Aortic Valve Regurgitation Treatment in India
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What is an Aortic Valve Regurgitation?
Aortic Valve Regurgitation occurs when the aortic valve fails to close properly after the left ventricle pumps blood into the aorta. This backward blood flow increases the volume of blood in the left ventricle, which may cause the heart to enlarge and work harder over time. Aortic regurgitation may result from a bicuspid aortic valve, aortic root enlargement, infective endocarditis, rheumatic heart disease, congenital abnormalities, or other conditions affecting the valve or aorta.
What is the Importance of Timely Treatment?
Timely evaluation helps determine the severity and cause of aortic regurgitation, assess left ventricular size and function, monitor disease progression, and identify when medical or surgical treatment may be appropriate. Treating significant regurgitation at the appropriate stage can help prevent progressive heart enlargement, heart failure, and other cardiovascular complications.
What are the Common Symptoms of Aortic Valve Regurgitation?
- Shortness of Breath: Breathlessness may occur during physical activity and can become more noticeable as the condition progresses.
- Fatigue: Increased cardiac workload and reduced effective forward blood flow may cause tiredness and reduced stamina.
- Chest Discomfort: Some people may experience chest pain or discomfort, especially with more advanced disease.
- Palpitations: A fast, pounding, or irregular heartbeat may occur, especially when associated rhythm abnormalities develop.
- Reduced Exercise Tolerance: Physical activities that were previously comfortable may become more difficult because of breathlessness or fatigue.
- Dizziness or Fainting: Significant disease may sometimes cause lightheadedness or fainting, particularly when cardiac output is affected.
Causes and Risk Factors of Aortic Valve Regurgitation
Causes
- Bicuspid Aortic Valve: A congenital valve with two leaflets instead of three may become dysfunctional and cause regurgitation.
- Aortic Root Enlargement: Enlargement of the aortic root can prevent the valve leaflets from meeting properly.
- Infective Endocarditis: Infection can damage the aortic valve and cause leakage.
- Rheumatic Heart Disease: Rheumatic fever can cause permanent structural changes to the valve.
- Congenital Valve Abnormalities: Structural abnormalities present from birth may affect valve closure.
- Aortic Dissection: A tear in the aortic wall can interfere with aortic valve function and may cause acute regurgitation.
- Degenerative Valve Changes: Progressive changes in valve tissue can impair proper closure.
- Connective Tissue Disorders: Conditions such as Marfan syndrome and other inherited disorders can affect the aortic valve and aortic root.
Risk Factors
- Bicuspid aortic valve
- Older age
- High blood pressure
- Previous rheumatic fever or rheumatic heart disease
- Previous infective endocarditis
- Aortic aneurysm or aortic root enlargement
- Previous aortic or cardiac surgery
- Certain connective tissue disorders
- Family history of aortic or valve disease
- Certain congenital heart abnormalities
Latest Research and Technologies in the Treatment of Aortic Valve Regurgitation in India
Modern care for aortic valve regurgitation increasingly uses advanced echocardiography, 3D imaging, cardiac CT, cardiac MRI, and detailed assessment of the aortic root and left ventricular function to determine disease severity and treatment timing. Surgical aortic valve repair or replacement remains important for patients with significant disease who meet treatment criteria. Transcatheter approaches for aortic regurgitation are also developing, with selected transcatheter valve technologies being evaluated or used in appropriate patients with suitable anatomy who may not be candidates for conventional surgery.
Treatment options for Aortic Valve Regurgitation
Surgical Aortic Valve Replacement (SAVR): The absolute gold-standard definitive therapy for severe chronic AR. Implantation of a mechanical or bioprosthetic valve is triggered by the presence of symptoms, a drop in left ventricular ejection fraction, or severe left ventricular dilation.
Bentall procedure : A complex open-heart surgery that simultaneously replaces a diseased aortic valve, a weakened aortic root, and the ascending aorta. It uses a specialised medical device called a composite graft, a synthetic tube with a mechanical or tissue heart valve built inside it.
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Transcatheter Aortic Valve Replacement (TAVR) : This is highly specific and appropriately qualified. While TAVR is traditionally reserved for aortic stenosis, it is an emerging, specialised off-label or device-specific consideration for pure, severe AR only in patients who are completely inoperable, as the lack of valve calcification makes securing a transcatheter valve technically difficult.
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- Clinical assessment:
- Medical History: Assessment includes symptoms, previous rheumatic fever, infections, congenital heart disease, previous cardiac procedures, aortic disease, and family history.
- Physical Examination: A doctor may listen for an abnormal heart murmur and assess blood pressure, pulse, heart rhythm, breathing, and signs of fluid retention.
- Electrocardiogram (ECG): Evaluates heart rhythm and electrical activity and may show changes associated with cardiac enlargement or strain.
- Exercise or Stress Testing: May help assess functional capacity and symptoms in selected patients who can safely exercise.
- Blood Tests: Selected tests may assess kidney function, blood counts, infection, or other conditions relevant to treatment.
- Imaging Tests:
- Transthoracic Echocardiography (TTE): The primary test for assessing aortic valve structure, the severity of regurgitation, left ventricular size and function, and associated abnormalities.
- Transesophageal Echocardiography (TEE): Provides detailed images of the aortic valve and surrounding structures and may be particularly useful for treatment planning or suspected acute disease.
- 3D Echocardiography: Provides detailed information about valve anatomy and aortic root structures in selected patients.
- Cardiac CT: Helps evaluate the aortic valve, aortic root, ascending aorta, and anatomy relevant to selected procedures.
- Cardiac MRI: Can quantify regurgitant blood flow and assess ventricular volumes and function when echocardiographic findings are inconclusive or additional information is needed.
- Chest X-ray: May show heart enlargement or changes associated with advanced cardiac disease.
- Cardiac Catheterisation: May be used in selected patients for haemodynamic assessment, coronary evaluation, or treatment planning.
MediRehab (a chain of Rehab centres, part of MediGence) provides comprehensive rehabilitation services designed to support Aortic Valve Regurgitation patients in India. These services include:
- Cardiac Rehabilitation: Selected patients may benefit from structured rehabilitation following valve surgery or other cardiac treatment.
- Gradual Physical Activity: Increase activity according to symptoms, ventricular function, treatment history, and guidance from the cardiac team.
- Exercise Conditioning: Individualised exercise may help improve strength and endurance,
- Long-Term Follow-Up: Regular cardiology and echocardiographic assessment helps monitor valve function, left ventricular size and function, and the aorta when relevant.
- Medicines are selected according to the severity and cause of aortic regurgitation and the patient's overall cardiac condition. Blood-pressure medicines may be used to reduce cardiovascular workload when hypertension is present, while diuretics may help manage fluid retention in patients with heart failure. Other medicines may be prescribed for heart failure, coronary artery disease, or abnormal heart rhythms when indicated.
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Hospitals for Aortic Valve Regurgitation in India
Apollo Multispecialty Hospitals
Kolkata, India
Apollo Multispecialty Hospitals located in Kolkata, India is accredited by JCI, NABH. Also listed below are some of the most prominent infrastructural details:
- International patient Center
- Focus on research and innovation
- Different amenities: Transport, Security, Travel Desk, Places of Worship, Telecommunication Service, Special Nurse, Food & Dietary Services
- Several kinds of rooms: General ward, Semi Private Rooms, Private Rooms, Deluxe, Super Deluxe, Suite, Maharaja Suite, HDU, Gastro ICU, Emergency, Neonatal ICU, Level 1, Level 2 & Level 3
- Health Insurance coverage available
- Here is a comprehensive list of the various kinds of key medical procedures performed through the latest technology.
- Arthroscopy
- Bone Marrow Transplant
- Cosmetic Surgery
- Da Vinci Robotic Surgical System
- Fractional Flow Reserve (FFR)
- Hand Microsurgery
- Hip Arthroscopy
- Minimally Invasive Cardiac Surgery
- Minimally Invasive Subvastus Total Knee Replacement
- Oral & Maxillofacial Surgery
- 128 Slice PET CT
- Bioresorbable Vascular Scaffold (BVS)
- ECMO
- OCT Technique - Optical Coherence Tomography
- Single Port Endoscopic technique of Carpal Tunnel Release (ECTR)
BGS Gleneagles Global Hospitals
Bangalore, India
Gleneagles BGS Hospital, Kengeri, is a leading healthcare centre in Bengaluru, committed to delivering compassionate, patient-focused care locally and globally. The hospital houses 15 specialised departments with over 30 medical and surgical specialities, supported by 450 beds, advanced emergency services, imaging, laboratory, and transfusion facilities.
It is renowned for pioneering initiatives such as South India’s first 5G-enabled ambulance and Karnataka’s largest Multi-Organ Transplant Program. Recognised among India’s top paediatric cranio-maxillofacial centres, it is also the first in Karnataka to receive the AHPI Award 2024 for “Excellence in Nursing Practices” consecutively.
Indraprastha Apollo Hospital
Delhi, India
Indraprastha Apollo Hospital is known for delivering treatment to over 200,000 patients every year; 10,000 of which are generally medical tourists. The efficient team of doctors has the record of 99.6 percent success rate. Indraprastha Apollo Hospital deals in treatment of over 50 specialities.
Let’s see some of the features of the infrastructure:
- Spread over 15 acres, the hospital has 710 beds.
- 6 beds dedicated to bone marrow transplant units with very strict infection control practices.
- 64-Slice Scan coupled with data acquisition which provides highest temporal resolution
- One of the hospitals to be using Da Vinci Robotics Surgery System
- In South Asia, the Spect-CT and Pet-CT got their first installation at Indraprastha Apollo Hospital in India
- Technologies such as PET- MR, BrainLab Navigation System, PET-CT, Portable CT Scanner, Tilting MRI, NovalisTx, Cobalt based HDR Brachytherapy, Hyperbaric Chamber, DSA Lab, Fibroscan, 3 Tesla MRI, Endosonography, 128 Slice CT scanner are all installed at the hospital.
- The Cancer Institute at Indraprastha Apollo is equipped with a highly advanced Radiation Oncology Center with ClinaciX, NovalisTx, and HDR-Brachytherapy.
- It is equipped with the largest Sleep Lab in Asia, & has one of the largest Dialysis Units in India.
- A large number of ICU beds than any other Private Hospitals in India.
- WIFI is accessible across the whole campus.
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Why Choose India for Aortic Valve Regurgitation Treatment?
- Experienced Cardiac Specialists: Access to cardiologists, interventional cardiologists, cardiac surgeons, and specialists involved in aortic valve and aortic disease management.
- Advanced Cardiac Imaging: Major centres may provide TTE, TEE, 3D echocardiography, cardiac CT, and cardiac MRI.
- Aortic Valve Repair: Selected centres offer surgical valve repair for patients with suitable anatomy.
- Valve Replacement: Hospitals may provide surgical aortic valve replacement using mechanical or biological prosthetic valves.
- Aortic Surgery: Complex centres may manage patients requiring combined valve and aortic root or ascending aorta surgery.
- Transcatheter Treatment: Selected patients may have access to evolving transcatheter approaches when appropriate for their anatomy and clinical situation.
- Multidisciplinary Heart Teams: Cardiologists, cardiac surgeons, imaging specialists, anaesthesiologists, intensivists, and rehabilitation professionals can coordinate complex cases.
- International Patient Support: Many major Indian hospitals provide assistance with medical records, appointments, treatment coordination, accommodation, and follow-up.