Aortic Valve Replacement Cost In India - Get Cost Estimate

What is Aortic Valve Replacement Surgery Cost in India?

The burden of heart valve disease is increasing in developing nations like India. One of its significant contributors is rheumatic heart disease in which the heart valve gets permanently damaged. If left untreated it may also lead to congestive heart failure and ultimately death. The best possible solution to this deadly situation is replacement of damaged heart valves.

A recent estimate suggests that India has performed more than 30,000 valve replacement surgeries in 2022.

The average cost of aortic valve replacement surgery in India ranges between INR 3,50,000 and INR 5,00,000 for Indian patients. For international patients, the cost ranges between USD 8000 and USD 11000. This cost includes the price of the prosthetic valve, surgeon fees, anaesthesia charges, OT charges, medical consumables, and a hospital stay for 3-7 days.

What is Aortic Valve Replacement Surgery?

The heart is the primary organ involved in blood circulation. Each heart chamber (atria and ventricle) contain flaps-like structures called valves. These valves, surrounded by a ring-like structure, are responsible for maintaining flow speed and preventing backflow. Any complication associated with the valve leads to insufficient blood supply and intermixing of oxygenated and deoxygenated blood.

Aortic valve is one of the heart valves, which maintains blood flow to the aorta and ensures that oxygen-rich blood does not flow back into the left ventricle.

Sometimes, these aortic valves can't function properly due to the following conditions:

Aortic stenosis

In this condition, the valve becomes narrow and stiff, preventing it from opening or closing correctly. This stiffening is caused by calcification or some genetic disorder, a condition known as aortic stenosis. 

Atherosclerosis

Deposition of cholesterol, calcium, and other fatty substances builds up and hardens inside the arteries. These are known as plaques that can partially or entirely limit blood circulation to the heart.

Congenital heart conditions

The aortic valve is a tricuspid valve. However, due to genetic defects, some children are born with a two-cusped aortic valve instead of three. This bicuspid aortic valve is a hereditary congenital heart defect that limits the heart's function.

Infective endocarditis

In this condition, there is significant inflammation in the heart, with fevers, chills, and fatigue caused by bacterial infection. This infection leads to the inflammation of the valves,thus reducing its capacity to open.

Aortic valve regurgitation

In this heart condition, the aortic valve fails to close tightly, leading to backward leakage of blood into the left ventricle of the heart instead of flowing forward into the aorta. 

These conditions mentioned above can lead to the following symptoms:

• Shortness of breath
• Persistent chest pain
• Irregular heartbeat
• Feeling of dizziness followed by fainting

To treat this condition, cardiac surgeons perform aortic valve replacement surgery. In this procedure, the damaged valve is replaced with a prosthetic valve, which can be mechanical or biological.

Mechanical Valves: These are made from artificial materials, usually pyrolite carbon, covered in a polyester knit fabric ring. Though they are durable and can last a lifetime without needing replacement, patients with mechanical valves need to take anticoagulants for the rest of their lives to prevent blood clots. 

Prosthetic Valves: These are made from biological tissue or animal valves, usually from pigs or cows. It doesn't require lifelong blood-thinning medication. However, they may deteriorate over time and need to be replaced.

What are the Types of Aortic Valve Replacement Surgery?

Based on the invasiveness of the approach being utilised to replace the aortic valve, the type of the aortic valve replacement surgery can be categorised into the following types-

Surgical aortic valve replacement

This is a traditional method in which large incisions are made in the patient’s chest to access the heart valve. Then, the damaged aortic valve is replaced with a prosthetic valve. Since it is an open-heart surgery, it allows direct visualisation of the inside of the heart and then performing the surgery.

Minimal invasive aortic valve replacement

This technique focuses on creating minimal incisions to carry out the process of aortic valve replacement surgery. It ensures faster recovery and less chances of infection due to minimal exposure.

Transcatheter aortic valve replacement/implantation

This is an advanced and highly effective minimal invasive technique, in which a cardiac surgeon inserts a catheter into the heart via which the prosthetic valve is inserted there pushing the damaged valve at the back.

What are the Key Factors That Affect the Aortic Valve Replacement Surgery Cost in India?

The cost factors associated with aortic valve replacement surgery help cardiac patients and their families avoid financial burdens or unexpected expenses related to the surgery. It allows them to plan the treatment, analyse cost-saving strategies, and manage the risk of any sudden financial necessity resulting from immediate medical needs.

The key factors affecting the aortic valve replacement cost in India are listed below.

Type of prosthetic valve used :

The cost associated with the aortic valve replacement surgery procedure may vary based on the selection of valve type, including options like mechanical or biological valves. Certain valves may be costly due to their particular model, like self-expandable or balloon-expandable designs, or due to advanced technological features utilised in their making. In transcatheter aortic valve implantation (TAVI), a biological prosthetic valve is typically employed.

The cost of a mechanical valve for Indian patients is INR 1,00,000, and for international patients, it is USD 2500. In comparison, a biological valve is costly, which is INR 1,50,00 for Indian patients, whereas, for international patients, it is USD 3000. 

Hospital location and cardiac's surgeon expertise

The hospital's location and distance from major cities impact the cost. Top hospitals provide better services that may add some expenses to the overall transaction. Cardiac surgeons at top hospitals may charge extra fees because of their high skill and expertise in this field. 

Additional stay at hospital/ICU

In particular, in cardiac complexities, the patient may have to stay for some additional days in the hospital or ICU for post-operative care. Thus, the additional hospital stay costs around INR 12,000 and INR 20,000 (USD 200 to USD 300) on a per-day basis.

What are the Costs Associated with Aortic Valve Replacement Before and After the Procedure?

Before aortic valve replacement, cardiac surgeons recommend various tests and examinations to understand the extent of the damage caused to the aortic valve. Even after the replacement procedure is over, follow-ups are necessary to ensure that the prosthetic valve is functioning efficiently. These affect costs of aortic valve replacement surgery in India and should not be overlooked by the patients and their families.

• Pre-procedural examination cost (complete blood count, electrocardiogram, echocardiogram, coronary angiography, CT scan, nuclear stress test, etc.): INR 15,000 to INR 20,000 (USD 300 to USD 400)
• Post-procedural cost (follow-up consultations and medications): INR 3,000 to INR 4,000 (USD 50 to USD 100)

What should be Post Aortic Valve Replacement Surgery Care?

Since a patient is now surviving on a prosthetic valve that has replaced the naturally present valve, it's essential to look for any risk of infection and the performance efficiency of the replacement valve. Other medical complications, such as bleeding, infection, etc., require immediate intervention and should never be overlooked. The success of the aortic valve replacement surgery and the patient's overall well-being depends significantly on the post-surgical care they receive. Some of the measures for post-aortic valve surgery care are as follows:

Follow Medical Advice

After aortic valve replacement surgery, patients must strictly follow their healthcare provider's instructions. This includes taking prescribed medications, attending follow-up appointments regularly, and following dietary guidelines recommended by their doctor.

Activity restrictions

Heavy lifting, gym work, and other strenuous exercises should be limited during the initial phase of recovery. This allows the body to adjust to the changes in the cardiac muscles caused by the prosthetic implant and provides enough time to heal properly.

Monitor for Infection 

In some cases, prosthetic valve endocarditis occurs when infection-causing bacteria reach the prosthetic valve via the bloodstream. In this condition, your doctor may suggest an antibiotic course. Also, any discomfort should be reported to the doctor. 

Attend Cardiac Rehabilitation 

Cardiac rehabilitation programs are formulated to assist patients in recovering from heart surgery and improve their cardiovascular health. Supervised exercise sessions and a guided diet plan significantly enhance recovery and reduce the risk of future heart problems.

Does Insurance Cover Aortic Valve Replacement Surgery in India?

Insurance agencies in India cover cardiac surgeries procedures which include aortic valve replacement surgery as well . After consulting your cardiac surgeon, you have to submit your doctor’s prescription, investigation reports and hospital documents to the insurance agency along with the policy papers. Then, they will check whether you are eligible for the claim or not. After all the necessary paperwork, the insurance agency will then coordinate with the hospital to cover the medical expenses as per policy terms.

Generally, health insurance policies may cover a portion or all of the expenses associated with aortic valve replacement surgery. This includes the price of the prosthetic valve, hospitalisation, surgeon fees, pre-operative tests, and post-operative care