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Tricuspid Valve Repair
- Days In Hospital 7 days
- Outside Hospital Stay 15 days
- Success Rate 85%
Minimum Cost
$ 6000
Maximum Cost.
$ 12000
Overview of Tricuspid Valve Repair in India
Tricuspid valve repair is a surgical procedure performed to repair tricuspid valves that have been damaged, one of four valves that control blood flow.
The heart has two main valves on the right - the pulmonary valve and the tricuspid valve. The tricuspid valve has three flaps that open and close and control blood flow from the right atrium to the right ventricle and prevents blood from flowing back towards the heart. When this does not work properly either it does not close properly and blood leaks backward to the atrium (regurgitation) or it is narrowed to the degree that enough blood cannot pass through into the right ventricle (stenosis). In either case, Tricuspid Valve Repair surgery is performed to restore normal blood flow and maintain the function of the heart muscle.
What Are Tricuspid Valve Replacement And Repair?
Procedures for tricuspid valve repair and replacement are treatments for problems with your heart's tricuspid valve.
The tricuspid valve is one of your heart’s four valves that controls the direction of blood flow in your heart. The tricuspid valve is located on the right side of your heart, in between the upper heart chamber (atrium) and the lower heart chamber (ventricle). It allows blood to flow in the right direction, which is from the right atrium down to the right ventricle. The tricuspid valve has three flaps (also called leaflets) that open and close in concert with blood flow.
It's not easy to hear that your heart is not functioning properly. The good news is that valve repair or replacement will help improve your daily life and help you get back to doing the things you want to do.
Why Is It Done?
The treatment of damaged valves depends on the severity of the health condition and whether it gets worse or not, as some patients with this disease might have no symptoms. For these patients, the doctor will need to assess it on a regular basis. There are three main valve diseases involving an individual's need for tricuspid valve replacement or repair:
Tricuspid Valve Regurgitation - Occurs when the tricuspid valve does not properly close allowing blood to flow back into the right atrium.
Tricuspid Valve Stenosis - In this instance, the tricuspid valve is narrowed or obstructed, making it difficult for blood to move from the right atrium to the right ventricle.
Tricuspid Atresia - This is a form of congenital heart disease. This happens when a baby is born with an opening to allow blood to flow from the right atrium to the right ventricle or without a tricuspid valve.
Is It Better To Repair Or Replace The Tricuspid Valve?
Typically, it is preferred to repair your tricuspid valve and preserve your own heart tissue. However, you may need a replacement valve if there is too much damage to your valve or surrounding tissue.
Replacement valves can either be biological (from an animal or deceased human donor) or mechanical (made entirely of artificial material).
If you receive a valve from an animal or human donor, you may not have to take blood thinners afterwards. Alternatively, mechanical valves come with an increased risk of blood clots, and you will have to take blood thinners for life.
Types of Tricuspid Valve Repair:
Tricuspid Valve Repair
Repairing the patient's native valve is often the first choice for tricuspid valve surgery – particularly for cases of tricuspid regurgitation in which the tricuspid valve continues to be largely intact, but is dilated or loosened. During repair, the surgeon may perform an annuloplasty, in which a ring or band is placed around the valve's annulus (opening) to tighten and improve its shape. Other techniques may involve reshaping or reinforcing the valve leaflets, or reconstructing the chordae tendinea and papillary muscles.
Repair can be especially advantageous as it preserves the patient’s native tissue, avoids complications associated with prosthetic materials, and eliminates the need for long-term anticoagulation use. Tricuspid valve repair is routinely performed at the time of mitral valve surgery when tricuspid regurgitation coexists with left-sided valve pathology. The durability of the surgical repair depends on the underlying pathology and the effectiveness of surgical technique.
Minimally Invasive Tricuspid Valve Surgery
Minimally invasive approaches consist of completing the valve procedure using a small incision (usually between the ribs on the right side of the chest) as opposed to opening up the sternum. Specialized instrumentation and video-assisted technology enables surgeons to work precisely in a confined space.
Minimally invasive tricuspid valve operations can be used for repairs or replacements and can involve less trauma, less pain, quicker recovery, and less hospital length of stay. This approach is best utilized in select patients without extensive disease or multiple additional comorbidities. While it may not remain the standard of care for the majority of patients, it has persevered through recent years of popularity and is certainly advantageous in isolated tricuspid surgeries or reoperations.
Procedure:
Before the Procedure
The patient will be informed about the procedure's hazards and what to anticipate from it by the physician and medical staff. Steer clear of jewellery, eyeglasses, contact lenses, dentures, and nail paint on the day of surgery.
During the Procedure
Anaesthesia will be administered to the patient, rendering him unconscious throughout the procedure. The body uses a heart-bypass machine to control blood flow. The following sorts of repairs could be part of the repair procedures:
Traditional Tricuspid Valve Repair Surgery
Since this is an open-heart procedure, which means that the cardiothoracic surgeon makes a 6 to 8 inch long incision in the breastbone to open the chest. The heart is stopped and a heart-lung bypass machine works as the heart to circulate blood through the patient. Depending on the valve problem, a doctor will perform different repair procedures on torn leaflets, reshaping parts of the valve, or separating leaflets that have narrowed or fused. These procedures can be Annulus support or Leaflet patching.
In Annulus support, a synthetic or tissue-based ring is placed to reinforce the annulus. The annulus is the ring of tissue at the bottom of the leaflets. The annulus is restored to the right size and shape and allows the leaflets to close and open normally. Annulus support is preferred surgical approach to treat tricuspid regurgitation. In leaflet patching, the surgeon repairs the diseased leaflet with a patch to control the leakage in the valve. Leaflet patching is used to treat tricuspid valve regurgitation.
Minimally Invasive Tricuspid Valve Repair Surgery
In minimally invasive surgery, the surgeon makes two to four J-shaped incisions to open the chest cavity. This procedure is not safe for all patients, but based on the patient's circumstances and symptoms, the doctors will recommend surgery. The advantages of minimally invasive surgery are as follows:
- Less blood loss
- Less surgical trauma
- Less time spent in hospital
Cone Tricuspid Valve Repair
It is a sophisticated method of repairing the tricuspid valve. To make leaflet cones, surgeons detach the leaflets, rotate them, and then reattach them to the leaflet tissue.
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Cost of Tricuspid Valve Repair in India
The price of a tricuspid valve repair operation in India is not disclosed, but a tricuspid valve replacement typically costs around $5,000 and $10,000 USD. If we assume that repair surgeries do not cost more than replacement surgeries, the costs will fulfill (or fall within a similar range), depending on the complexity of the repair, and it could be lower. Overall costs will depend on several factors, including choice of hospital, pre-operative testing, post-operative care and whether a tissue valve or a mechanical valve is chosen.
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Indications of Tricuspid Valve Repair:
A heart specialist can identify an abnormal heart sound when listening with a stethoscope. This is only the first step. After noting the abnormality, the doctor will usually perform one or a combination of the following tests to better understand the abnormality or to provide additional diagnoses:
- Electrocardiogram (ECG or EKG)
- Chest X-ray
- Echocardiogram (Echo)
- Magnetic resonance imaging (MRI)
- 2D echocardiogram (2D Echo)
- Computed Tomography (CT) Angiography
- Transesophageal echocardiogram (TEE)
- Cardiac catheterization
Risk Factors:
Repairing or replacing a tricuspid valve is an invasive procedure that comes with several potential risks. These include:
- Bleeding
- Blood clots
- Arrhythmia or the need for a pacemaker
- Infection
- Stroke
- Heart failure
- Kidney failure
- Valve dysfunction even with replacement