Double Valve Replacement in Gurgaon, India

What is Double Valve Replacement (DVR)?

Double Valve Replacement (DVR) is a type of open-heart surgery performed to replace two malfunctioning heart valves, typically the aortic and mitral valves. This procedure is necessary when both valves are severely damaged due to conditions like valve stenosis (narrowing) or regurgitation (leakage), leading to symptoms such as fatigue, chest pain, shortness of breath, and swelling in the legs.

Types of Double Valve Replacement Procedures

When heart valves become too damaged or diseased to function properly, they can be repaired or replaced. In cases where replacement is necessary, patients and doctors choose between mechanical valves and bioprosthetic valves. Each type has its own advantages, risks, and specific uses based on the patient's age, lifestyle, and medical condition.

Mechanical Valves

Mechanical valves are made from strong, long-lasting materials such as carbon, titanium, or polyester. These are designed to mimic the function of natural heart valves and are highly durable.

Advantages

• Long lifespan: Can last 20 years or more, often outliving the patient.

• Ideal for younger patients: Especially for those under 60 who would otherwise need multiple surgeries for biological valves.

Bioprosthetic Valves (Tissue Valves)

Bioprosthetic valves are made from animal or human tissue. These valves are processed and treated so the body does not reject them and they can perform like natural valves.

Advantages

• No long-term anticoagulation therapy required (except in specific cases), making them suitable for older patients or those with bleeding risks.

• More natural blood flow and reduced risk of clot formation.

Subtypes of Bioprosthetic Valves

Allograft (Homograft)

• This is a valve taken from a human donor (either deceased or from a heart transplant).

• Commonly used in aortic valve replacements and in patients with infective endocarditis.

• Offers a good fit and works naturally with the body.

Porcine Valve

• Made from pig heart tissue, which closely resembles human heart valve structure.

• Processed and sterilised to reduce immune reaction.

• Commonly used in both aortic and mitral valve replacements.

Bovine Valve

• Made from cow heart tissue, typically pericardial tissue (sac around the heart).

• Known for durability and flexibility, making it a good option for many patients.

• Often used in minimally invasive valve procedures as well

When is the Double Valve Procedure Needed?

Double Valve Replacement (DVR) is a major heart surgery performed when both the aortic and mitral valves in the heart are damaged and no longer functioning properly. These two valves are crucial for controlling blood flow through the heart and into the body. When they become severely diseased, the heart cannot pump blood efficiently, leading to a range of serious health problems.

DVR is typically needed in the following conditions:

Valve Regurgitation (Leakage)

Valve regurgitation occurs when the valve does not close completely, causing blood to leak backward instead of moving forward through the heart.
This can lead to:

• Decreased blood supply to the body and brain

• Volume overload in the heart chambers, making the heart work harder

• Enlarged heart and eventual heart failure

If both the aortic and mitral valves are leaking, it puts immense pressure on the heart, and DVR may be the only way to restore proper function.

Valve Stenosis (Narrowing)

Valve stenosis happens when the valve leaflets become thick, stiff, or fused, making it difficult for blood to flow through the valve. This can result in:

• Obstructed blood flow from the heart to the body

• Increased heart pressure

• Reduced oxygen supply to organs
  Severe stenosis in both the mitral and aortic valves can significantly limit a person’s ability to breathe, exercise, or even perform daily tasks.

Combined Valve Disease

In many patients, one valve may be leaky while the other is narrowed. This mixed condition is even more dangerous because it affects both filling and pumping phases of the heart’s cycle, leading to serious complications if untreated.

Associated Symptoms That Indicate the Need for DVR Surgery

When both valves are failing, patients usually develop a combination of the following symptoms:

• Fatigue and weakness – due to poor oxygen circulation

• Shortness of breath – even with mild activity or when lying flat

• Chest pain or tightness – especially during physical effort

• Dizziness or fainting (syncope) – from poor blood flow to the brain

• Swelling (edema) – in the legs, ankles, or abdomen due to fluid buildup

• Palpitations – irregular or fast heartbeats

• Bluish lips or fingertips (cyanosis) – in severe cases where oxygen is low

Underlying Causes of Valve Damage

Common medical conditions that can lead to valve failure include:

• Rheumatic heart disease – often due to untreated strep throat infections

• Congenital heart defects – present at birth

• Infective endocarditis – infection of the heart lining or valves

• Age-related degeneration – as valves wear out over time

• Calcium buildup, which makes valves stiff

Some Symptoms of a Leaky or Irreparable Valve Include

When a heart valve becomes leaky (regurgitation) or stiff and narrowed (stenosis), it can't control blood flow properly. This puts pressure on the heart and reduces the amount of oxygen-rich blood reaching the body. As a result, a variety of symptoms can appear, ranging from mild to severe, depending on how advanced the condition is. Here’s an overview of the most common symptoms and why they happen:

Fatigue and Dizziness

When your heart valves don’t open or close properly, your heart has to work harder to pump blood. This can reduce the amount of oxygen-rich blood reaching your muscles and brain. As a result, you may feel tired all the time, even after a full night's sleep, and dizzy during light activity. Tasks that were once easy, like walking short distances or climbing stairs, can become exhausting.

Dizziness

Dizziness is a common symptom of poor blood flow to the brain. When the heart can’t pump enough blood due to leaky or narrowed valves, your brain receives less oxygen, which can make you feel unsteady, light-headed, or as if the room is spinning. In some cases, this can even lead to fainting spells, especially during physical exertion.

Cyanosis

Cyanosis refers to a bluish or purplish tint to the skin, lips, or fingernails. It happens when your body doesn’t get enough oxygen due to poor circulation. In people with severe valve disease, the lack of oxygen in the blood becomes visible, particularly in the extremities or during cold weather or activity.

Chest Pain

Chest pain, or angina, can occur when your heart muscle isn’t getting enough oxygen. As the heart struggles to pump against the faulty valves, it may become overworked, especially during exercise or stress. This can lead to tightness, pressure, or a squeezing feeling in the chest. It’s a serious symptom that shouldn’t be ignored.

Lightheadedness

Lightheadedness is closely related to dizziness, but may feel more like you’re about to faint. It can occur suddenly and is usually triggered by standing up too quickly, overexertion, or dehydration. In the context of valve disease, it’s caused by a drop in blood pressure or a temporary lack of oxygen to the brain.

Fluid Retention (Especially in the Lower Limbs)

When the heart valves fail to circulate blood properly, fluid can accumulate in the body, especially in the legs, ankles, and feet. This condition, called oedema, causes noticeable swelling and heaviness, particularly by the end of the day. In severe cases, fluid may also collect in the lungs or abdomen, making breathing and digestion more difficult.

Who is a Candidate for DVR Surgery?

Double Valve Replacement (DVR) surgery is a specialised procedure meant for people who have severe damage to both the aortic and mitral valves. It is usually recommended when the valve damage is so extensive that it affects heart function and causes troubling symptoms, even with medication or other non-surgical treatments. Below is a detailed look at who qualifies for this surgery and who might not. Ideal Candidates for DVR Surgery

Individuals with Severe Valve Disease (Both Aortic and Mitral Valves)

• These patients often suffer from a combination of stenosis (narrowing) and/or regurgitation (leakage) in both valves.

• The dual valve failure puts excessive strain on the heart, which can lead to heart failure, arrhythmias, or even sudden cardiac arrest if not treated surgically.

• Diagnostic tests like echocardiograms, cardiac MRI, and heart catheterisation help confirm the extent of the valve damage.

Patients with Significant, Worsening Symptoms

• People who feel shortness of breath, chest pain, fatigue, swelling, or have frequent dizziness or fainting spells may be suitable for DVR.

• These symptoms suggest that the heart is no longer coping well, and surgery could dramatically improve quality of life and longevity.

Patients Who Have Not Responded to Medications or Other Therapies

• In many cases, doctors first try medications such as diuretics, beta-blockers, or ACE inhibitors to relieve symptoms.

• When these medications are no longer effective or the condition progresses despite treatment, surgery becomes necessary to fix the underlying problem.

Patients with Acceptable Overall Health

• Candidates need to be in good enough general health to tolerate anesthesia and the stress of open-heart surgery.

• Pre-surgical evaluations typically include blood work, lung function tests, and cardiac stress testing to assess readiness.

How to Prepare for DVR Surgery?

Preparing for Double Valve Replacement (DVR) surgery is a crucial step in ensuring a smooth procedure and a successful recovery. This major heart surgery requires careful planning, medical evaluations, and lifestyle adjustments in the days or weeks before the operation. Here’s a detailed look at how patients should get ready for DVR surgery:

Medical Tests and Evaluations

Before the surgery, your medical team will conduct several tests to assess heart function and overall health, including:

• Echocardiogram: Uses ultrasound waves to visualize the heart valves and measure how well they are working.

• CT scan or MRI: Provides detailed images of the heart and blood vessels to help plan the surgery.

• Chest X-ray: Evaluates lung health and heart size.

• Electrocardiogram (ECG): Checks for irregular heart rhythms.

• Blood tests: Assess kidney and liver function, check for anemia or infection, and determine blood type.

• Coronary angiogram (if needed): Examines blood flow in the coronary arteries to see if bypass surgery is also required.

Discussing Current Medications

Your doctor will ask for a list of all medications, supplements, or herbal products you are taking. Some drugs may need to be stopped or adjusted before surgery, including:

• Blood thinners: May be paused a few days before to reduce bleeding risk.

• Diabetes medications: Dosages might be changed, especially if you are fasting.

• Blood pressure medications: Your cardiologist will guide whether to continue them.

• Herbal supplements: Some can interfere with anesthesia or increase bleeding and should be stopped.

Fasting Before Surgery

You’ll be instructed to avoid eating or drinking for 8–12 hours before the operation. This is done to prevent aspiration (inhaling food or liquid into the lungs) during anesthesia.

• Typically, you’ll be asked to stop eating after midnight the night before surgery.

• You may be allowed to take small sips of water for essential medications, but only if your doctor permits.

Planning for Post-Surgery Recovery at Home

DVR surgery requires a hospital stay of 5–7 days, followed by 4–8 weeks of home recovery. To make this period easier:

• Arrange for help at home: You'll need someone to assist with daily tasks like cooking, cleaning, and transportation, especially during the first two weeks.

• Prepare your home: Place frequently used items within easy reach and remove tripping hazards.

• Stock up on easy-to-prepare meals or ask a family member to help with cooking.

• Plan time off work and avoid strenuous activities until cleared by your doctor.

Lifestyle Changes Before Surgery

Making healthy lifestyle choices before surgery can improve your recovery:

• Quit smoking at least 2–4 weeks before surgery—it helps improve lung function and healing.

• Reduce alcohol intake as advised by your doctor.

• Eat a balanced diet to build strength for recovery.

• Stay active with light exercise if recommended—this helps keep your body strong for surgery.

Mental and Emotional Preparation

DVR surgery is a major procedure, and it’s normal to feel anxious. You can prepare mentally by:

• Talking to your doctor about what to expect during and after surgery.

• Speaking with a counsellor or support group if you feel overwhelmed.

• Practising relaxation techniques like deep breathing or meditation to manage stress.

How is the Double Valve Replacement Procedure Performed?

Double Valve Replacement (DVR) is a complex but life-saving open-heart surgery used to replace two malfunctioning heart valves, usually the aortic and mitral valves. These valves regulate blood flow between the heart chambers and the rest of the body. When both are damaged, it severely affects heart function, and DVR becomes necessary. Here’s a step-by-step breakdown of how the DVR procedure is typically performed:

Administering General Anesthesia

• The procedure begins with the administration of general anaesthesia so the patient is fully asleep and does not feel any pain.

• A breathing tube is inserted to support the patient’s breathing during surgery.

• The patient is also connected to monitors to track vital signs like heart rate, oxygen levels, and blood pressure.

Making a Chest Incision (Sternotomy)

• A long incision is made down the centre of the chest to access the heart. This is known as a median sternotomy, where the breastbone (sternum) is divided to open the chest cavity.

• In some cases, a minimally invasive approach may be used, but this depends on the patient’s condition and the surgeon’s recommendation.

Connecting to the Heart-Lung Machine

• The patient is connected to a cardiopulmonary bypass machine (heart-lung machine).

• This machine takes over the function of the heart and lungs, allowing the surgeon to stop the heart temporarily and operate in a blood-free, still environment.

• The machine oxygenates and circulates blood throughout the body during the procedure.

Removing Damaged Valves

• The surgeon carefully opens the heart chambers and removes the diseased aortic and mitral valves.

• This may involve cutting out calcified or stiffened tissue and preparing the area to fit the new valves.

Replacing With New Valves

• The damaged valves are replaced with mechanical or biological prosthetic valves, depending on the patient’s needs.

• Mechanical valves are made of strong materials like carbon and last longer but require lifelong blood thinners.

• Bioprosthetic (tissue) valves are made from animal or human tissue and do not usually require long-term anticoagulation.

• The new valves are stitched securely into place to ensure a tight, leak-free fit.

Closing the Incision and ICU Transfer

• Once the valves are in place and heart function is restored, the heart is restarted, and the heart-lung machine is disconnected.

• The sternum is closed using surgical wires, and the chest incision is closed with sutures or staples.

• The patient is then moved to the Intensive Care Unit (ICU) for close monitoring for the next 24–48 hours.

• Vital signs, oxygen levels, and heart rhythms are watched carefully during this critical recovery phase.

What Happens During a Double Valve Replacement (DVR) Procedure?

During DVR surgery, both the aortic and mitral valves in the heart are replaced. The procedure is done under general anesthesia, and it involves open-heart surgery. Here's what typically happens:

• Anesthesia is given so you sleep through the surgery and feel no pain.

• A long incision is made in the chest, and the breastbone is separated to reach the heart.

• A heart-lung machine is used to take over the function of your heart and lungs during the operation. This keeps blood and oxygen moving through your body.

• The surgeon opens the heart and removes the two damaged valves—usually the mitral and aortic valves.

• The valves are then replaced with new ones—either mechanical (made from metal or carbon) or biological (made from pig, cow, or human tissue).

• Once the new valves are in place and working properly, the surgeon restarts the heart and disconnects the heart-lung machine.

• The chest is closed with wires and sutures, and the patient is moved to the ICU (Intensive Care Unit) for monitoring.
  The entire procedure usually takes around 4 to 6 hours.

Recovery from Double Valve Replacement

Recovery from DVR surgery happens in stages:

Hospital Stay (5–7 days)

• You'll stay in the ICU for the first 1–2 days for close monitoring.

• After that, you'll move to a regular room to continue healing and start light activity.

Initial Recovery (First Few Weeks)

• You may feel tired, weak, or have chest discomfort. This is normal and improves with time.

• You’ll start breathing exercises and gentle movement to prevent complications like pneumonia or blood clots.

• Your doctor will adjust your medications, including blood thinners if a mechanical valve was used.

Home Recovery (4–8 weeks)

• Most patients return home after a week in the hospital.

• You’ll need help with daily tasks for the first few weeks.

• Regular follow-up visits and heart rehabilitation programs help you recover safely.

• Most people return to work and daily activities within 6–12 weeks, depending on how quickly their body heals.

Risks and Complications of Double Valve Replacement

Like all major surgeries, DVR surgery carries certain risks. However, it's important to know that many people have successful outcomes, especially when performed by experienced heart surgeons. Some possible risks include:

• Bleeding during or after surgery

• Infection at the incision site or inside the heart

• Blood clots, which can lead to stroke or heart attack

• Irregular heart rhythms (arrhythmias)

• Valve malfunction or leakage over time

• Complications from anesthesia, such as breathing difficulties

• Need for a pacemaker, if the heart’s rhythm becomes too slow

• Organ problems, such as kidney or lung complications (especially in older or high-risk patients)

Why Choose Artemis Hospital for Double Valve Replacement Surgery In Gurgaon?

Artemis Hospital in Gurgaon is recognized for:

• Experienced cardiac surgeons specializing in DVR procedures.

• State-of-the-art medical technology and facilities.

• Comprehensive patient care and support services.

• High success rates and positive patient outcomes.

We use the latest technology, including nerve conduction tests and MRIs, to ensure accurate diagnosis and fast treatment.

To book an appointment with some of the best cardiologists in Gurgaon at Artemis Hospitals, call our customer care at +91-124-451-1111 or WhatsApp us at +91 959-928-5476. Appointments can also be scheduled through the online patient portal or by downloading the Artemis Personal Health Record mobile app, available on both iOS and Android devices.

Reviewed By Dr. D.K. Jhamb
Chief - Cardiology
Artemis Hospitals

Frequently Asked Questions

How Common is Double Valve Replacement?

DVR is less common than single valve replacement but is necessary when both the aortic and mitral valves are severely damaged

Is DVR an Open-Heart Surgery?

Yes, DVR is a major open-heart surgery involving a sternotomy (chest incision) and use of a heart-lung machine.

When is DVR Surgery Necessary?

DVR is recommended for severe valve regurgitation or stenosis in both the aortic and mitral valves, causing symptoms like fatigue and shortness of breath.

How Long Does DVR Surgery Take?

The procedure typically lasts between 4 to 6 hours, depending on the complexity and patient's condition.

What Factors Affect Double Valve Replacement (DVR) Surgery Cost at Artemis Hospital, Gurgaon?

At Artemis Hospital, Gurgaon, the cost of Double Valve Replacement depends on the type of valves used, surgical approach, hospital stay, and follow-up care.Other factors include diagnostic tests, surgeon’s expertise, and whether any complications arise post-surgery.

What are the Risks Involved in DVR Surgery?

Potential risks include bleeding, infection, blood clots, arrhythmias, and valve dysfunction.

Which Valves are Replaced in DVR?

Typically, the aortic and mitral valves are replaced during DVR surgery.

Is DVR Surgery Safe for Elderly Patients?

Elderly patients can undergo DVR if they are medically stable; however, risks increase with age and comorbidities.

Who is the Best Doctor near me for Double Valve Replacement?

At Artemis Hospital, Gurgaon, you’ll find highly experienced cardiologists, cardiothoracic surgeons, and cardiac care teams specializing in complex procedures like Double Valve Replacement. Our multidisciplinary approach ensures each patient receives expert, personalized care from diagnosis through recovery.