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.
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WhatsApp UsWhat 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
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Frequently Asked Questions Related to Aortic Valve Replacement Cost
A day before the surgery, a physical examination of the person and some tests are done to assess one’s health, including chest X-ray, electrocardiogram (ECG), blood tests, echocardiogram, and coronary angiogram. All the tests are usually covered in the medical package.
There are different types of valves used for aortic valve surgery depending upon the patient’s condition. These include Open Aortic Valve Replacement (AVR) via Sternotomy, Transcatheter Aortic Valve Implantation (TAVI), and Minimally Invasive Cardiac Surgery (MICS). AVR is for low-risk patients, TAVI is used for patients who are at risk from complications of AVR whereas MICS is a fast method among all three. However, the most expensive procedure among all the three is TAVI.
In addition, AVR and MICS can last up to a lifetime and TAVI has a life span of approximately five years but more research is required on it.
All the pharmaceutical expenses and medical consumables are included in the medical package during the patient’s stay in the hospital however, these benefits are not covered once the patient is discharged.
Post-surgery, the patient is usually advised to stay in the hospital for a week to recover. However, it may take a month for the patient to recover fully. The package covers the patient’s stay in the hospital although, depending upon the facilities and type of room, the package cost may increase.
After surgery, the patient has monitored for the risk of infection or increased blood pressure. He is also assisted in managing discomfort or pain and is helped in walking and doing exercise. All these services are included in the package. The patient might also go for personal sessions for breathing exercises after discharge. In addition, the patient may require medication for at least three months following surgery.
With respect to the follow-ups, the patient may need to see his cardiologist six to eight weeks after the surgery and the doctor then recommends the number of follow-ups required according to the patient’s condition.
Depending upon the health insurance cover the person has taken, the costs are covered. Some premium covers provide full cost whereas some others provide the partial cost of the treatment.
The aortic valve replacement procedure puts immense strain on the body and may require alternative approaches that include aortic valve balloon valvuloplasty, TAVI, and sutureless aortic valve replacement.
Everything You Need to Know About Aortic Valve Replacement: Q&A
Before the Procedure · 26 Questions
Mechanical valves usually last 20 years or more.
Mechanical valves last longer than tissue valves. They are less likely to wear out or break down. If you are age 50 or younger, a mechanical valve may be a good choice.
However, the patient has to follow a strict blood thinner medication regime. Hence, the tissue valve is advised for older people to avoid the risks of blood thinners.
Mechanical valves are made from carbon and metal. Tissue (biological or bioprosthetic) valves are usually made from animal tissue, or sometimes from human tissue (in which case they may be called homograft valves), that has been treated to make sure it is not rejected by the body.
A still poorly addressed issue of mechanical valve prostheses is the noise they produce. This is perceived by many patients, many are happy to hear their heart constantly beating, but some dislike the noise.
Mechanical valves in some patients have lasted as long as 25 years without problems. Tissue valves in some patients have lasted as long as 15 years without problems.
There are ways to strengthen the heart valve firstly, Get moving as your heart is a muscle and as with any muscle, exercise is what strengthens it., Quit smoking, Lose weight, Eat heart-healthy foods and don't take the stress.
Your treatment depends on the severity of your condition. You may need surgery to repair or replace the valve. Left untreated, aortic valve stenosis can lead to serious heart problems.
That is absolutely right. If your surgeon felt, he will not be able to achieve the desired results in minimally invasive surgery, he will not offer it in the first place.
There are two main types of heart replacement valves to choose from — mechanical and biological, Doctor will advise according to the patient age, lifestyle, food habits etc.
When valves are damaged or diseased and do not work the way they should they may need to be repaired or replaced.
Tissue valves can last 10-20 years, and usually don't require the long-term use of medication.
These tissues are treated and neutralized so that the body will not reject them.
Tissue heart valves (sometimes called “bioprosthetic” valves) are harvested from animal heart valves (porcine) and have passed the tests on human trials before being used.
A third, small difference between the two valve options is sound. Tissue valves work silently, while mechanical valves can make a quiet clicking noise that some people find bothersome, especially when trying to fall asleep.
Tissue valves in some patients have lasted as long as 15 years without problems.
There are ways to strengthen the heart valve firstly, Get moving as your heart is a muscle and as with any muscle, exercise is what strengthens it. Quit smoking, Lose weight, Eat heart-healthy foods and don't take the stress.
Your treatment depends on the severity of your condition. You may need surgery to repair or replace the valve. Left untreated, aortic valve stenosis can lead to serious heart problems.
When valves are damaged or diseased and do not work the way they should they may need to be repaired or replaced.
There are two main types of heart replacement valves to choose from — mechanical and biological, Doctor will advise according to the patient.
This surgery is usually done for the individuals aged between 53 to 92 years
That is absolutely right. If your surgeon felt, he will not be able to achieve the desired results in minimally invasive surgery, he will not offer it in the first place.
In aortic valve replacement the doctor removes the aortic valve and then replaces it with a mechanical or valve which is being made from cow, pig or human heart.
Aortic tissue valve will lasts up to 10 to 20 years and there be no use of taking medicines for long term. If the person is young and needs a tissue valve replacement the need for other surgery or other valve replacement is very less.
Aortic valve replacement will treat the aortic valve diseases and then help to restore normal blood flow, reduce the symptoms and then increase the life expectancy and preserve the function of your heart muscles.
Aortic valve replacement is needed for two reasons either the valve has become narrowes or the opening of the valve has become smaller which obstructs the flow of blood out of the heart. The aortic valve allows the blood to flow back through in the heart.
Yes, aortic valve replacement is a major surgery it involves removing a faulty or damaged valve and then replacing it with a new valve made from synthetic material or animal tissue. This surgery is not suitable for everyone and it will take time to recover.
During the Procedure · 3 Questions
The procedure of aortic valve replacement will take around two to four hours to complete.
Aortic valve replacement is being done by cardiologist.
In this procedure, doctor will make an incision in your chest and then removes the aortic valve and then replaces it with mechanical valve which are made from either cow, pig or human heart.
Post the Procedure · 8 Questions
After an aortic valve replacement, you'll usually need to stay in the hospital for about a week. The time it takes to fully recover varies depending on factors like your age and overall health.
Your breastbone will usually heal in about 6 to 8 weeks, but it maybe 2 to 3 months before you feel your normal self again.
Exercising will help to speed up your recovery and it's a key component of a healthy lifestyle. Exercise increases your fitness levels, helps control blood pressure, weight and cholesterol and keep you relaxed.
After an aortic valve replacement, you'll usually need to stay in the hospital for about a week. The time it takes to fully recover varies depending on factors like your age and overall health.
Your breastbone will usually heal in about 6 to 8 weeks, but it maybe 2 to 3 months before you feel your normal self again.
Exercising will help to speed up your recovery and it's a key component of a healthy lifestyle. Exercise increases your fitness levels, helps control blood pressure, weight, and cholesterol and keep you relaxed.
You will need to be in hospital for about a week after surgery.
The time it takes to fully recover varies depending on factors like your age and overall health. Your breastbone will usually heal in about 6 to 8 weeks, but it may be 2 to 3 months before you feel your normal self again.
After your aortic valve replacement surgery you have to regularly monitor your blood pressure, breathing and heart rate. You have to carefully watch your incision site. You should walk regularly and then increase your activity.
Some of the risks of aortic valve replacement are bleeding, blood clots, heart rhythm, problem, infection and stroke.
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