VALVE REPAIR & REPLACEMENT

Overview

The mere thought of undergoing an open heart surgery is so scary and ominous that people try to avoid it as much as possible. Your doctor will typically not suggest an open heart surgery unless it becomes mandatory and crucial for you. So, instead of avoiding you can speak to your doctor about the procedure to allay your fears.

An open heart surgery has traditionally been performed by making an incision in your skin and through the breastbone. This leads to increase in the recovery time after the bone has been attached back together with the help of special wires. But, with advancement in medical technology, now you may not need to go through the traditional bypass surgery. Instead, doctors can perform minimally invasive heart surgery, where they do not need to touch the breastbone entirely or may do so only partially.

Isn’t is like a wish come true? Lesser invasive surgery, faster and less painful recovery, reduced risk of infusion due to much lesser blood loss and minimum scarring. That’s the magic of technology for you. So how exactly does this minimally invasive open heart surgery work?

Valve Repair

In case of repairs any of the valves can undergo reshaping, reinforcement, adjustment, decalcification or patching

  • Reshaping & Commissurotomy – the shape of the valve is corrected and sewed in shape
  • Valvuloplasty – valves are reinforced with additional support
  • Decalcification – elimination of calcium deposits hampering the movement
  • Patching - tissue patch to cover up holes and tears
  • Adjustment – Cords supporting the valves are either shortened or substituted with a prosthetic

Valve repair and replacement surgery hospital in Hyderabad

Virinchi Hospitals offers best heart valve repair and replacement surgery solutions in Hyderabad through experienced and highly trained valve repair and replacement cardiothoracic surgeons. Based on the symptoms, diagnostic outcomes, our specialists shall advise either repair or replacement of the valves to provide long term relief from associated complications. Also, the surgeons elaborate the surgery details with the patient and discuss the benefits over risks of using all the available devices or artificial valves for the repair or replacement procedures.

Invasive and Minimally Invasive Surgeries for Valve Replacement

Depending on the type of anomaly, the surgeon may choose to perform either open or minimally invasive procedure. On many occasions, minimally invasive surgery can act as preferred alternative to many of the valvular conditions for offering less trauma and faster recovery. However, patients suffering from severe valve damage, atherosclerosis, obesity and requiring multiple valve repairs or replacements need to go through the traditional open surgery.

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Tricuspid Valve Repair

Typically tricuspid valve repair is performed through an open heart surgery involving necessary repair procedures like reshaping, reinforcing, adjusting, patching and decalcifying the valve leaflets. In some instances, annuloplasty procedure is performed to implant a supporting ring around the valve base. In cone procedure for repair, the leaflets are reshaped and repositioned to restore normal functioning. Rarely stenosed tricuspid valve can be repaired through a minimally invasive catheter mediated balloon valvuloplasty or valvotomy. Usually, valvuloplasty of stenosed tricuspid valve is followed by a replacement at a later date.
Tricuspid valve repair is offered as a treatment option to patients suffering from Ebstein anomaly, tricuspid valve stenosis, tricuspid valve regurgitation & Tricuspid atresia

Tricuspid Valve Replacement

When the tricuspid valve is completely diseased beyond repair, replacement is advised either through an open or minimally invasive valve-in-valve procedure. As a replacement, either biological or mechanical valve is considered depending on the age and other diagnostic outcomes. Replacement is typically performed when there is significant stenosis/regurgitation of tricuspid valve or stenosis of right atrium–to–right ventricle (RA-to-RV) conduit.

Bicuspid Valve or Mitral Valve Repair

Typically Bicuspid valve repair is performed through an open heart or keyhole surgery involving necessary repair procedures like removal of loose and extra and unwanted segments, implantation of artificial cords to provide required elastic support and fixing of supporting ring structure around the bicuspid valve base through annuloplasty. Transcatheter mitral valve repair (TMVR) is a minimally invasive technique for treatment of selected patients with symptomatic chronic moderate-severe or severe mitral regurgitation with prohibitive or high surgical risk; however it is costly.
Bicuspid valve repair is offered as a treatment option to patients suffering from bicuspid valve stenosis, bicuspid valve regurgitation & mitral valve atresia.

Bicuspid Valve or Mitral Valve Replacement

An irreparable bicuspid valve is the candidate for replacement through open surgical procedure. Though minimally invasive catheter mediated bicuspid valve implantation is a possibility, procedural efficiency and longevity is still being tested in the clinical trials. As a replacement, either biological or mechanical valve is considered depending on the age and other diagnostic outcomes. Replacement is typically performed when there is symptomatic chronic severe primary mitral regurgitation with 30% or above left ventricular ejection fraction/LVEF.

Pulmonary Valve Repair

Typically tricuspid valve repair is performed through an open heart surgery involving necessary repair procedures like separating & adjusting, reconstructing, reshaping, reinforcing and decalcifying the valve leaflets. In some instances, annuloplasty procedure is performed to implant a supporting ring around the valve base.
Stenosed pulmonary valve can be repaired through a minimally invasive catheter mediated balloon valvuloplasty or valvotomy. Usually, valvuloplasty of stenosed pulmonary valve is followed by a replacement at a later date.
Pulmonary valve repair is offered as a treatment option to patients suffering from pulmonary valve stenosis, pulmonary valve regurgitation & pulmonary atresia

Pulmonary Valve Replacement

When the pulmonary valve is completely diseased beyond repair, replacement is advised either through an open or minimally invasive procedure. As a replacement, either biological or mechanical valve is considered depending on the age and other diagnostic outcomes.
Replacement is typically performed when there is significant stenosis/regurgitation of pulmonary valves.
Transcatheter pulmonary valve replacement (TPVR) has revolutionised the care of patients suffering from Tetralogy of Fallot, truncus arteriosus, Right Ventricular Outflow Tract Dysfunction; and also used for replacing worn out or faulty pulmonary valves implanted previously through an invasive surgical procedure or having diseased pulmonary homograft from an ineffective Ross procedure. These procedures are costly.

Aortic Valve Repair

Typically aortic valve repair is performed through an open heart surgery involving necessary repair procedures like separating & adjusting, reconstructing, reshaping, reinforcing and decalcifying the valve leaflets. In some instances, annuloplasty procedure is performed to implant a supporting ring around the valve base.
Stenosed aortic valve can be repaired through a minimally invasive catheter mediated balloon valvuloplasty or valvotomy. Usually, valvuloplasty of stenosed aortic valve is followed by a replacement at a later date.
Aortic valve repair is offered as a treatment option to patients suffering from aortic valve stenosis, aortic valve regurgitation & aortic atresia

Aortic Valve Replacement

When an aortic valve is completely diseased beyond repair, replacement is recommended either through an open or minimally invasive procedure. As a replacement, biological or mechanical or human allograft/homograft is considered depending on the age and other diagnostic outcomes.
Replacement is typically performed when there is significant stenosis/regurgitation of aortic valves.

Transcatheter aortic valve implantation (TAVI) or Transcatheter aortic valve replacement (TAVR)

This FDA approved minimally invasive catheter mediated valve replacement is suitable for patients suffering from to symptomatic aortic valve stenosis and who do not qualify for open heart surgery due to medical history and demographics. The procedure is performed under general anaesthesia with or without cardiopulmonary bypass by our highly trained interventional cardiologists, cardiac surgeons and anaesthetists under the guidance of ultrasound and fluoroscopy.

Ross procedure

It is a complex procedure where pulmonary artery allograft is used to replace the arota and the pulmonary artery is replaced by a conduit / homograph.

Fontan Surgery

Right heart bypass can be done in patients with unrepairable right ventricular morphology with normal Pulmonary artery pressures

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