Heart Valve Replacement Cost in Thailand (AVR/MVR)

Double valve replacement involves the replacement of both the mitral and the aortic valves that are either damaged or defected. Both these valves are present on the left side of the heart. This surgery is not as common as single valve replacement surgery and the mortality rate associated with this procedure is slightly higher than the replacement of a single valve.  During this surgery, the defected or damaged valves are either replaced with synthetic valves or biological valves.

Double Valve Replacement in Thailand

Patients requiring double valve replacement can comfortably travel to Thailand for this surgery. The best cardiac care hospitals in Thailand are equipped with the latest technology and modern facilities. Moreover, the state-of-the-art infrastructure at these hospitals intends to make the journey of the patients comfortable and make medical care a holistic experienced for patients. This surgery is performed by a team of highly experienced cardiac surgeons who are mostly trained and educated from abroad.

Cost Comparison

Double valve replacement cost in Thailand is greater than the cost of single valve replacement surgery. The cost of this surgery depends on various factors, including the fees charged by the surgeons, the total duration of hospital stay, and the number of days spent in the cardiac intensive care unit. Some of the other factors include the cost of medicines, hospital charges, and the cost of tests conducted before and after the surgery.

Treatment and Cost

21

Total Days
In Country

2 No. Travelers

7 Day in Hospital

14 Days Outside Hospital

Treatment cost starts from

USD 50000

Hospitals

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.

Patient Stories

Frequently Asked Questions

What is the health care infrastructure of Thailand / Why should opt for Thailand as a destination for your medical treatment
Hospitals in Thailand have seen an increase in number in the past few years. One of the many reasons for such surprise growth in the healthcare division can be the development of the public health sector which comprises 9,765 health locations along with 1,002 hospitals. As the Public Hospitals in Thailand are operated by the MOPH (Ministry of Public Health), the Private Hospitals in Thailand are regulated under the Medical Registration Division. The treatments in Thailand are also keeping up with that of other major countries all across the globe. As of 2002, the Thai Government has provided a countrywide general healthcare system that covers 99.5% of the Thai population and ensures high-quality treatments in Thailand and affordable primary medical amenities to each and every citizen of Thailand. In the year 2009, the total national expenditure on healthcare was 4.3% of the GDP of Thailand. Due to such medical advancements in Thailand, the country has become the most preferred medical destination in the world providing wide-ranging medical treatments at highly-reasonable rates at good hospitals in Thailand.
What are the conditions of the hospitals in Thailand? Are they JCI certified? What is the quality of the support staff in the hospitals?
The Joint Commission International (JCI) is a global leader in health care accreditation. JCI accreditation is considered a gold standard in worldwide health care. It provides the most skilled and experienced healthcare professionals in the medical industry, as evaluators of the rigorous international standards in healthcare quality and patient safety. Here are a few JCI certified hospitals in Thailand :
  • Yanhee Hospital
  • Bumrungrad Hospital
  • Bangkok Hospital
  • Chaophya Hospital
  • BNH Hospital
  • Ramkhamhaeng Hospital
  • Vejthani Hospital
  • Bangkok Hospital Phuket
  • Samitivej Sukhumvit Hospital
  • Praram 9 Hospital
  • Chiangmai Ram Hospital
  • Sikarin Hospital
  • Synphaet Hospital
  • Bangkok Hospital Samui
  • Nonthavej Hospital
  • Bangkok Hospital Pattaya
  • Samitivej Srinakarin Hospital
  • Samitivej Sriracha Hospital
Are the doctors/surgeons in Thailand of the best quality?
Thailand is gaining recognition for the quality of its healthcare services after the US magazine CEOWORLD placed Thailand 6th in its 2019 list of countries with the best healthcare systems. Thai doctors gain a lot of skills during their course and this helps them practice effectively. Many doctors and surgeons also visit other countries for training and certification courses to enhance their skills and knowledge. Most doctors are exposed to a public and private healthcare system in order to be able to work in any condition. It is a collective effort from all the professionals to maintain the standard of health and Thailand is doing just that.
What is the process for obtaining a medical visa in Thailand?
Currently, medical tourists To Thailand are allowed in from 34 countries. All visitors must have proof of travel health insurance that covers a minimum of US$100,000 of medical costs incurred in Thailand, including medical costs in the event that they contract COVID-19. Under the CCSA regulations, medical tourists have to arrive by air to ensure effective disease control, not via land border checkpoints. All must have an appointment letter from a doctor in Thailand and entry certificates issued by Thai embassies across the globe. People wanting to visit Thailand for medical procedures need to contact the Thai Embassy in their country to organize the visa and paperwork. Thailand’s major hospitals will provide potential candidates with an appointment letter. Permission for medical tourists to be accompanied by up to three attending persons is intended to allow such patients to have spouses, parents, or assistants in attendance during their treatment in Thailand. However, such persons will have to conform to all the same entry requirements as the medical tourists themselves, including visas and health status.
What support services does MediGence provide in Thailand?
MediGence enables you to plan and manage your medical decisions better. These are some of our services offered:
  • Expert Opinion
    We help you seek an Expert Opinion on your diagnosis and treatment from an experienced team of doctors at MediGence and specialists from a reputable hospital.
  • Hospital Recommendation
    We recommend a hospital or a healthcare institution that is best suited for you, based on your ailment and its criticality.
  • 360-degree Hospital Review
    We give you a transparent and holistic view of the hospital and its infrastructure, accreditation, facilities, and expertise to give you confidence.
  • Doctor Validation and Communication
    We share a comprehensive profile of the treating doctor and also arrange a call to clear queries regarding treatment if needed.
  • Options to Choose From
    Based on your choice of destination and other preferences, we provide you multiple options with respect to hospitals and doctors to choose from.
  • 24X7 Patient Care Support
    A dedicated patient case manager stays in constant touch with you to help you at every step of the decision-making process and resolve queries that you may have.
  • Transparent Treatment Cost and Other Expenses
    We give a clear and accurate indication of the total cost of treatment including treatment, stay, meals, and other expenses.
  • Visa Assistance
    We provide and help prepare documentation for visa approval and coordinate with the embassy to expedite the visa process.
  • Accommodation Arrangements
    We propose to you a choice of accommodation based on your preference such as long stay, short stay, or luxury properties.
Which are the best cities in Thailand for medical treatment?
Bangkok is the capital of Thailand and the most sought - after destination for healthcare. It has more than 10 of the major hospitals in Thailand. The cost of treatment in Thailand is reasonable here. People tend to spend their recovery time in Bangkok as well as it is a beautiful city to visit as a tourist.

Our team of healthcare experts would be happy to assist you

Get In Touch
or call

(+1) 424 283 4838