Double Valve Replacement in Dubai

As the age of an individual increase, the valves in the heart thicken and become stiffer. This may pave way for a heart valve disease.  Additionally, certain risk factors such as high cholesterol, high blood pressure, and history of rheumatic fever, heart attack, and infective endocarditis (IE) increases the risk of heart valve disease.

On the other hand, some babies are born with two flaps in the aortic valve instead of three. This congenital disorder, along with heart valve disease, may warrant the need for heart valve replacement. In aortic valve replacement and mitral valve replacement surgery, the concerned defected or damaged valve is replaced with a mechanical or a tissue valve. This restores the normal functioning of the valve.

Heart Valve Replacement Cost in Dubai

AVR/MVR in Dubai is conducted by a team of highly experienced and skilled surgeons. United Arab Emirates is one of the leading medical tourism destinations in the world because it houses some of the best hospitals in the world. Additionally, the country is centrally located and can be accessed from any part of the world. This is the reason why many patients from abroad prefer to visit U.A.E for valve replacement, among other cardiac procedures.

Cost Comparison

Heart Valve Replacement cost in U.A.E is quite affordable and reasonable as compared to the Western countries. However, there are several factors that dictate the cost of valve replacement surgery in the country. For example, the total cost of Double Valve Replacement in Dubai may depend on how many days the patient spends in the intensive care or in the hospitals as he or she recovers from the surgery.

Additionally, it depends on whether a single or both the valves are replaced, the type of valve used, hospital charges, and the fees of the surgeon. The cost of medications and other consumables used before and after surgery is also counted in the final bill.

Treatment and Cost

21

Total Days
In Country

2 No. Travelers

7 Day in Hospital

14 Days Outside Hospital

Treatment cost starts from

USD 45000

Hospitals

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.

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.

Frequently Asked Questions

The United Arab Emirates is counted among the most developed countries in the world in terms of healthcare benefits. UAE is home to some of the most progressed states and cities in the world which are praised for embracing modern advancements with open arms. Apart from the various other developments, the healthcare benefits, including the professionals and the infrastructure, are astounding. In contrast to the other major countries, the United Arab Emirates, however, does not charge an exorbitant fee in return for necessary treatment, which is why thousands of people opt UAE as their primary medical treatment destination. Besides, it is well-connected to various corners of the world which also makes it easily accessible by candidates all around.
The hospitals in the United Arab Emirates are known for providing exemplary services to the visitors. A high number of these hospitals and clinics are known for their incomparable patient interaction as well as infrastructure. The hospitals are very well-maintained and thus, pose least threat to survival. A large number of hospitals are known to be JCI approved as they have accomplished every infrastructural requisites as well as maintained a healthy medical environment to serve international tourists for healthcare purposes. Though there are several JCI approved hospitals in UAE, here are five popular ones among them:
  • American Hospital Dubai
  • International Modern Hospital
  • Dubai Hospital- DOHMS
  • Rashid Hospital- DOHMS
  • Oasis Hospital
One of the primary reasons for the hospitals bagging JCI accreditation is the quality of staffs working there. Not only the doctors and the surgeons serving patients, but also the support staffs are well-rounded to handle all kinds of situations to ensure quality support required by the candidates.
The doctors and surgeons in the United Arab Emirates are globally recognized for their service towards the medical field. Furnished with degrees from reputed universities and decades of training and experience, the doctors have earned high success rates throughout their professional career.
Certain countries allow visitors to enjoy visa-free entry for a period of 30 days, 90 days or 180 days, varying upon the country and the rules followed. In the UAE, the Patient Companion Visa and the UAE Medical Treatment Visa might be required, depending on the period of staying for medical purposes. Although the visas are arranged by the hospitals (in most cases) where treatment in being availed, yet the candidate must posses the following documents necessary for travelling and availing medical benefits from UAE:
  • Two passport size pictures of the candidate not older than six months
  • Valid passport (original and photocopy) which should not have expiration at least 6 months beyond the stipulated stay of the candidate
  • Valid proof of medical insurance showing the financial credibility
  • Medical certificate issued by the registered medical practitioner treating the candidate, clearly stating the requirement and the cause of the travel.
  • Acceptance letter from the medical practitioner to whom the candidate is being referred to.
Candidates availing treatment in a different country goes through high speculations. Besides the urgency and the immediate need for treatment, there are several other hassles, dealing which becomes tough for the individuals. Keeping in mind such dilemma, MediGence takes complete responsibility and provides umpteenth care so as to relieve the candidate from unnecessary exhaustion. Thus, the services provided are:
  • On-Ground Support
  • Teleconsultations
  • Visa Assistance
  • Accommodations Assistance
  • Free Airport to Hospital Transfer
  • Rehabilitation and recovery services
The United Arab Emirates is known for housing some of the most advanced metropolises in the world. However, among them only a handful are renowned for the medical treatment facilities offered. Hence, some of the best cities for medical treatment in the United Arab Emirates are:
  • Dubai
  • Abu Dhabi
  • Sheikh
  • Sharjah

Our team of healthcare experts would be happy to assist you

Get In Touch
or call

(+1) 424 283 4838