle.

Causes of Heart Valve Disease

Some of the causes of heart valve disease include the following:

  • Cardiac stenosis or narrowing
  • High blood pressure and heart failure, which enlarges the heart and arteries and contribute to valvular diseases
  • Atherosclerosis
  • Scar tissue formation and damage due to heart attack or any injury to the heart
  • Strep throat or rheumatic fever can give rises to valve problems
  • Infection due to germs entering bloodstream can affect heart valves and one such infection is infective endocarditis
  • Lupus-like autoimmune diseases can affect the aorta and mitral valve
  • Carcinoid syndrome
  • Diet medicines such as fenfluramine and phentermine can at times give rise to valve diseases
  • Marfan syndrome
  • Metabolic disorders such as Fabry disease or high blood cholesterol
  • Radiation therapy to the chest can give rise to heart valve diseases.

Symptoms of Double Valve Replacement

Some of the symptoms of valvular heart disease include the following:

  • Fluid retention in the lower limbs
  • Chest pain
  • Fatigue and light-headedness
  • Dizziness and shortness in breath
  • Cyanosis

About heart valve replacement

Double valve replacement surgery is a complicated procedure as compared to single valve replacement surgery. Aortic valve replacement and mitral valve replacement involves the replacement of just one valve but during double valve replacement surgery, both the diseased valves are removed at the same time and replaced with a synthetic (mechanical) or a biological valve.

In the case of mechanical valves, the components used are not of organic or natural origin. They are created from a combination of polyester and carbon material that the human body can tolerate and accept. Blood-thinning medications are given to patients who get mechanical valves to prevent blood clot formation.

Bioprosthetic valves or the biologic valves are either created from animal or human tissues and can be of the following types:

  • A bovine valve is usually derived from the tissues of a cow and is connected to the heart with the help of silicone rubber
  • A porcine valve has its origin rooted from a pig tissue and is implanted in the heart with or without the frame like a stent
  • A homograft or an allograft is usually collected from the human donor’s heart

The choice of a particular type of valve depends on the age, overall fitness, and the ability to metabolize anticoagulant medications. The only problem associated with a bioprosthetic valve is that it may not last a lifetime and one may have to undergo a replacement again later.

How is Heart Double Valve Replacement performed?

For the purpose of hemodynamic monitoring, the peripheral arterial and venous access are installed. The patient is anaesthetized in a supine position with a single lumen endotracheal tube.

In the jugular vein, two percutaneous sheath introducers are placed for central venous pressure monitoring and drug administration. Another similar one is placed in the same right jugular vein for the purpose of introducing endocavitary pacemaker leads if required. External defibrillator pads are placed on the patient’s back and on the anterior left chest.

TEE or transesophageal echocardiography probe is used for an assessment of cardiac function, percutaneous venous cannulation guidance, and valve assessment. The skin is sterilized with iodine solution and an aseptic strip is applied on areas exposed. The double valve replacement procedure is very similar to isolated aortic valve replacement or mitral valve replacement, which is conducted via a single access right anterolateral minithoracotomy.

Before systemic heparinization, the venous introducer sheath is positioned in the femoral vein to prevent any unwanted bleeding. In the third intercostal space, an incision of 6 to 8 cms is made. Minithoractomy is made and in the 3rd and 5th intercostals spaces, two auxiliary working ports are placed. The first is for video assistance and the second is for gas insufflation, cardiotomy vent, and pericardial stay sutures. The pericardium is opened upwards and downwards after removal of the pericardial fat, which is 3 to 4 cm above the phrenic nerve. The pericardium is retracted using silk sutures.

In a standard way, two aortic purse strings are placed for direct arterial cannulation after the aorta has been exposed. The operation is continued with venous cannulation under the guidance of TEE. A guidewire in moved through the venous introducer and positioned in the superior vena cava.

With the central cannulation of the ascending aorta, arterial inflow is established. The cannula has an obturator and an advanced tip to aid aortic insertion within the thorax. With cannula rings, the tip is secured and with two tourniquets the cannula is secured. They allow maximum space to work during thoracotomy access.

Carbon dioxide flow keeps running and when the heart gets arrested, the aorta is opened in an oblique way with an incision like a hockey stick, k which is further extended to the non-coronary sinus Valsalva. After this, aortotomy is made far away from the cross-clamp and from the main pulmonary artery trunk; for the closure of aortotomy, enough aortic tissue must be kept. Now the problematic valve is excised. The annulus size is measured and calibrated with a sizer and then prosthesis is implanted. The aortic prosthesis is lowered and made to remain above the final plane of implantation.

Now focus shifts to the left atrium. It gets dissected in a Sondergaard’s plane, and with the help of one single silk suspension stitch and an atrial retractor, the mitral valve is exposed. If now required the left atriotomy can be further extended behind upwardly behind the superior vena cava or along the inferior vena cava downwardly.  In right minithoracotomy the visualization of the mitral valve is very good and allows valve and subvalvular repairs easily.

The procedure starts with synthetic braided sutures being placed in the mitral annulus whose diameters are measured using suitable valve sizes. For the mitral valve, reductive annuloplasty is performed. The sutures are passed and the retractor is removed and then attention is again diverted towards the aortic valve prosthesis. This is lowered into the annular plane and thereafter knotted.

For the assessment of the results of the repair, the atrial retractor is again positioned in the left atrium.  To estimate the competence of the valve, a water probe is applied with an implanted open mitral ring. After successful completion, the left atrium is closed leaving behind the ventricular vent via the mitral valve in the left ventricle. Aortic cross-clamp is removed and aortotomy suture is further knotted. The aortic vent is positioned in the ascending aorta. A polypropylene purse-string suture is hand-knotted after aortic vent is removed. After confirmation by the TEE, the procedure moves to the final stage where the aortic cannula is removed and a percutaneous cannula is also withdrawn with the femoral vein temporarily placed under compression, the skin incision is closed with a single silk stitch.

Recovery from Heart Double Valve Replacement

After the surgery, the patient is shifted to ICU for close monitoring for several days. Blood pressure, ECG tracing, breathing rate, and oxygen levels are closely studied. You may require staying in the hospital for several days after heart valve replacement surgery. With the help of the ventilator, breathing is assisted via a tube inserted in the throat. The breathing machine will be further adjusted as the patient keeps growing stable and once the patient is able to breathe and cough on their own, the tube is removed. Along with this, the stomach tube is also removed.

In every two hours, a nurse would help the patient take deep breaths and cough. This feels sore but is vital to prevent accumulation of mucus in the lungs and prevent pneumonia. The patient is taught to hug a pillow tightly while coughing to ease out any discomfort. The patient must express discomfort felt at coughing and medications are suggested accordingly. Slowly fluid intake is initiated and you can gradually increase your daily activities such as walking around the room. After a few days, the patient is shifted to the recovery room where the rest of the recovery takes place before discharge.

Notify your doctor if you feel swelling and redness around incision area, fevers and chills, or pain in the area of the incision. You should rest and keep the surgical area as clean as possible at home.

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