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 Heart Double Valve Replacement package cost in Spain varies from one hospital to another and may offer different benefits. The top hospitals for Heart Double Valve Replacement in Spain covers all the expenses related to the pre-surgery investigations of the candidate. The comprehensive Heart Double Valve Replacement package cost includes the cost of investigations, surgery, medicines and consumables. There are many things that may increase the cost of Heart Double Valve Replacement in Spain, including prolonged hospital stay and complications after the procedure.
Many hospitals in Spain perform Heart Double Valve Replacement. The top hospitals for Heart Double Valve Replacement in Spain include the following:
While the speed of recovery may vary from patient to patient, they are still required to stay for about 21 days after discharge. This period is important to conduct all the follow-up tests to ensure that the surgery was successful and the patient can go back to the home country.
Spain is one of the most popular countries for Heart Double Valve Replacement in the world. The country offers the best cost of Heart Double Valve Replacement, best doctors, and advanced hospital infrastructure. Some of the other popular destinations for Heart Double Valve Replacement include the following:
|Saudi Arabia||USD 33000|
|South Korea||USD 70000|
|United Arab Emirates||USD 45000|
Apart from the Heart Double Valve Replacement cost, the patient may have to pay for additional daily expenses such as for guest house after discharge and meals. The per day extra expenses in Spain per person are about USD 50 per person.
Some of the best cities in Spain which offer Heart Double Valve Replacement are:
Patients who are interested in availing telemedicine consultation before they travel for Heart Double Valve Replacement in Spain can opt for the same. There are many Heart Double Valve Replacement surgeons who offer video telemedicine consultation, including the following:
|Doctor||Cost||Schedule Your Appointment|
|Dr. Juli Carballo||USD 833||Schedule Now|
|Dr. Antonio Berruezo||USD 833||Schedule Now|
|Dr. Xavier Ruyra Baliarda||USD 833||Schedule Now|
|Dr. Josep Brugada||USD 833||Schedule Now|
|Dr. Raul F Abella||USD 606||Schedule Now|
The patient is supposed to stay at the hospital for about 5 days after Heart Double Valve Replacement for monitoring and care. During the recovery, the patient is carefully monitored and control tests are performed to see that everything is okay. If required, physiotherapy sessions are also planned during recovery in hospital.
There are more than 7 hospitals that offer Heart Double Valve Replacement in Spain. These hospitals have propoer infrastructure as well as offer good quality of services when it comes to Heart Double Valve Replacement 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 healthcare accredition standards followed in Spain have ensured that the quality of healthcare is maintained at every level of functioning. There are many healthcare parameters on which hospitals in Spain have proven their mettle time and time again. The hospitals in Spain are being set to higher quality standards by Joint Commission International, the world leader in safety and patient care quality. The evaluators from the accrediting body in Spain are experienced and skilled healthcare professionals and their evaluation is trustworthy.
There is a good number of popular multispecialty hospital groups in Spain that are servicing patients from different hues and backgrounds for a long time. As the name suggests multispecialty hospitals encompass treatment being provided to patients across specialties. We list here some of the best multispecialty hospitals in Spain.
Their is a good range of specialties covered by the multispecialty hospital groups in Spain that ensure that all your medical and surgical needs are taken care of.
The healthcare in Spain is at par with the best in the world and is continuously upgraded with the technologies of today. The doctors in Spain are skilled and competent and are adept at treating any ailment or injury which you maybe suffering from. If you are planning to get your treatment done in Spain you are at an advantage as their is universal cost coverage (except prescription drugs) or uni payer system. Do opt for healthcare in Spain because this country is a great combination of wonderful tourist centers and exceptional healthcare facilities.
The doctors in Spain have been educated from the best institutions and excel in treating their patients. Spain has a rich and vibrant healthcare community with doctors who have refined their skills as they have practical experience of several years. The doctors in Spain are great at adapting to and in application of new techniques and technologies. Getting your treatment done in Spain should be a seamless affair as there is not even a language barrier with english the second language for many doctors.
It is important that you start your medical travel planning by creating a checklist of documents that you need to carry. At no point during your journey and treatment in Spain should the documents be a reason for any hindrance. The travel documents needed are your passport, visa, roundtrip ticket, travel medical insurance, accomodation proof, civil status proof, financial means proof like bank statement, sponsorship letter, treatment payment proof or proof of your government covering the costs and employment documents (as per status). Also, you must carry your medical documents such as medical reports, letter from the doctor/hospital referring you for treatment, correspondence between the doctor/hospital that referred you and the one where you are going to get treated and test reports.
Spain is an exclusive medical tourism destination like no other which is frequented by tourists the world over. The sporting culture in Spain makes sports medicine and orthopaedics a natural fit as both medical and surgical specialties in Spain. All sorts of procedures are done in hospitals and clinics in Spain but we are listing the ones most popular for your convenience. Fertility treatments, plastic surgery, elective surgery, dentistry, eye care, bariatric surgery, orthopaedic procedures, spine surgery and sports medicine related procedures.
In todays' uncertain world, it is not just advisable but mandatory to take vaccinations before going to Spain. Routine vaccines before going to Spain are Chickenpox (Varicella), Diphtheria-Tetanus-Pertussis, Flu (Influenza), Measles-Mumps-Rubella (MMR) and Polio. A set of vaccinations are considered mandatory for a particular set of travellers only like for Hepatitis A, Hepatitis B and Measles only. Please get vaccinated for Meningitis, Shingles, Pneumonia, Covid19 and Rabies before traveling to Spain.
Hospitals in Spain provide facilities that make the treatment journey smooth for medical travellers everyday. In line with this endeavour, international patient services are available in major hospitals in Spain. If you are visiting Spain as a medical tourist, it helps if you can avail of private health insurance and this is a facility available in hospitals in Spain. Hospitals in Spain provide many additional facilities as well such as:
Spain is well known for its various medical tourism destinations such as
Among these destinations, Madrid healthcare is synonymous with reproductive health services and general healthcare and Barcelona is famous for child healthcare hospitals. In Spain, there is increasing focus in the field of medical tourism and investments are being done to achieve this end goal.Medical tourism is one of the key industries in Spain and there is an increased investment drive to further enhance the capabilities of this sector. Medical tourists are also coming to spain because of its outstanding healthcare infrastructure which is being updated regularly with the best of technologies.
MediGence has pre-negotiated bundled pricing for many surgical procedures that helps you save cost and avail unmatched benefitsExplore our Best Offers
Ask your healthcare adviser for the best multiple options and choose the one that meets your expectations
(+1) 424 283 4838