The valves are responsible for delivering rich oxygenated blood to the heart chambers. In total, there are four heart valves performing the same operation. Each valve closes completely after pushing the blood in the following chamber. Hence the flow is maintained. The ill-conditioned heart valve is incapacitated to perform this operation. When the blood vessels narrow, the lesser amount of blood flows in the chambers causing the heart muscles to work harder. This condition is called stenosis. Weak valves cause disruptive flow of blood as the valve sometimes may close lightly. This causes the blood to flow backward which is termed as regurgitation.
Getting a valve replacement means to replace the faulty valves with either mechanical or biological alternatives. Replacing both the mitral and the aortic valves is called double valve replacement, or the entire left side of the heart. This type of surgery is not as common as the others and the mortality rate is slightly higher.
Figuring out the right candidate for the double valve replacement can be a little tricky as the procedure is a bit uncommon. Also, the factors involved in deciding who should get the replacement would vary from person to person. A general viewpoint may lead to patients having these symptoms.
Other factors that play an important role in deciding the candidature of double valve replacement are:
The factors affecting the cost of double valve replacement procedure may depend on:
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.
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.
Some of the causes of heart valve disease include the following:
Some of the symptoms of valvular heart disease include the following:
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:
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.
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.
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.
Heart Double Valve Replacement package cost in Hungary has different inclusions and exclusions. Some of the best hospitals for Heart Double Valve Replacement offer a comprehensive package that covers the end-to-end expenses related to investigations and treatment of the patient. The treatment cost usually includes the expenses related to hospitalization, surgery, nursing, medicines, and anesthesia. Extended hospital stay, complications after the surgery or new diagnosis may affect the overall cost of Heart Double Valve Replacement in Hungary.
Many hospitals in Hungary perform Heart Double Valve Replacement. The following are some of the most renowned hospitals for Heart Double Valve Replacement in Hungary:
Upon discharge from the hospital after Heart Double Valve Replacement in Hungary, the patients are advised to stay for about 21 days for recovery. This is important to ensure that the surgery was successful. During this time, control and follow-up tests take place to check for medical fitness.
Hungary is considered to be one of the best places for Heart Double Valve Replacement in the world. This is because of the availability of some of the best doctors, advanced medical technology and good hospital infrastructure. Some of the other destinations that are popular for Heart Double Valve Replacement include the following:
|Saudi Arabia||USD 33000|
|South Korea||USD 70000|
|United Arab Emirates||USD 45000|
There are certain additional cost that the patient has to pay apart from the Heart Double Valve Replacement cost. The extra charges may start from USD 50 per person.
The following are some of the best cities for Heart Double Valve Replacement in Hungary:
The patient is supposed to stay at the hospital for about 5 days after Heart Double Valve Replacement for monitoring and care. This phase is important to ensure that the patient is recovering well and is clinically stable. During this time, several tests are performed before the patient is deemed suitable for discharge.
There are more than 1 hospitals that offer Heart Double Valve Replacement in Hungary. The above listed clinics are approved to perform the surgery and have proper infrastructure to handle Heart Double Valve Replacement patients. Also, these hospitals follow the necessary guidelines as required by the medical associations for the treatment of Heart Double Valve Replacement patients.
It is the latest technologies combined with the best in the world medical and surgical specialists that is taking healthcare in multispecialty hospitals in Hungary to greater heights everyday. We have listed here some popular multispecialty hospitals in Hungary:
A wide range of specialties are offered in the multispecialty hospitals and clinics in Hungary which enables both straightforward procedures and complex procedures. When we talk of the multispecialty hospitals in Hungary, they are always identified with their willingness to go to extra lengths which result in brilliant outcomes and satisfied patients.
The multispecialty hospitals in Hungary are identified with absolutely world class medical and surgical specialists and outstanding healthcare technologies that are making the lives of innumerable patients better and healthier everyday. You should opt for healthcare in Hungary as the healthcare centers on high precision in procedures and giving good quality care to the patients. The wide research based influence of healthcare providers of Hungary makes this country a natural choice for patients to explore the choicest procedures in the country. Hungary is the natural choice to get your healthcare from as the exceptional safety and comfort any patient experiences here is several notches higher than several popular medical tourism destinations.
The great quality of doctors in Hungary is a testament to their collaborating ability with the larger international doctor community of the world ensuring knowledge sharing and excellent results. The good quality of doctors is because of the fact that they acquired their education from world’s best universities and are highly skilled in providing the right treatment to their patients. The doctors in Hungary keep up to date with the recent developments in their field of expertise and medicine in general and are willing to work with fellow doctors so that the best results can be achieved for their patients. The quality of doctors in Hungary can be gauged from the fact that they have really great experience with providing healthcare solutions to patients from different nationalities.
Please find below the essential documents that you must carry when traveling to Hungary:
We are outlining the three different types of documents that you need for your travel to Hungary and these are travel related, strength of your finances and related to your medical treatment The purpose of carrying all the important documents for your medical travel and treatment is that you are well prepared to navigate all the systems you encounter in Hungary. Your medical travel to Hungary must be supported and prescribed by the right authorities and it is important that you prepare documents as per your checklist.
Let us have a look at the procedures that are popular in Hungary:
There are several popular procedures done in Hungary but orthopaedics can be safely said to be the most popular medical and surgical specialty as the most frequently performed procedures are from this specialty. The strengths of healthcare in Hungary are its excellent healthcare infrastructure and its expert specialists because of which the procedures being performed here are a huge draw for medical travellers the world over. There is a lot of advancement in the techniques applied in procedures such as Hip Replacement, Knee Replacement and Shoulder Arthroscopy making them some of the most popular procedures being performed in Hungary.
Please visit the doctor atleast a month before your trip to go through the list of required vaccinations and be vaccinated for the ones which are a must. We have outlined below the routine vaccinations that are a must before your travel to Hungary.
We bring to you some vaccinations that are required according to age or for some health hazards.
Please be extra careful before your travel to Hungary by reconfirming the vaccinations that your doctor has suggested with the ones mentioned by the CDC or Centers for Disease Control and Prevention and WHO or World Health Organisation.
It is good to know that in addition to the core medical treatment being a comfortable experience, there are several additional facilities being provided to the medical travellers by the hospitals in Hungary. We have listed here for you the several additional facilities that you can get on your visit to a hospital in Hungary:
The online and video consultation provided by hospitals in Hungary for patients in the process of making their treatment decision helps them in a wonderful way. The International patient coordination is streamlined in the multispecialty hospitals in Hungary, making it very easy for the patients traveling from other countries to travel, get their required treatment and travel back home.
Hungary is ranked 23rd in the 46 global destinations in the 2020-2021 Medical Tourism Index. This is because of the high quality of services and number of facilities. In Hungary, there are many beautiful medical tourism locations, some of which we have listed here for you:
In Hungary, there are places like Csongrad county, Debrecen, Pecs and Szeged which have found a spot as the best medical tourism destination in the country.
We have listed below the documents required for medical treatment (Schengen visa type C) to Hungary:
When planning your medical travel to Hungary, kindly make sure whether you require the Schengen visa or not to enter Hungary. The basic purpose of the documents that you present during your visa application is to prove the following:
The medical visa is granted for a period of 90 days or less, a longer stay warrants you to approach the authorities for National Visa for Medical Treatment. Plus the medical visa takes around two weeks to be processed
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