The primary function of heart valves is to make sure that the blood flows freely in the heart in one direction and does not leak back into the heart. When one or more heart valves don't open or close properly, a backflow of blood can occur. Valve stenosis (stiffness) and valve regurgitation (leaky valve) are two major conditions that may cause dysfunction of the valves. Such diseased or damaged heart valves may need to be repaired or replaced. Based on the symptoms and overall condition of your heart, the doctor decides whether the diseased valve(s) needs to be surgically repaired or replaced.

The major cause of a damaged or diseased valve is stenosis (stiffness) or narrowing of blood vessels (which can be caused due to rheumatic fever, birth defects, infection or aging). These conditions may lead to a decrease in the amount of blood that flows to the heart. Leaky valves can also be a problem. One or more valves may remain slightly open instead of closing tightly, letting the blood flow backward. This is called regurgitation.

Damaged or diseased heart valves majorly cause disruption in the blood flow through your heart to your body, resulting in uncomfortable symptoms. If the valve damage is mild, it can be treated with medicines. But, if damage to the valve is severe, surgery to repair or replace the valve may be needed.

The primary sign of heart valve disease is a heart murmur (an unusual heartbeat noise). Symptoms and signs include:

• Chest pain
• Breathing difficulties
• Unusual fatigue (tiredness) or weakness
• Dizziness
• Swelling of the feet, ankles, legs, abdomen and veins in the neck
• Rapid weight gain due to fluid retention
• Fluttering, racing or irregular heartbeat
• Light-headedness or loss of consciousness

For the identification of heart valve disease, the doctor will first check for the signs and symptoms. Later, your doctor will conduct a physical examination and listen for a heart murmur, a major sign of heart valve damage. Finally, the below tests would be performed for confirmation:

• Echocardiogram
• Electrocardiogram
• Cardiac catheterization
• Stress Evaluation
• Cardiac MRI

Valve repair may be done using a ring to support the damaged valve or the entire valve may be removed and replaced by an artificial valve. Open-heart surgery is the conventional procedure used to repair or replace heart valves. The latest less invasive techniques are also available to replace or repair heart valves.

Depending on the type of valve and the severity of your symptoms, your doctor might recommend a surgical procedure or a transcatheter, a minimally invasive procedure to repair or replace the leaky valve. When possible, heart valves are repaired rather than replaced.

• Eat a heart-healthy diet.
• Improve physical activity, other heart-healthy lifestyle changes
• Check your blood pressure regularly
• Quit smoking
• Keep your teeth and gums healthy
• Get your heart murmur checked periodically
• Keep your weight in check
• Decrease salt intake
• Be sure to treat rheumatic fever as soon as you notice symptoms like sore throat and fever

Recovery after valve surgery may take a long time, depending on how healthy you were before the operation. You will have to rest and limit your activities. Your doctor may want you to begin an exercise program or to join a cardiac rehabilitation program. You can expect to stay in the hospital for about a week, including at least 1 to 3 days in the Intensive Care Unit (ICU).

Yes, heart valve repair is major surgery. Possible risks associated with the heart valve repair or replacement surgery include:

• Infection
• Bleeding during or after the surgery
• Pneumonia
• Blood clots that can cause heart attack, stroke or lung problems
• Pancreatitis
• Breathing problems
• Arrhythmias (abnormal heart rhythms)
• Death

The average cost of heart valve replacement surgery in India is approximately Rs. 3,00,000 to 5,00,000. However, the prices may vary depending upon various factors, including:

• Hospital Factors (type of hospitals, insurance coverage, etc)
• Technology/Approach (surgery and sedation type, the extent of surgery needed etc)
• Patient Factors (diagnosis, room selected, conjunction treatment)