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.
The cost of Heart Double Valve Replacement procedure starts from USD 70000 in South Korea. Heart Double Valve Replacement in South Korea is available across many hospitals in different states.
Heart Double Valve Replacement package cost in South Korea 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 comprehensive Heart Double Valve Replacement package cost includes the cost of investigations, surgery, medicines and consumables. Stay outside the package duration, post-operative complications and diagnosis of a new condition may further increase the Heart Double Valve Replacement cost in South Korea.
Many hospitals in South Korea perform Heart Double Valve Replacement. Some of the best hospitals for Heart Double Valve Replacement in South Korea include the following:
The recovery of the patient many vary, depending on several factors. However, on an average, patient is supposed to stay for about 21 days in the country after discharge. During this time, the patient undergoes medical tests and consultations. this is to ensure that the treatment was successful and the patient us safe to return.
South Korea 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 such countries are:
|Saudi Arabia||USD 33000|
|South Korea||USD 70000|
|United Arab Emirates||USD 45000|
Apart from the Heart Double Valve Replacement cost, there are a few other daily charges that the patient may have to pay. These are the charges for daily meals and accommodation outside the hospital. The per day extra expenses in South Korea per person are about USD 50 per person.
The following are some of the best cities for Heart Double Valve Replacement in South Korea:
The patient is supposed to stay at the hospital for about 5 days after Heart Double Valve Replacement for monitoring and care. The doctors team review the patient's recovery during this time with the help of blood tests and imaging scans. Once they feel that everything is on track, the patient is discharged.
There are more than 1 hospitals that offer Heart Double Valve Replacement in South Korea. The above mentioned clinics have the required infrastructure and a dedicated unit where patients can be treated. Apart from good services, the hospitals are known to follow all standard and legal guidelines as dictated by the local medical affairs body or organization.
The two accreditation bodies in South Korea are Commission International (JCI) and Korea Institute for Healthcare Accreditation. JCI, which has certified around 29 hospitals in South Korea, has set strong quality parameters based on which hospitals are evaluated. KOIHA evaluates a healthcare facility based on parameters, such as performance management, administrative management and quality of patient care. The standards set by JCI and KOIHA require strict monitoring of all critical events to ensure that the quality of healthcare is as per the international standards.
South Korea is recognized as one of the popular medical tourism destinations in the world with state-of-art infrastructure and the latest medical technologies. Backed by world-class hospitals, South Korea has well-qualified doctors who are highly trained and skilled to handle even the most complicated cases with a high success rate. Proving quality care at an affordable cost, South Korea is declared most innovative in healthcare practices which helps the country to offer a wide range of procedures with excellent results. A number of other factors make South Korea the most sought-after destination for medical tourism, such as affordable accommodation, a wide range of food options, scenic value, visa availability, transportation facilities, and language assistance.
The well-trained and highly skilled doctors in South Korea use their deep expertise in performing various procedures with a high success rate. The well-qualified doctors have received education from reputed universities and have recorded high success rates throughout their career. In order to ensure quality medical care and patient safety, the doctors completely adhere to international standards and medical protocols. The doctors focus on preventative medicine to check complications and believe in treating patients with a human touch.
Always get in touch with the concerned authority to know if you require any other document other than those mentioned here. Make a list of all the documents you might need in South Korea in order to make sure that you do not miss any of them. When traveling to another country, you may also require some other documents, such as travel insurance paper, currency/forex card, and international SIM card. Make sure that you carry all the essential documents when traveling to South Korea, such as passport copies, test reports, residence/ driver’s license, bank statement, doctor referral notes, medical history, details of health insurance, visa, credit/debit cards.
The most sought-after procedures in South Korea are
. With the highest number of plastic surgeries per capita on earth, South Korea has a large number of plastic surgery clinics spread all over the country. Other most sought-after procedures available in South Korea are hip and shoulder replacement, cancer treatment, organ transplant, and cardiovascular surgeries. South Korea has also made major advances in cancer treatment and the latest technology used to remove cancer cells are robotic surgeries and proton therapies.
Some of the most visited cities offering quality treatment in South Korea are Seoul, Busan, Incheon, Daegu, Cheonan, and Cheonan. There are several factors that help make these cities popular for seeking treatment, such as top-notch hospitals, superior infrastructure, and highly experienced doctors. Transportation facilities, affordable accommodation, more food options, and language assistance are some other reasons why these cities are more preferred by medical tourists. A large number of plastic surgeries are formed in Seoul every year and the city is flocked with several aesthetic centers.
The Korean embassy follows a strict process for obtaining a visa for traveling to South Korea. The processing of obtaining a medical visa starts with the submission of medical records and the referral certificate signed by the registered medical expert. The person who is accompanying a patient traveling to South Korea for medical treatment is granted a medical dependent visa. You need to also produce relevant letters/documents with details of the treatment, signed by the doctors and hospitals, and a declaration form signed by the patient or any family member.
South Korea boasts of having top-quality multispecialty hospitals, such as:
Equipped with modern equipment and the latest medical technologies, the multispecialty hospitals in South Korea are backed by the modern infrastructure to provide world-class treatment. The hospitals adopt a patient-centric and holistic approach for providing world-class treatment and strictly comply with healthcare standards and protocols to ensure quality. The hospitals are backed by highly skilled and trained doctors who are efficient in performing even the most complex surgeries with great accuracy and precision.
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