Best Doctors in India for Aortic Valve Repair / Replacement

Profile Highlights:

  • Dr. Z S Meharwal is a well-known cardiac surgeon in India who has performed over 20,000 cardiac surgeries, including some of the most complex and high-risk cardiac procedures.
  • Dr. Meharwal is a member of the founding team that started the Fortis Escorts Heart Institute and has been associated with the hospital since then.
  • His interest lies in Minimally Invasive Cardiac procedures, valve repair, and replacement, and heart transplants among other major vascular and thoracic surgeries.

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 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. Naresh Trehan is one of the most highly skilled and globally recognized cardiothoracic and vascular surgeons.
  • 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.
Dr. Mukesh Goel
Senior Consultant, Cardio Thoracic and Vascular Surgery Indraprastha Apollo Hospital, New Delhi

Profile Highlights:

  • Dr. Mukesh Goel is a reputed Cardio-Thoracic and Vascular surgeon serving as a Senior Consultant of the specialty at Indraprastha Apollo Hospital, New Delhi.
  • He carries an experience of 16+ years and has performed more than 3000 different cardiac surgeries. Dr. Mukesh Goel is constantly on the lookout to develop new and innovative techniques to perform cardiac procedures that help in quick recovery with minimum incisions.
  • His expertise lies in on and off-pump bypass surgeries and also finds interest in beating heart bypass surgery, open-heart surgery, minimally invasive heart valve surgery, and pediatric cardiac surgery among several others.
  • Dr. Mukesh Goel received his training in CTVS from one of the most renowned cardiac surgeons in India, Dr. Naresh Trehan, and has been using the exposure to perform various advanced and complex heart surgeries.
  • Before joining Indraprastha, Dr. Goel has been associated with other prestigious heart centers in India like Escorts Heart Institute, Apollo Hospital in New Delhi, and Medanta in Gurugram where he helped in starting the Heart surgery unit.
  • He frequently gets invited to attend cardiology conferences and seminars to deliver lectures and present papers. He also regularly takes part in workshops and CMEs for cardiac surgeries.
  • Dr. Mukesh Goel is a keen researcher and has published a number of papers and articles on CTVS in renowned national and international medical journals.

Profile Highlights:

  • Dr. Sandeep Attawar is a highly recognized Heart and Lung transplant surgeon in India who has over 2 decades of experience as a cardiac surgeon and has performed more than 10,000 cardiac surgeries on adult and pediatric patients.
  • Dr. Attawar specializes in all types of surgeries for adults as well as pediatric heart patients and finds interest in heart and lung transplant surgery, congenital heart surgery, Aortic aneurysm repair, and implantation of heart failure devices.

Profile Highlights:

  • Padma Bhushan awardee Dr. Girinath M R is a senior cardio-thoracic Surgeon in Chennai having experience of more than 45 years in Cardiac Surgery.
  • Dr. M R Girinath was a fellow of Coronary Artery Surgery and Congenital Heart Surgery at the University of Wisconsin, USA.
  • He provides consultation and diagnostic services for Mitral/Heart Valve Replacement, Cardiac Pacing, Invasive Cardiology, ABPM, Balloon Mitral Valvuloplasty, CT Angiography, etc.

Profile Highlights:

  • Dr. Neville Solomon is one of the best Cardiothoracic Surgeons in South India.
  • Dr. Neville Solomon heads the Cardiology unit; his team has performed over 6000 heart operations to date, including 3000 congenital cardiac surgeries in newborns and adults
  • In addition to this, Dr. Solomon runs the Save a Child’s Heart Initiative (SACHI) Program with his associates at Apollo Hospital.

Profile Highlights:

  • LF Sridhar is a well-known Cardiothoracic & Vascular Surgeon in Chennai, now working at Apollo Hospital in Greams Road, Chennai, and has an experience of 37 years in this arena.
  • Some of the services available with the doctor are Mitral/Heart Valve Replacement, Cardiac Pacing, and Intra – Arterial Thrombolysis, Pacemaker Implantation, and bypass surgery besides the regular OPD procedures.

Profile Highlights:

  • Dr. K Madhan Kumar is a well-known Cardiac Surgeon in Tamil Nadu, having many years of experience in the domain.
  • His experience came from practice and teaching. These days, he is associated with Apollo Hospital Greams Road in Chennai as a Senior Consultant Cardiothoracic & Transplant Surgeon.
  • Dr. Kumar has also completed Fellowships in Cardiothoracic Surgery at SGH in London as well as ECMO, VAD, and transplantation at HH in London.

Profile Highlights:

  • Dr. Kulbhushan Singh Dagar, a pioneer and an expert in the cardiology field earned his reputation through his exceptional performance in the field of complex congenital heart defects, especially for newborns.
  • With over 21 years of experience, Dr. Dagar has dedicatedly performed complex surgical procedures by implementing innovative techniques and cutting-edge technologies in his procedures and is currently considered an asset to the cardiac industry, not just nationally, but internationally too!

Best Hospitals in India for Aortic Valve Repair and Replacement

Indraprastha Apollo Hospital, New Delhi

Hospital Highlights:

  • Indraprastha Apollo Hospital is a 700-bedded multispecialty hospital in the heart of the capital of India. It is a part of Apollo Hospital group, one of India’s most reputed healthcare chains. Indraprastha Apollo Hospital has been accredited by Joint Commission International, making it the first internationally accredited hospital in the country in 2005.
  • There are 52 specialties in the hospital with one of the best cardiology centers in the country. The hospital is also equipped with State of the art infrastructure facilities with the largest Sleep Lab in Asia and the largest number of ICU bed facilities in India.
  • The hospital also has one of the largest dialysis units in India along with a dedicated Bone Marrow Transplant unit.
  • The latest and highly advanced technologies that are installed in the hospital include Da Vinci Robotic Surgery System, PET-MR, PET-CT, Cobalt-based HDR Brachytherapy, Brain Lab Navigation System, Tilting MRI, Portable CT scanner, 3 Tesla MRI, 128 Slice CT scanner, DSA Lab, Endosonography, Hyperbaric Chamber and Fibro scan.

Fortis Memorial Research Institute, Gurugram

Hospital Highlights:

  • Fortis Memorial Research Institute is a multi-super-specialty, quaternary care hospital with 1000 beds. The hospital comprises reputed clinicians, and international faculty and is also equipped with cutting-edge technology. The hospital is a part of Fortis Healthcare Limited, a reputed chain of private hospitals in India.
  • It is a NABH-accredited hospital that is spread across 11 acres of land and has a capacity of 1000 beds. The hospital has 55 specialties and is one of the premier health care centers in the Asia Pacific region popularly known as “the Mecca of Healthcare”.
  • The hospital has 260 diagnostic centers and is also equipped with the latest and advanced techniques that include 3 Telsa which is the world’s first Digital MRI technology. The hospital also has world-class Radiation Therapy techniques which have been developed by leading technology experts from Elekta and Brain Lab.

Apollo Hospital, Chennai

Hospital Highlights:

  • Apollo Hospitals, Chennai, is one of the best hospitals for heart care in India. Over the years, Apollo has expanded all over India, as a healthcare chain.
  • India’s first ‘Only Pancreas’ transplant was performed in Apollo Hospital. The hospital is known for successfully performing Asia’s first en-bloc combined heart and liver transplant, and over the years, it has attained a remarkable achievement in the global healthcare space. Around 3-4 organ transplants are performed in the hospital per day.
  • Equipped with over 500 beds, this hospital in Chennai was established in 1983 and since then has been among the most preferred hospital for patients from all over the world.
  • The hospital holds accreditation of the NABH and JCI and is the first hospital in India to be ISO 9001 and ISO 14001 certified. It is also the first South Indian Hospital to receive subsequent reaccreditation from the JCI USA 4 times.

Medanta-The Medicity, Gurgaon

Hospital Highlights:

  • One of India’s best and largest multi-specialty hospitals, Medanta was built with the aim to bring India to the highest standards of medical care. The hospital has been providing the best medical services to its patients, since its inception, with care, commitment, and compassion.
  • Equipped with 1250 beds, the hospital was founded by Dr. Naresh Trehan in the year 2009 with an aim to provide the best medical care at affordable costs. The hospital is spread across 43 acres and includes 45 operation theatres and 350 beds dedicated solely to ICU. The hospital includes over 800 doctors, and more than 22 specialty departments and has a dedicated floor for individual specialty in order to offer the best services under one roof.
  • The hospital is considered one of the premier institutes in India for Cardiac Care and includes staffs and members of high caliber. The hospital has 6 distinct centers of excellence.

Max Super Specialty Hospital, New Delhi

Hospital Highlights:

  • One of the well-regarded providers in India committed to the highest standards of clinical excellence and patient care, Max Super Specialty Hospital is a part of Max Healthcare, which is the second-largest healthcare chain in India. Regarded as one of the most well-regarded healthcare providers in the country, Max Super Specialty Hospital is committed to the highest standards of clinical excellence as well as patient care. The hospital is also equipped with the latest technology as well as cutting-edge research. The hospital is known to deliver and ensure the highest level of patient care.
  • The hospital has more than 500 beds and offers treatment for over 35 specialties. The hospital also holds the credit of having installed the first Brain Suite in Asia. This is a highly advanced Neurosurgical machine that allows MRI to be taken while surgery is ongoing.
  • Other advanced and latest technologies are also installed in the hospital such as the 1.5 Tesla MRI machine, 64 Slice CT Angiography, 4D ECHO, LINAC, and 3.5T MRI machine.

Artemis Hospital, Gurugram

Hospital Highlights:

  • One of the most well-known hospitals in the Delhi NCR, Artemis Hospital is the first hospital in Gurugram to get accredited by the Joint Commission International.
  • With more than 40 specialties, the hospital has been designed to be one of the most technically advanced hospitals in the country, with the best medical and surgical health care. The hospital has eleven special and dedicated centers, for Heart, Cancer, Neurosciences, etc.
  • The latest technologies in the hospital include Endovascular Hybrid Operating Suite and Flat panel Cath Labs for the cardiovascular department, 3 Tesla MRI, 16 slice PET CT, 64 Slice Cardiac CT Scan, HDR Brachytherapy, and highly advanced Image Guided Radiation Therapy techniques (LINAC) are installed in the hospital.
  • The hospital has won several awards as well, since its inception.

BLK Max Super Specialty Hospital, New Delhi

Hospital Highlights:

  • Equipped with 650 beds, BLK Superspecialty 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 Bone Marrow Transplant 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.

Gleneagles Global Hospitals, Chennai

Hospital Highlights:

  • Established in 1999, Gleneagles Global Hospital, Chennai, is one of the top healthcare facilities in Southern India. It is part of the Gleneagles Hospital Chain, which is the fourth largest healthcare chain in the country. The hospital specializes in multi-organ transplants of kidneys, liver, lungs, heart, etc.
  • The hospital has an excellent infrastructure and state-of-the-art lab and equipment set-up. The hospital boasts cutting-edge technologies, a highly skilled team of doctors and surgeons, and trained support staff. Located in Perumbakam, Chennai, it is one of India’s premier health care destinations. The hospital has performed some of the most complex surgical and clinical procedures in India including multi-organ transplantations.
  • The hospital’s lung transplantation program is one of the best in the country. The hospital is known for having performed India’s first single lung transplant and first minimal invasive lung transplant. It is also the only Indian hospital to be associated with King’s College Hospital, London, United Kingdom for liver transplantations.

Fortis Hospital, Mulund, Mumbai

Hospital Highlights:

  • Fortis Hospital in Mulund is a 315-bed multi-speciality tertiary care hospital with five JCI accreditations that offers a wide variety of diagnostic and therapeutic services. The Fortis Hospital in Mulund delivers patient-centred treatment with cutting-edge technology, highly skilled and experienced surgeons, and paramedical staff.
  • This institution houses Maharashtra’s largest multi-organ transplant centre. It is also the first heart transplant centre in western India to conduct 100 or more consecutive heart transplants in under four years. It is the only hospital in the city to have multi-organ transplants and has handled the youngest patient for angioplasty. Fortis Hospital Mulund now boasts the first advanced surgical robot in central Mumbai.
  • Cardiology and heart surgery, urology, nephrology, neurosciences, orthopaedics, digestive care, emergency and critical care, and maternity care are among the services provided by the hospital.

Kokilaben Dhirubhai Ambani Hospital, Mumbai

Hospital Highlights:

  • Kokilaben Dhirubhai Ambani Hospital, Named after the wife of Indian industrialist Dhirubhai Ambani, the founder of Reliance Industries, this is one of the top hospitals in Mumbai. This 750-bed multi-specialty hospital became operational in 2009. Known as one of India’s most advanced tertiary care facilities, the hospital is designed to raise India’s global standing as a healthcare hub, with an emphasis on excellence in clinical services.
  • Kokilaben Dhirubhai Ambani Hospital uses Protocol and Care Pathway based treatment models to ensure the best outcomes for patients.
  • The hospital represents a confluence of top-notch talent, cutting-edge technology, state-of-the-art infrastructure, and, most importantly commitment.
  • The hospital also holds the accreditation of the NABH, NABL, CAP, and JCI.
  • The hospital has been recognized as the No. 1 Multispecialty Hospital in Mumbai and the West Zone for the fifth year in a row in 2020 by The Week.

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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