Heart valve replacement abroad

Heart valve replacement is a cardiac surgery procedure that avoids death due to heart failure and heart defects. According to the World Health Organization, heart disease is the No. 1 cause of death from disease in the world.

Aortic stenosis is the most common cardiac pathology, for the treatment of which patients come to foreign clinics.

Surgeries to replace heart valves are performed at a high level in many countries where medicine is developed. Cardiac surgeons from Germany (University Hospital in Cologne), Turkey (Anadolu Clinic), South Korea (Samsung Medical Center), and Lithuania (Kardiolita Clinic) have achieved particular success. At the same time, many leading clinics have affordable prices for mitral valve replacement surgery.

Patients from Eastern Europe and Central Asia choose foreign clinics because they use advanced surgical methods and the latest generation of transplant models.

Heart valve replacement abroad is the optimal solution. This can guarantee the most favorable prognosis for patients who suffer from cardiac pathologies.

The main advantage of foreign clinics: the survival rate of patients after cardiac surgery reaches 98.8%. Foreign patients prefer to undergo heart valve replacement abroad for various reasons, including:

1. Availability of modern medical equipment that meets international standards.
2. High level of training of medical personnel.
3. The presence of hybrid operating rooms in which several minimally invasive procedures are performed simultaneously.
4. Heart valve replacement is performed using modern techniques in accordance with international protocols.
5. Cardiac surgeons have developed technologies for minimally invasive interventions, in which there is no need to connect the patient to a heart-lung machine (ACB).
6. Doctors use certified Edwards-Sapien and Medtronic-Melody prostheses, which have an unlimited service life.
7. Possibility of performing gentle cardiac surgical procedures on elderly people for whom the risks are high. According to the Society of Thoracic Surgeons, over 89% of mitral valve reconstruction procedures in patients over 65 years of age are successful.
8. The availability of advanced technologies abroad allows heart valve replacement to be performed without traditional open-heart surgery.
9. Possibility of heart valve replacement using the Da Vinci robotic unit. This increases the safety of the procedure by 25% and minimizes postoperative complications to 1%.
10. In foreign hospitals, much attention is paid to postoperative and rehabilitation monitoring of patients who have undergone heart valve repair.
11. The availability of package offers for heart valve replacement allows patients to receive a full range of services at a competitive price in the best hospitals.

According to the European Association of Cardiothoracic Surgeons, patients with an artificial valve who were operated on abroad can live for 30-40 years without replacement with a new one.

The heart valve is the part of the heart that allows proper blood flow. There are four types of valves in the heart: pulmonary, aortic, tricuspid and mitral. Treatment of mitral valve pathologies allows for both replacement and reconstruction of the organ in specific cases; in case of damage to the aortic valve, prosthetics are indicated.

Injuries to the mitral and aortic valves account for the vast majority of surgical valve replacement procedures.

Heart valve replacement is indicated in the presence of the following cardiac pathologies:

• severe aortic stenosis, which is manifested by frequent fainting, progressive shortness of breath, pain in the sternum;
• mitral valve prolapse, in which the valves do not fit well together, allowing blood to leak into the left atrium;
• persistent narrowing of the valve lumen in people after coronary artery bypass surgery;
• chronic heart failure, in which shortness of breath is observed at rest;
• mitral valve stenosis, which leads to thickening of the walls, which impedes blood flow;
• any valve damage in young patients that may threaten their life.

According to WHO, after heart valve replacement surgery, the 3-year survival rate of patients is more than 87%. Only 21% of people reach the 3-year mark without surgery.

Before performing the operation, the doctor takes into account the patient’s general condition, the presence of chronic diseases, allergic reactions to medications and other indicators.

Surgery to replace heart valves is contraindicated for certain diseases and conditions, including:

• acute myocardial infarction;
• acute cerebrovascular accidents – ischemic or hemorrhagic strokes;
• ARVI in the active stage;
• exacerbation of chronic diseases (for example, diabetes, bronchial asthma);
• extremely severe heart failure with an ejection fraction of less than 20% with mitral stenosis. In this situation, the doctor decides whether a heart transplant is necessary.

The decision to perform heart valve replacement surgery is made by a multidisciplinary commission after a thorough examination of the patient, taking into account risk factors.

To make an accurate diagnosis and draw up a treatment regimen, cardiologists abroad prescribe a set of examinations to patients. Basic diagnostics that allow you to identify cardiac pathologies associated with the functioning of the aortic valve include the following tests:

1. Electrocardiography (ECG) – monitoring the heart rate, the presence of left ventricular hypertrophy, myocardial damage.
2. Coronary angiography – x-ray of the heart vessels.
3. Daily blood pressure monitoring (ABPM) – monitoring of blood pressure and heart rate during the day in a continuous mode.
4. Ultrasound of the heart (echocardiography) – assessment of the size, structure and condition of the valves, heart muscle and large vessels.
5. Functional stress test (bicycle ergometry) – identifying disturbances in the functioning of the heart during physical activity.
6. Lab tests.

Another great advantage of foreign hospitals is the opportunity for a person to undergo comprehensive monitoring of the functioning of the cardiovascular system. Cardiological check-up is a modern and most reliable study that allows you to identify cardiac pathologies at an early and even asymptomatic stage of the disease.

There are two types of operations to replace heart valves:

• on an open heart – with its switching off and the use of an AIK;
• modern minimally invasive procedures without shutting down the heart.

It is also possible to replace a heart valve without removing it. Among foreign patients, this surgical intervention is most in demand.

Heart valve replacement is the most successful treatment for aortic valve disease. There are two types of valve grafts:

1. Mechanical heart valve. They are created using high-strength alloys and plastics. Such options are more durable and can serve the patient for life, although they require constant use of anticoagulants.
2. Biological heart valve. They are made from animal valves. They are less traumatic and do not require anticoagulants. Among the disadvantages is a shorter service life – 10-15 years, after which they are replaced again.

Traditional heart valve replacement involves open heart surgery under general anesthesia.

How long heart valve replacement surgery takes depends on the specific heart pathology. As a rule, the duration of the procedure is 3-6 hours.

During the operation, the surgeon makes an incision in the sternum and connects the patient to the ICU. The heart is temporarily stopped and cooled. This is necessary to remove the damaged valve and install an artificial prosthesis in its place.

After implanting the valve, the doctor starts the heart and checks the blood flow. Only after all manipulations the patient is disconnected from the artificial blood pressure pump and stitches are applied.

Many foreign patients travel abroad to undergo valve replacement as an alternative to open heart surgery. This mainly applies to older people, as well as those who have contraindications for the traditional procedure.

Possible alternative procedures for aortic valve replacement without major open heart surgery include:

1. Transcatheter aortic valve implantation (TAVI) is a heart valve replacement without traditional surgery. The procedure is performed not through an incision in the chest, but through blood vessels.
2. Balloon valvuloplasty – a special balloon is used to expand the valve.
3. Sutureless aortic valve replacement is designed to minimize the time spent on bypass; the valve is not secured with sutures.

Surgeons perform all alternative interventions primarily in cases where open-heart surgery to replace a valve has increased risks for the patient.

Transcatheter aortic valve implantation (TAVI/TAVR) is an innovative treatment for aortic stenosis. This is a worthy alternative to open heart surgery. The intervention is indicated for patients who are considered to be at high risk of complications after open heart surgery.

Advantages of the TAVI method:

1. There is no need to connect the patient to the AIK.
2. The procedure is gentle – the new valve is transported to the heart using a catheter. This minimizes the occurrence of possible complications and guarantees a quick recovery for the patient.

Heart valve replacement using the TAVI method is minimally invasive. The surgeon implants the artificial valve through a catheter that is inserted into the femoral artery or a small incision in the chest.

Transcatheter valves are made from pig or cow heart tissue. The new prosthesis is placed on top of the existing valve and fixed inside the aorta. It immediately begins to function and restores blood flow.

Heart valve replacement is carried out under the control of modern imaging systems. Unlike traditional open heart surgery, heart valve replacement with the TAVI method takes 40-120 minutes and is performed under local anesthesia.

The patient stays in the intensive care unit for only a few hours. The rehabilitation period usually lasts 3 days. A special feature of the procedure is the use of exclusively biological valves. The patient must take antithrombotic drugs for 3 months.

Heart valve replacement using the TAVI method provides for complete recovery of the patient in 2-3 weeks, in contrast to open heart surgery, in which rehabilitation lasts for several months.

Heart valve replacement is a serious cardiac surgery procedure, during which doctors take into account all possible risks and complications. Interventions are carried out with particular caution in older people and anyone in poor health.

Possible problems include:

1. Infection. Infections of the lungs, bladder, heart valves (endocarditis) and wound infections are most likely to occur. To reduce the risks, doctors may prescribe antibiotics.
2. Bleeding. In such cases, tubes may be placed into the chest to drain the blood, and a surgical procedure may be required to stop the bleeding.
3. Blood clots are more often detected when replacing a mechanical valve. Doctors prescribe anticoagulants to such patients.
4. A stroke or transient ischemic attack (TIA) is an acute condition in which the blood supply to the brain suddenly stops.
5. Valve wear. It is more common in patients who have had their biological valve replaced long ago.
6. Arrhythmia is an irregular heartbeat. A serious pathology that occurs in 25% of patients after valve replacement. For most people it goes away over time, although 1-2% of people need a pacemaker to control their heartbeat.

Also, 5% of patients experience kidney problems in the first days after surgery. In some cases, temporary dialysis may be required.

The price of mitral valve replacement surgery abroad depends on many factors, including:

• selected country and hospital price level;
• type of prosthetics – the price of replacing a biological mitral valve will be more expensive than a mechanical one;
• doctor’s experience and qualifications;
• number of days spent in hospital.

The best prices for heart valve replacement surgery in Turkish clinics start from $19,000. The average cost of the procedure in German hospitals starts from €27,000, heart surgery in Israel averages $26,000, Spain starts from €23,000, Austria starts from €25,000.

The Experts Medical website presents prices for heart surgeries, including valve replacement, in specific foreign clinics. For more detailed information on the cost of the procedure, please contact Experts Medical coordinating doctors.

The most successful results in primary replacement and reimplantation of heart valves by cardiac surgeons in Israel, Germany, Turkey, Spain, and Austria.

Thanks to reviews from its patients, Experts Medical has compiled the TOP 5 best hospitals that it can recommend for heart valve replacement:

1. University Hospital Essen in Germany. It is considered one of the most advanced hospitals in the country and is included in the TOP 100 best hospitals in the world according to Newsweek. Essen conducts research work in many medical fields, including cardiac surgery. This is the medical base of the University of Duisburg-Essen. In the clinic, valve replacement is performed by experienced doctors using minimally invasive technologies.
2. Sourasky Hospital (Ichilov) in Tel Aviv. The best clinic in Israel in 2019. Research base of Tel Aviv University. For heart valve replacement, optimal prices are set here, which are controlled by the Israeli Ministry of Health. Souraski has the highest number of positive reviews among patients who have undergone heart surgery. In-demand cardiac surgeons – Dr. Ben-Gal Yanai, winner of the. Ami Cohen for outstanding services, cardiologist Banai Shmuel, who has 34 years of experience and a large number of scientific works.
3. Schneider Children’s Medical Center in Tel Aviv. A university hospital known throughout the world for its unique operations in various fields, including cardiac surgery. Here they perform the most complex heart surgeries from 0 to 18 years old using advanced technologies and modern equipment. Every year, 500 surgical cardiac interventions and 1,200 catheterizations are performed here. Among the center’s achievements is open-heart surgery on a premature 800-gram baby. The operations are performed by the famous Israeli heart surgeon Birk Einat.
4. Memorial Medical Network in Turkey. One of the most popular Turkish clinics for valve replacement. The most sought-after specialist is cardiologist Ali Oto, who has over 38 years of experience. He is a world-renowned specialist in the field of cardiovascular diseases and has performed more than 5,000 heart valve replacements and coronary stents.
5. Assuta Clinic in Tel Aviv. The hospital specializes in precision surgery. Unique specialists work here who perform operations that are not yet available in other clinics in Israel and around the world. Among them are Professor Uretsky Gideon and Professor Alexander Tenenbaum, the founder of a new direction in cardiology – cardiovascular diabetology.

When choosing a medical center, patients are advised to pay attention to the following information:

• hospital level;
• the price of heart surgery to replace a valve;
• availability of international quality certificates;
• the number of procedures performed and the qualifications of the cardiac surgeon.

On the Experts Medical website you can find prices for diagnostic procedures and heart surgery for valve replacement in clinics abroad and read real reviews. For more detailed information, you need to call the company’s doctors.

In order to undergo surgery in the best foreign hospitals with experienced surgeons as quickly as possible, you need to leave a request on the Experts Medical website.

Coordinating doctors will help the patient:

• choose a clinic and a cardiac surgeon, taking into account the price of heart surgery to replace the valve;
• prepare medical documentation that will be handed over to the doctor for review;
• book hotel rooms and air tickets;
• Organize transfer from the airport to the clinic.

If necessary, Experts Medical will organize a preliminary online consultation between the patient and the attending physician.

With the support of Experts Medical, heart valve replacement will be as comfortable, organized and cost-free for the patient as possible.