What are Double Valve Replacement (DVR)
Double Valve Replacement (DVR) is a complex surgical procedure performed to replace both the aortic valve and the mitral valve of the heart with prosthetic valves. It is a significant surgical intervention that is typically done to treat severe and simultaneo
Symptoms
- Severe Aortic Valve Stenosis and Mitral Valve Regurgitation: When both the aortic valve and the mitral valve are significantly damaged and are causing obstruction (narrowing) of blood flow through the aorta and leakage of blood back into the left atrium, respectively, a double valve replacement may be required to address both issues.
- Infective Endocarditis: In some cases of infective endocarditis (infection of the heart valves), both the aortic and mitral valves may be affected and severely damaged, requiring surgical removal and replacement.
- Rheumatic Heart Disease: Rheumatic heart disease, a complication of rheumatic fever, can affect multiple heart valves simultaneously, including both the aortic and mitral valves. When the damage is severe, double valve replacement may be necessary.
Procedures
The DVR surgery follows a similar process to individual valve replacement surgeries, but it involves addressing two valves instead of one. Here's
a general outline of the procedure:
- Anesthesia: The patient is given general anesthesia to ensure they are unconscious and pain-free during the surgery.
- Incision: The surgeon makes an incision in the chest to access the heart. The incision may be through a median sternotomy (vertical incision down the middle of the chest) or a minimally invasive approach with smaller incisions.
- Cardiopulmonary Bypass: The heart is temporarily stopped, and the patient's blood is rerouted through a heart-lung machine to maintain blood circulation and oxygenation.
- Opening the Heart: The surgeon opens the pericardium, the protective sac surrounding the heart, to access the aortic and mitral valves
- Valve Inspection and Removal: The surgeon examines the aortic and mitral valves to assess the extent of damage and confirms the need for replacement. The damaged valves are then carefully removed
- Valve Replacement: The surgeon implants the prosthetic aortic valve and the prosthetic mitral valve in their respective positions. The prosthetic valves can be mechanical or bioprosthetic, as described in the previous sections
- Valve Testing: The surgeon tests the functionality of both new valves to ensure they open and close properly without any leakage.
- Closing the Heart: Once the valve replacement is successful, the surgeon closes the heart, and the heart-lung machine is gradually stopped, allowing the heart to resume its pumping function
- Chest Closure: The surgeon closes the chest incision using sutures or staples, and the skin incision is closed with stitches or surgical glue
- Anesthesia: The patient is given general anesthesia to ensure they are unconscious and pain-free during the surgery.
- Incision: The surgeon makes an incision in the chest to access the heart. The type of incision may vary depending on the surgeon's preference and the patient's condition. Common approaches include a median sternotomy (vertical incision down the middle of the chest) or a minimally invasive approach with smaller incisions.
- Cardiopulmonary Bypass: To perform the surgery, the heart needs to be temporarily stopped, and the patient's blood is rerouted through a heart-lung machine. This machine acts as a substitute heart and lung during the procedure, maintaining blood circulation and oxygenation.
- Opening the Heart: The surgeon opens the pericardium, the protective sac surrounding the heart, to access the aortic and mitral valves.
- Valve Inspection and Removal: The surgeon examines the aortic and mitral valves to assess the extent of damage and confirms the need for replacement. The damaged valves are then carefully removed.
- Valve Replacement: The surgeon implants the prosthetic aortic valve and the prosthetic mitral valve in their respective positions. The prosthetic valves can be mechanical (made from durable materials like titanium or carbon) or bioprosthetic (made from animal tissue or human tissue from donors)
- Valve Testing: The surgeon tests the functionality of both new valves to ensure they open and close properly without any leakage.
- Closing the Heart: Once the valve replacement is successful, the surgeon closes the heart, and the heart-lung machine is gradually stopped, allowing the heart to resume its pumping function.
- Chest Closure: The surgeon closes the chest incision using sutures or staples, and the skin incision is closed with stitches or surgical glue
Why Double Valve Replacement done ?
Mitral Valve Replacement (MVR) surgery is performed when the mitral valve, located between the left atrium and the
left ventricle of the heart, is damaged or diseased to a point where it cannot function properly. The primary goal of MVR
is to restore normal blood flow through the heart and improve overall heart function. The surgery is done for several
specific reasons:
- Mitral Valve Stenosis: In mitral valve stenosis, the mitral valve becomes narrowed and fails to open fully, obstructing the flow of blood from the left atrium to the left ventricle. Severe stenosis can cause blood to back up in the left atrium, leading to increased pressure in the pulmonary circulation (the circulation between the heart and lungs) and resulting in symptoms such as shortness of breath, fatigue, and fluid retention. MVR is performed to alleviate this obstruction and restore proper blood flow
- Mitral Valve Regurgitation (Mitral Insufficiency): In mitral valve regurgitation, the mitral valve does not close properly, allowing blood to leak backward from the left ventricle into the left atrium during ventricular contraction. This causes decreased forward blood flow and increased volume and pressure in the left atrium. Over time, this can lead to heart enlargement and heart failure. MVR is done to correct the regurgitation and prevent further damage to the heart.
- Mitral Valve Prolapse: Mitral valve prolapse occurs when the valve leaflets bulge back into the left atrium during ventricular contraction. While many cases of mitral valve prolapse are mild and may not require surgical intervention, severe cases with significant regurgitation or symptoms may necessitate MVR to repair or replace the valve.
- Other Mitral Valve Disorders: Various congenital or acquired conditions can lead to mitral valve dysfunction, such as rheumatic heart disease, infective endocarditis, and connective tissue disorders. If medical treatment is insufficient to manage the condition or if the valve damage is severe, MVR may be required to improve heart function and alleviate symptoms.
- Mitral valve replacement surgery is usually recommended when:
- The severity of the mitral valve disease is significant and causing symptoms that impair the patient's quality of life.
- The condition is getting worse despite medical treatment, and the valve cannot be repaired successfully.
- The patient is at risk of developing serious complications, such as heart failure or pulmonary hypertension, due to the mitral valve disease.
What Is Double Valve Replacement ?
Double Valve Replacement (DVR) is a surgical procedure in which both the aortic valve and the mitral
valve of the heart are replaced with artificial (prosthetic) valves. The aortic valve and the mitral valve
are two of the four valves that regulate blood flow through the heart.
The aortic valve is located between the left ventricle (the heart's main pumping chamber) and the
aorta (the main artery that carries oxygen-rich blood to the body). Its function is to allow blood to flow
from the left ventricle into the aorta during the heart's contraction (systole) and prevent backflow of
blood into the ventricle during relaxation (diastole).
The mitral valve is situated between the left atrium (the heart's upper chamber) and the left ventricle.
It ensures that blood flows from the left atrium to the left ventricle during the heart's relaxation phase
and prevents backflow into the atrium during ventricular contraction.
When both the aortic and mitral valves are severely damaged or diseased, it can lead to significant
heart problems and impair the heart's ability to pump blood effectively. Conditions such as severe
aortic valve stenosis (narrowing) or regurgitation (leakage), along with severe mitral valve stenosis or
regurgitation, may necessitate the need for double valve replacement. vAfter the surgery, the patient is closely monitored in the intensive care unit
(ICU) for a few days before being transferred to a regular hospital room.
Recovery from double valve replacement surgery may take several weeks,
and patients will need to follow their doctor's instructions for postoperative care, rehabilitation, and medication management
Includes
- Doctor Fees
- OT charges
- Anesthetic charges
- Drugs
- Investigation
- Professional charges
- Room Rents
- Nursing & Administrative charges
Procedure Fee : ₹183600 ₹201960 (Inclusive of all charges)
Book NowGet The Best Double Valve Replacement (DVR) Surgery Near You