Best Doctors in India for Aortic Valve Repair / Replacement

Profile Highlights:

  • Dr. Naresh Trehan is one of the most highly skilled and globally recognized cardiothoracic and vascular surgeons.
  • His experience encompasses 40+ years and is considered one of the most successful and accomplished cardiac surgeons in the country.
  • Dr. Naresh Trehan specializes in cardiovascular surgery, cardiothoracic surgery, Heart Transplant, and Minimally Invasive Cardiac Surgery and has performed more than 48,000 successful open-heart surgeries to date.
  • He started his career as a Cardiac Surgeon at New York University Medical Centre where he performed over 3000 coronary artery surgeries and returned to India in 1988 and founded the Escorts Heart Institute and Research Center in New Delhi.
  • Dr. Trehan is the Founder Chairman of Medanta- The Medicity in Gurugram, a premier multi-specialty hospital with state-of-the-art infrastructure and equipped with the latest and advanced technologies.

Profile Highlights:

  • Dr. Anil Bhan is an excellent Cardiovascular and thoracic surgeon who has performed more than 15,000 cardiac and vascular surgeries that include heart transplant surgery, aortic aneurysm surgery, pediatric cardiac surgery, valve repairs, and peripheral vascular surgery among several others.
  • He is one of the best pediatric cardiac surgeons in Delhi/ NCR and is credited with performing heart bypass surgery on the youngest patient in India in 2007 (18 months).
  • He performed the first extracorporeal membrane oxygenation (ECMO) and was the first to use a harmonic scalpel for harvesting radial mammary artery conduits in India in 2000 and 1995 respectively.

Profile Highlights:

  • Dr. Ajay Kaul is a leading name in the field of Cardiothoracic and Vascular Surgery in India.
  • He has over 3 decades of experience in performing cardiac surgeries and has done more than 25,000 cardiac operations till date.
  • He specializes in Coronary Bypass surgery and is one of the best with the highest number of total arterial coronary bypass surgery (4000+) by using two internal mammary arteries from the chest and without any cuts on arms and legs.
  • Dr. Ajay Kaul’s interest lies in complex congenital cardiac diseases in children, pediatric cardiac surgery, aneurysm surgery, valve repair surgery, and cardiac failure surgery.
  • He is also an expert in minimally invasive cardiac surgeries (MICS) and has performed more than 5000 MICS which is the highest by any cardiac surgeon in India.

Profile Highlights:

  • Dr. Z. S. Meharwal is a highly esteemed and accomplished Cardiac Surgeon, serving as the Chairman and Head of Adult Cardiac Surgery at Fortis Okhla, where he leads the Cardiac Sciences and Adult Cardiothoracic and Vascular Surgery (CTVS) departments.
  • With over 30 years of unparalleled experience, Dr. Meharwal has performed more than 30,000 cardiac surgeries, including some of the most complex heart operations and Left Ventricular Assist Device (LVAD) implantations.
  • Dr. Meharwal holds prestigious degrees in medicine, including MBBS, MS, M.Ch, and MNAMS.

Profile Highlights:

  • Dr. Rajneesh Malhotra is a distinguished cardiovascular and thoracic surgeon in India with over 31 years of experience.
  • He is a prominent leader in the field of Cardiac Sciences and Cardiac Surgery (CTVS).
  • Currently serving as the Vice Chairman and Head of CTVS at Max Healthcare, Dr. Malhotra has a robust background in both traditional and advanced cardiac surgical techniques.

Profile Highlights:

  • Dr. Vivek Jawali is a renowned Cardiothoracic and Vascular Surgeon in India and has performed more than 18,000 cardiothoracic and cardiovascular surgeries.
  • He has several firsts to his credit that including the first beating heart bypass surgery in 1992 and the first Minimally Invasive Heart Bypass surgery in 1994 in India.
  • He performed the first Awake Cardiac Surgery in 1999 which is done without general anesthesia or ventilator but under continuous high thoracic epidural. He also performed the first awake open heart surgery in the world without general anesthesia or ventilator on a 74-year-old patient for triple bypass with aortic valve replacement.

Profile Highlights:

  • Dr. Anvay Mulay is a renowned Consultant Cardio-thoracic Surgeon at Sir H. N. Reliance Foundation Hospital, specializing in advanced Cardiovascular, Thoracic Surgery, and Heart Transplant.
  • With over 30 years of global experience, he has a distinguished track record in leading-edge cardiac care.
  • Dr. Anvay Mulay has worked at Leeds General Infirmary, Providence St Vincent Hospital, and Bristol Royal Infirmary.
  • He holds an MBBS and MS from Grant Medical College, Mumbai, an MCh from the University of Mumbai, and completed his fellowship at St. Vincent’s Hospital, Oregon.

Profile Highlights:

  • Dr. Mukesh Goel is a distinguished Cardiothoracic and Vascular Surgeon with an impressive 21 years of experience in the field.
  • Currently affiliated with Apollo Hospitals Indraprastha in New Delhi, Dr. Goel is renowned for his expertise in managing complex cardiac and vascular conditions.
  • His extensive qualifications include an MBBS, MS, and MCh, which equip him with the comprehensive knowledge required to handle a diverse range of cardiovascular and thoracic disorders.

Profile Highlights:

  • Dr. Zainulabedin Hamdulay is one of the best cardiac surgeons in Mumbai, India, and specializes in devising new and innovative techniques for cardiac surgeries.
  • He has 24+ years of experience and has performed over 8000 cardiac surgeries that included complex valve repairs, congenital cardiac surgery, CABG, and several minimally invasive cardiac surgeries.
  • With a motive to provide the best, affordable and comprehensive cardiac care to all his patients, he founded the Hamdulay Heart Foundation to provide aid to the economically backward community.

Profile Highlights:

  • Dr. Sushant Srivastava is a highly respected Cardio-Vascular Surgeon with a distinguished career spanning over two decades.
  • He is currently the Chairperson for Heart & Lungs Transplant at Artemis Hospitals, Gurugram.
  • An expert in Cardio Thoracic and Vascular Surgery, Dr. Srivastava has performed over 10,000 surgeries, making significant contributions to the field with his expertise in complex procedures.

Best Hospitals in India for Aortic Valve Repair and Replacement

Hospital Highlights:

  • Over the last 33 years, the Fortis Escorts Heart Institute has set new standards in cardiac treatment with groundbreaking research. It is now known around the world as a centre of expertise for Cardiac Bypass Surgery, Interventional Cardiology, Non-invasive Cardiology, Paediatric Cardiology, and Paediatric Cardiac Surgery.
  • The hospital has cutting-edge laboratories that perform a wide range of diagnostic tests in Nuclear Medicine, Radiology, Biochemistry, Haematology, Transfusion Medicine, and Microbiology.
  • Fortis Escorts Heart Institute boasts a diverse group of bright and experienced doctors who are backed up by a team of highly qualified, experienced, and devoted support professionals as well as cutting-edge equipment such as the recently installed Dual CT Scan.
  • Approximately 200 cardiac doctors and 1600 personnel currently collaborate to manage over 14,500 admissions and 7,200 emergency situations each year. The hospital now has a 310-bed infrastructure, as well as five cath labs and a slew of other world-class amenities.

Hospital Highlights:

In the sprawling city of Faridabad, where healthcare needs are diverse and ever-evolving, one institution has consistently stood out as a beacon of excellence in the field of medicine—Marengo Asia Hospital. Established with a vision to provide world-class healthcare services to the community it serves, Marengo Asia Hospital has emerged as a trusted name synonymous with quality, compassion, and innovation in healthcare.

Hospital Highlights:

  • Equipped with 650 beds, BLK-Max Super Speciality Hospital is the largest stand-alone private sector hospital in Delhi.
  • With over 1500 healthcare providers and 150 globally renowned super specialists, the hospital is one of Asia’s largest BMT Centres. The hospital is known for having some of the best cancer doctors in the country.
  • The hospital is NABH and NABL accredited and was inaugurated by the first Prime Minister of India. Pt. Jawahar Lal Nehru.

Hospital Highlights:

  • Located in Chennai, India, MGM Healthcare is a top multispecialty hospital that provides all medical services under one roof.
  • Since its founding in 2019, MGM Healthcare has quickly become a leading national referral centre, creating several innovative flagship initiatives.
  • MGM Healthcare combines next-generation medical and digital technologies to provide better patient results.
  • With 12 centres of excellence, more than 400 inpatient beds, 100 intensive care unit beds, and 24/7 emergency care, MGM Healthcare leaves no chance in redefining the patient experience in Chennai.
  • MGM Healthcare boasts 250+ expert doctors across 30+ departments, including Cardiology, Pulmonology, Neurology, Obstetrics & Gynaecology, and more.
  • They house 12 specialized Centres of Excellence, including Neurosciences, Orthopaedics, and Multi-Organ Transplantation.
  • Their team of doctors, nurses, and paramedics works together to give every patient individualized treatment.

Hospital Highlights:

  • Fortis Hospital, Noida, stands as one of the oldest and most trusted healthcare institutions in the region, setting a benchmark for comprehensive medical care.
  • As the second mega hub hospital in the Fortis Healthcare Group, Fortis Hospital, Noida, upholds a legacy of trust among more than 1.2 million patients. By integrating top-tier professionals with cutting-edge technology, the hospital delivers superior treatment across various medical disciplines.
  • Specializing in advanced Neurosciences, Orthopedics, Kidney and Liver Transplant Programmes, Fortis Hospital, Noida has successfully performed over 1,500 transplants, solidifying its reputation as a leader in specialized medical interventions.

Aortic Valve Replacement

Aortic Valve replacement is a procedure that is required if there is a problem in the aortic valve of your heart. When this valve opens, the blood from your heart goes to the aorta and on to the rest of your body. When the aortic valve closes, it helps to keep blood from flowing the wrong way back into your heart. With every heartbeat this cycle keeps repeating. If there is something that goes wrong with your valve, it can interfere with the blood flow, which can force the heart to work harder to send blood to the rest of your body. In such a condition, your doctor might recommend surgery for replacing it. Generally, your doctor initially considers repairing the aortic valve. However, when valves can’t be repaired, heart valve replacement is considered.

Purpose

There are several types of valve diseases for which aortic valve replacement might be considered. Some of them include:

Aortic valve regurgitation- This condition is known to occur when your blood flows backward through your aortic valve into the left ventricle each time the ventricle relaxes. Normally, blood is supposed to flow in one-way direction from the ventricle to the aorta. A dysfunctional or a leaky valve can lead to the backflow. This may be due to the valve deteriorating, an abnormal valve shape present at birth or due to an infection.

Aortic valve stenosis- The stenosis can lead an aortic valve to become narrowed or obstructed, which can make it even more difficult for the heart to pump blood into the aorta. This may be caused by multiple factors, such as congenital heart disease, thickening of the valve’s closure flaps or post-inflammatory changes, such as those which are associated with rheumatic heart disease.

Congenital heart disease- This can contribute to either aortic valve regurgitation or stenosis. It can also result in other problems that can prevent the proper functioning of the aortic valve. For example, a person might be born with an aortic valve not having enough tissue flaps or there may not be an opening in the valve to allow normal blood flow. The valve can also be of the wrong shape of size.

For some people who are having mild aortic valve disease without any symptoms, careful monitoring under an experienced doctor’s supervision might be all that is required.

However, in many cases aortic valve disease and dysfunction can worsen over time despite medical treatment. Most aortic valve conditions are mechanical problems that are not treatable with medications alone. Such conditions can eventually require surgery for reducing symptoms.

Your doctor and healthcare team will decide whether to go for repair or replacing the heart valve. It can depend on various factors, such as the severity of your aortic valve disease, your age and overall health or whether you require any heart surgery for any additional heart problem.

Preparation

Before you undergo the surgery for having your aortic valve repaired or replaced, your doctor and treatment team will be explaining what you can expect before, during and after your surgery as well as the potential risks the surgery may cause.

You need to discuss with your doctor and the treatment team any questions you might have about your procedure.

Before you are admitted to the hospital for your surgery, talk to your caregivers about your hospital stay and discuss any help you may require when you return home.

Also remember to talk to your doctor about when you can resume taking your medications regularly and whether you will be able to take them before your surgery. Also, ask whether you should stop eating or drinking the night before the surgery. You may also need to bring several items to the hospital including a list of your medications, eyeglasses, hearing aids, etc.

Procedure

For the aortic valve replacement procedure, you will be receiving anesthetics so that you will not be feeling any pain. You will be unconscious during the procedure.

You will be connected to a heart-lung bypass machine, which will keep your blood moving through your body during the procedure.

First, your doctor will be removing the aortic valve and replacing it with a mechanical valve or a valve made from a pig, cow or human heart tissue (valve).

Often biological tissue valves eventually need replacement as they degenerate over time. If you have a mechanical valve, you will require blood-thinning medications for the rest of your life for preventing blood clots. Doctors will be discussing with you the risks as well as the benefits of each type of valve and discuss which valve is appropriate for you.

The surgery can be performed through traditional open-heart surgery or minimally invasive methods. It involves smaller incisions than those used in open-heart surgery. There is another type of minimally invasive aortic valve replacement which is known as transcatheter aortic valve replacement.

However, minimally invasive aortic valve replacement is generally less common since not all situations are best addressed by this method of access to the damaged valve. Results similar to those with traditional open-heart surgery can be achieved if it is performed by experienced surgeons.

After the procedure

If you had open-heart surgery, you will generally require spending a day or more in the ICU. You will receive oxygen, fluids, medications as well as nutrition through the intensive care unit. Other tubes will be draining urine from your bladder, draining fluid and blood from your chest.

Later you’ll be moved to a regular hospital room where you will need to spend some days. The amount of time you will spend in the ICU and hospital may vary depending on your condition and procedure.

During your stay at the hospital, your treatment team will be watching for signs of infection in your incision sites. They will also be checking your blood pressure, breathing and heart rate periodically. If you experience pain after the surgery, they will be working with you in managing it.

Your doctor might also advise you to avoid driving a car or lifting anything more than 10 pounds for a few weeks.

Risks

There are certain risks associated with aortic valve replacement. The type of procedure and the expertise of your health care team also plays a role.

Although most people do well during this surgery, it might lead to a few problems, which include:

  • Bleeding after surgery
  • Infection
  • Blood clots
  • Heart rhythm getting thrown off for a while
  • Kidney problems that can last for multiple days after surgery
  • Stroke
  • New valve not functioning or wearing out over time

 

Although rare death can also occur in a few cases. To minimize risk it is recommended that the surgery is performed by an experienced team of qualified doctors.

Aortic Valve Replacement & Aortic Valve Repair

Aortic valve repair and aortic valve replacement are procedures that treat diseases affecting the aortic valve. Types of Aortic Valve Surgery are:

  • An annuloplasty is a procedure to tighten or reinforce the ring around a valve in the heart.
  • A valvuloplasty, also known as balloon valvuloplasty or balloon valvotomy, is a procedure to repair a heart valve that has a narrowed opening.

Open Heart surgery versus Catheter method of Heart Replacement

Traditionally, all valve replacement procedures required a open-heart surgery. However, recent advances in catheter methods have resulted in the development of catheter- based (non-surgical)  heart valve replacement procedures.

The Catheter based  approach to Valve Repair is generally recommended in case of Valve Stenosis (condition in which the valve narrows down).The procedure is called Transaortic Valve Implantation/ Replacement (TAVI/TAVR) for Aortic Valve Repair. In case of Mitral Valve Repair, it is called Transaortic Mirtral Valve Implantation/ Replacement (TMVI/R).

TAVI / TMVI is the first line of treatment in cases of Valve narrowing /stenosis.

The advantage of TAVI/TMVR is that in this procedure, the valve is replaced with no scar (unlike surgery) and recovery time is minimal. 

However, in cases of Valve Regurgiation (leakage), surgery is still required / recommended.

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