The human heart comprises four valves: a mitral valve, tricuspid valve, pulmonary valve, and aortic valve. Each of these valves has flaps – called leaflets in the case of mitral and tricuspid valves, and cusps in the case of aortic and pulmonary valves. With every heartbeat, the flaps of the valves open and close each time. When the valves fail to function correctly, the blood flow through the heart and to the whole body gets disrupted. This may happen due to the narrowing of a valve, called stenosis, or leakage in a valve that allows blood to back up, called regurgitation.
A person with these heart defects may require valve repair or valve replacement surgery depending on their condition.
In a heart valve replacement surgery, the surgeon removes the diseased heart valve and puts an artificial valve in its place. The surgery can be performed as open-heart surgery or a minimally invasive procedure. Heart Valve Replacement surgery cost in India varies depending on the type of surgery performed, type of valve used, and several other factors.
There are mainly two types of artificial heart valves used for replacement surgery: mechanical and tissue (bioprosthetic) heart replacement valves
The choice of the type of valve to be used is influenced by the following:
- Patient’s age
- Presence of other medical conditions, if any
- Personal preference
The American College of Cardiology and the American Heart Association recommends the use of mechanical valves for people below the age of 50 and biological or tissue valves for patients above the age of 70. For people who fall between these age limits, a particular type of prosthetic valve has shown no prominent advantage over the other type. Therefore, the choice of replacement valve type also depends on the preference of the patient – whether they wish to go with a biological valve which is likely to need replacement over time, specially if they are younger patients or have a mechanical one which is less likely to fail over time but will require the use of anticoagulation medications throughout their life.
Mechanical valves are made of carbon and metal, which are strong durable materials and therefore are the most long-lasting replacement valves. These prosthetic valves usually last throughout the remaining life of the patient.
Patients who receive a mechanical valve have to take blood-thinning or anticoagulant medications throughout their lives to prevent the formation of the clots, which can be critical for people with a mechanical valve. The clots may get stuck in the valve flaps or hinges and result in their malfunction, or they may break off and travel through the bloodstream and form an embolism by wedging into a blood vessel in other parts of the body. The embolism can eventually cause a heart attack or stroke in a person.
Mechanical valves are reported to make a low clicking sound that can be heard by the patients, although it may not be heard by all patients. These types of prosthetic valves are usually implanted in young patients, and they typically last for around 20 to 30 years without the need for secondary surgery for replacement.
These valves are recommended for patients:
- Less than 65 years of age
- Want to avoid a secondary replacement surgery over time
- Having an overactive parathyroid gland that can affect the patient’s blood calcium levels.
Tissue Valve also called the bioprosthetic valve
Tissue valves are made from valves of the animal donors or other animal tissue that is strong and flexible enough. These replacement heart valves can last for 10-20 years and generally, patients who have tissue valves don’t require the use of long-term anticoagulant medicines. The advantage of this type of valve is it does not pose a higher risk of having blood clots, so the patient usually doesn’t need to take a blood thinner.
Young patients with a tissue valve replacement are more likely to require another surgery for valve replacement in their life as.
Biological valves are considered for people who:
- Are above 65 years of age
- Suffer from kidney disease
- Are pregnant
- Have a recreational sport or hobby or job that increases the risk of bleeding or injury.
Another type is Donor Valve which uses a human donor valve. It is usually not a common choice and is generally used for people with a disease that affects their valve, such as infective endocarditis. Donor valves may last for about 10-20 years.
For every patient who requires valve replacement, careful considerations are given to durability and options and risks related to medications required. Successful operations usually have a high rate of long-term success.